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Prognostic impact of left ventricular dilatation in heart failure with mildly reduced ejection fraction

Objective - This study investigated the prognostic value of left ventricular (LV) dilatation in patients with heart failure with mildly reduced ejection fraction (HFmrEF). - Background - Adverse cardiac remodeling may lead to LV dilatation and impaired prognosis in heart failure with reduced ejectio...

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Main Authors: Steffen, Henning Johann (Author) , Behnes, Michael (Author) , Dudda, Jonas (Author) , Schmitt, Alexander (Author) , Abel, Noah (Author) , Lau, Felix (Author) , Reinhardt, Marielen (Author) , Bertsch, Thomas (Author) , Weidner, Kathrin (Author) , Dürschmied, Daniel (Author) , Akın, Ibrahim (Author) , Schupp, Tobias (Author)
Format: Article (Journal)
Language:English
Published: February 2026
In: European journal of internal medicine
Year: 2026, Volume: 144, Pages: 1-8
ISSN:1879-0828
DOI:10.1016/j.ejim.2025.106510
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejim.2025.106510
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0953620525003887
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Author Notes:Henning Johann Steffen, Michael Behnes, Jonas Dudda, Alexander Schmitt, Noah Abel, Felix Lau, Marielen Reinhardt, Thomas Bertsch, Kathrin Weidner, Daniel Duerschmied, Ibrahim Akin, Tobias Schupp
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Summary:Objective - This study investigated the prognostic value of left ventricular (LV) dilatation in patients with heart failure with mildly reduced ejection fraction (HFmrEF). - Background - Adverse cardiac remodeling may lead to LV dilatation and impaired prognosis in heart failure with reduced ejection fraction (HFrEF). Its significance in HFmrEF remains unclear. - Methods - Patients hospitalized with HFmrEF (2016-2022) were included and stratified by the presence or absence LV dilatation (males: LV end-diastolic diameter (LVEDD) >58 mm; females: >52 mm). Kaplan-Meier and multivariable Cox regression analyses assessed 30-month all-cause mortality and HF-related rehospitalization. - Results - Among 2154 patients (median LVEDD 49.0 mm), 290 (13.5 %) had LV dilatation. These patients were younger (73 vs. 76 years; p = 0.001), less often males (42.2 % vs. 67.2 %; p = 0.001), and more likely to have non-ischemic cardiomyopathy (10.0 % vs. 6.3 %; p = 0.019). LV dilatation was not associated with 30-month all-cause mortality (29.7 % vs. 31.4 %; HR = 0.933; 95 % CI 0.744-1.171; p = 0.548) but was linked to higher HF-related rehospitalization risk (19.1 % vs. 12.5 %; HR = 1.606; 95 % CI 1.193-2.161; p = 0.003), even after multivariable adjustment (HR = 1.613; 95 % CI 1.163-2.238; p = 0.004). - Conclusion - In HFmrEF, LV dilatation independently predicts HF-related rehospitalization but not all-cause mortality.
Item Description:Online verfügbar: 16. September 2025, Artikelversion: 2. Februar 2026
Gesehen am 05.03.2026
Physical Description:Online Resource
ISSN:1879-0828
DOI:10.1016/j.ejim.2025.106510

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