J Cardiovasc Interv.  2022 Jul;1(3):101-114. 10.54912/jci.2022.0007.

Predictors for the Recovery of Left Ventricular Ejection Fraction in Myocardial Infarction

• Oh S
• Jeong MH
• Kim MC
• Sim DS
• Hong YJ
• Kim JH
• Ahn Y
• on behalf of KAMIR-NIH Registry Investigators

• KMID: 2561248
• DOI: http://doi.org/10.54912/jci.2022.0007

Abstract

Background
Heart failure with recovered ejection fraction (HFrecEF) is a new medical term for the normalization of left ventricular ejection fraction (LVEF), subsequent to a history of its deterioration. However, positive or negative prognostic factors for HFrecEF in patients with ischemic causes remain unclear.
Methods
A total of 656 patients with acute myocardial infarction (AMI) and LVEF < 40% identified in the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry were included. The participants were allocated to 2 groups: ischemic HFrecEF and ischemic heart failure with no recovered ejection fraction (HFnrecEF). The follow-up LVEF was evaluated at least 1 year after discharge in all patients. All baseline characteristics were examined, and independent prognostic factors for the recovery of LVEF were analyzed using a binary logistic regression method.
Results
The mean age of patients was 65 years, and 73.3% were men. The median followup interval was 1,089 days. Multivariable analysis showed that old myocardial infarction, elevated white blood cell count, elevated cardiac troponin-I, preprocedural Thrombolysis In Myocardial Infarction flow 0–I, and multivessel coronary artery disease were negative predictors for HFrecEF, whereas angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and right coronary artery as the culprit artery were positive predictors for HFrecEF. In the 3-year follow-up, the HFrecEF group showed lower rates of major adverse cardiac and cerebrovascular events and hospital readmissions than the HFnrecEF group.
Conclusions
The discovery of predictors for HFrecEF is clinically important because it shows better long-term outcomes in patients with AMI.

Keyword

Heart failure; Left ventricular ejection fraction; Myocardial infarction; Ventricular dysfunction