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Improvement of Cardiac Function Persists Long Term With Medical Therapy for Left Ventricular Systolic Dysfunction

Department of Cardiology, Loma Linda University Medical Center, Loma Linda, California

Richard Chang, MD

Department of Cardiology, Loma Linda University Medical Center, Loma Linda, California

Branavan Umakanthan, MD

Department of Cardiology, Loma Linda University Medical Center, Loma Linda, California

Liset N. Stoletniy, MD

Department of Cardiology, Loma Linda University Medical Center, Loma Linda, California

J. Thomas Heywood, MD

Heart Failure Recovery Program, Scripps Clinic, La Jolla, California, jthomasheywood{at}yahoo.com

In certain patients with left ventricular (LV) systolic dysfunction, improvements in cardiac function are seen after initiation of medical therapy; however, the long-term stability of ventricular function in such patients is not well described. We retrospectively analyzed 171 patients who had a baseline ejection fraction of 45% or less, a follow-up echocardiogram at 2 to 12 months after initiation of medical therapy, and a final echocardiogram. We found that 48.5% of the patients demonstrated initial improvements in LV function after initiation of medical therapy, and the improvements appear to be sustained (88% of patients) at 44 ± 21 months follow-up. A nonischemic etiology and younger age were the only independent predictors of change of LV ejection fraction of 10 or more at a mean 8.4 ± 3.4 months after optimal medical therapy. Our study revealed a trend toward improved long-term survival in individuals with an early improvement in LV ejection fraction with medical therapy, especially in those with sustained improvement.

Key Words: heart failure • left ventricular systolic dysfunction • medical therapy • mortality

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