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2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II Anthracycline-induced cardiotoxicity: A multicenter randomised trial comparing two strategies for guiding prevention with enalapril: The International CardioOncology Society-one trial Role of intravascular ultrasound in patients with acute myocardial infarction undergoing percutaneous coronary intervention Current treatment of significant left main coronary artery disease: A review Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions Intravascular ultrasound predictors of angiographic restenosis after sirolimus-eluting stent implantation Management of left main disease: an update Two-year outcomes following unprotected left main stenting with first vs new-generation drug-eluting stents: the FINE registry. EuroIntervention.
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Expert OpinionVolume 6, Issue 9, September 2018

JOURNAL：JACC: Heart Failure Article Link

Heart Failure With Improved Ejection Fraction-Is it Possible to Escape One’s Past?

G Gulat, JE Udelson. Keywords: HFrEF; left ventricular ejection fraction; management; outcomes

ABSTRACT

Among patients with heart failure with reduced ejection fraction, investigators have repeatedly identified a subgroup whose left ventricular ejection fraction and structural remodeling can improve to normal or nearly normal levels with or without medical therapy. This subgroup of patients with “heart failure with improved ejection fraction” has distinct clinical characteristics and a more favorable prognosis compared with patients who continue to have reduced ejection fraction. However, many of these patients also manifest clinical and biochemical signs of incomplete resolution of heart failure pathophysiology and remain at some risk of adverse outcomes, thus indicating that they may not have completely recovered. Although rigorous evidence on managing these patients is sparse, there are several reasons to recommend continuation of heart failure therapies, including device therapies, to prevent clinical deterioration. Notable exceptions to this recommendation may include patients who recover from peripartum cardiomyopathy, fulminant myocarditis, or stress cardiomyopathy, whose excellent long-term prognoses may imply true myocardial recovery. More research on these patients is needed to better understand the mechanisms that lead to improvement in ejection fraction and to guide their clinical management.

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