Evidence mapPaperPMID 39925148Full record

Observational studyESC heart failure2025

Predictors of sustained reverse remodelling in patients with heart failure with reduced ejection fraction.

Silas Ramos Furquim, Edimar Alcides Bocchi, Maria Tereza Sampaio de Sousa Lira, Mauro Rogerio de Barros Wanderley, Daniel Catto de Marchi, Pamela Camara Maciel, Andre Zimerman, Felix Jose Alvarez Ramires, Luciano Nastari, Bruno Biselli and 4 more

Abstract readObservational Study
In one paragraph

Observational study in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Silas Ramos FurquimInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.ORCID https://orcid.org/0000-0001-8727-0940
Edimar Alcides BocchiInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Maria Tereza Sampaio de Sousa LiraInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Mauro Rogerio de Barros WanderleyBeth Israel Deaconess Medical Center/Harvard Medical School, Boston, EUA, Boston, Massachusetts, USA.
Daniel Catto de MarchiInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Pamela Camara MacielInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Andre ZimermanClinical Trials Unit, Hospital Moinhos de Vento, Moinhos de Vento College of Health Sciences, Porto Alegre, Brazil.
Felix Jose Alvarez RamiresInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Luciano NastariInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Bruno BiselliInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Paulo Roberto ChizzolaInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Robinson Tadeu MunhozInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Fábio FernandesInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Silvia Moreira Ayub-FerreiraInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with heart failure with reduced ejection fraction (HFrEF) who achieve reverse remodelling (RR) can experience a new decrease in ejection fraction (EF), and the predictors of sustained RR (SRR) are not completely understood.

objectivesThe study aims to identify predictors of SRR in patients with HFrEF after an increase in EF and evaluate SRR prognosis.

methodsIn this retrospective, observational study, we evaluated a real-life cohort of patients with HFrEF and ≥2 consecutive echocardiograms, divided according to left ventricular EF (LVEF) trajectory: no RR (NRR: 3/3 LVEF measurements < 40%), non-SRR (NSRR: second LVEF ≥ 40%, third LVEF < 40%), and SRR (SRR: second and third LVEF ≥ 40%).

resultsWe included 3628 of 8072 assessed HF patients in the analysis, with mean age 56.2 (±13.4) years, 64.4% male and 77.7% New York Heart Association (NYHA) I-II. Improved EF was observed for 1342 (37%) patients. Among those who achieved RR, 310 (23%) were NSRR, and 1032 (77%) were SRR. The mean (±SE) survival after the second echocardiogram was 10.6 (±0.2) years. The SRR group had the longest survival (12.2 ± 0.3 years), followed by the NSRR (10.6 ± 0.5) and NRR (9.8 ± 0.2 years) groups (P < 0.001). According to logistic multivariable regression, second LVEF [odds ratio (OR) = 1.06, confidence interval (CI) = 1.03-1.90, P < 0.001], second left ventricular end-systolic diameter (LVESD) (OR = 0.93, CI = 0.90-0.96, P < 0.001), second IV septum thickness (OR = 1.12, CI = 1.03-1.23, P = 0.012), systolic blood pressure (OR = 1.01, CI = 1.00-1.02, P = 0.014), NYHA I-II (OR = 1.86, CI = 1.27-2.74, P = 0.001) and furosemide non-use (OR = 1.87, CI = 1.27-2.74, P < 0.001) independently predicted SRR.

conclusionsPatients with greater EF increases and LVESD reductions at EF recovery, greater septum thickness, higher blood pressure, no need for diuretics and NYHA I/II maintenance had the best chance of maintaining recovered ventricular function.

Indexed as

Heart FailureHeart VentriclesStroke VolumeVentricular Function, LeftVentricular RemodelingAgedEchocardiographyFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective Studiesheart failure with reduced ejection fractionreverse remodellingsustained reverse remodelling

Identifiers

PMID39925148
PMCPMC12055365

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.