{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:40:59Z","timestamp":1791319259721,"version":"4.3.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":644,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Charles University Research Program Cooperatio Cardiovascular Science"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In patients with recently diagnosed non-ischaemic LV systolic dysfunction, left ventricular reverse remodelling (LVRR) and favourable prognosis has been documented in studies with short-term follow-up. The aim of our study was to assess the long-term clinical course and stability of LVRR in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We prospectively studied 133 patients (37 women; 55 [interquartile range 46, 61] years) with recently diagnosed unexplained LV systolic dysfunction, with heart failure symptoms lasting &amp;lt;6 months and LV ejection fraction &amp;lt;40% persisting after at least 1 week of therapy. All patients underwent endomyocardial biopsy (EMB) at the time of diagnosis and serial echocardiographic and clinical follow-up over 5 years. LVRR was defined as the combined presence of (1) LVEF \u2265 50% or increase in LVEF \u2265 10% points and (2) decrease in LV end-diastolic diameter index (LVEDDi) \u2265 10% or (3) LVEDDi \u2264 33 mm\/m2. LVRR was observed in 46% patients at 1 year, in 60% at 2 years and 50% at 5 years. Additionally, 2% of patients underwent heart transplantation and 12% experienced heart failure hospitalization. During 5-year follow-up, 23 (17%) of the study cohort died. In multivariate analysis, independent predictors of mortality were baseline right atrial size (OR 1.097, CI 1.007\u20131.196), logBNP level (OR 2.02, CI 1.14\u20133.56), and PR interval (OR 1.02, CI 1.006\u20131.035) (P &amp;lt; 0.05 for all). The number of macrophages on EMB was associated with overall survival in univariate analysis only. LVRR at 1 year of follow-up was associated with a lower rate of mortality and heart failure hospitalization (P = 0.025). In multivariate analysis, independent predictors of LVRR were left ventricular end-diastolic volume index (OR 0.97, CI 0.946\u20130.988), LVEF (OR 0.89, CI 0.83\u20130.96), and diastolic blood pressure (OR 1.04, CI 1.01\u20131.08) (P &amp;lt; 0.05 for all).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LVRR occurs in over half of patients with recent onset unexplained LV systolic dysfunction during first 2 years of optimally guided heart failure therapy and then remains relatively stable during 5-year follow-up. Normalization of adverse LV remodelling corresponds to a low rate of mortality and heart failure hospitalizations during long-term follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14643","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T02:04:52Z","timestamp":1704938692000},"page":"859-870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long-Term Outcomes and Reverse Remodelling in Recently Diagnosed Unexplained Left Ventricular Systolic Dysfunction"],"prefix":"10.1093","volume":"11","author":[{"given":"Petr","family":"Kuchynka","sequence":"first","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Podzimkova","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Marek","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara Anna","family":"Danek","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Washington Medical Center , Seattle, WA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Vitkova","sequence":"additional","affiliation":[{"name":"Institute of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miluse","family":"Kreidlova","sequence":"additional","affiliation":[{"name":"Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka","family":"Roblova","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Kovarnik","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanislav","family":"Simek","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Horak","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Habasko","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ales","family":"Linhart","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Palecek","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"2026012113160082400_ehf214643-bib-0001","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1093\/eurheartj\/ehm342","article-title":"Classification of the cardiomyopathies: A position statement from the European society of cardiology working group on myocardial and pericardial diseases","volume":"29","author":"Elliott","year":"2008","journal-title":"Eur Heart J"},{"key":"2026012113160082400_ehf214643-bib-0002","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1161\/CIRCULATIONAHA.106.174287","article-title":"Contemporary definitions and classification of cardiomyopathies","volume":"113","author":"Maron","year":"2006","journal-title":"Circulation"},{"key":"2026012113160082400_ehf214643-bib-0003","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.pcad.2017.05.009","article-title":"Heart failure with myocardial recovery - The patient whose heart failure has improved: what next?","volume":"60","author":"Nijst","year":"2017","journal-title":"Prog Cardiovasc Dis"},{"key":"2026012113160082400_ehf214643-bib-0004","doi-asserted-by":"publisher","first-page":"1468","DOI":"10.1016\/j.jacc.2010.11.030","article-title":"Prevalence and prognostic significance of left ventricular reverse remodeling in dilated cardiomyopathy receiving tailored medical treatment","volume":"57","author":"Merlo","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026012113160082400_ehf214643-bib-0005","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1016\/j.amjcard.2014.02.028","article-title":"Frequency and predictors of normalization of left ventricular ejection fraction in recent-onset nonischemic cardiomyopathy","volume":"113","author":"Zou","year":"2014","journal-title":"Am J Cardiol"},{"key":"2026012113160082400_ehf214643-bib-0006","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.ahj.2016.06.019","article-title":"Outcomes and predictors of recovery in acute-onset cardiomyopathy: A single-center experience of patients undergoing endomyocardial biopsy for new heart failure","volume":"179","author":"Gilotra","year":"2016","journal-title":"Am Heart J"},{"key":"2026012113160082400_ehf214643-bib-0007","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.amjcard.2018.04.017","article-title":"Usefulness of addition of magnetic resonance imaging to echocardiographic imaging to predict left ventricular reverse remodeling in patients with nonischemic cardiomyopathy","volume":"122","author":"Merlo","year":"2018","journal-title":"Am J Cardiol"},{"key":"2026012113160082400_ehf214643-bib-0008","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1007\/s00380-015-0648-2","article-title":"Time course of left ventricular reverse remodeling in response to pharmacotherapy: Clinical implication for heart failure prognosis in patients with idiopathic dilated cardiomyopathy","volume":"31","author":"Ikeda","year":"2016","journal-title":"Heart Vessels"},{"key":"2026012113160082400_ehf214643-bib-0009","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1093\/eurheartj\/ehs104","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC","volume":"33","author":"McMurray","year":"2012","journal-title":"Eur Heart J"},{"key":"2026012113160082400_ehf214643-bib-0010","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s00430-009-0141-6","article-title":"Presence of Borrelia burgdorferi in endomyocardial biopsies in patients with new-onset unexplained dilated cardiomyopathy","volume":"199","author":"Palecek","year":"2010","journal-title":"Med Microbiol Immunol"},{"key":"2026012113160082400_ehf214643-bib-0011","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1093\/ejechocard\/jep007","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography","volume":"22","author":"Nagueh","year":"2009","journal-title":"J Am Soc Echocardiogr"},{"key":"2026012113160082400_ehf214643-bib-0012","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1016\/j.echo.2005.10.005","article-title":"Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology","volume":"18","author":"Lang","year":"2005","journal-title":"J Am Soc Echocardiogr"},{"key":"2026012113160082400_ehf214643-bib-0013","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/S0046-8177(87)80363-5","article-title":"Myocarditis: The Dallas criteria","volume":"18","author":"Aretz","year":"1987","journal-title":"Hum Pathol"},{"key":"2026012113160082400_ehf214643-bib-0014","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1093\/eurheartj\/eht210","article-title":"Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: A position statement of the European Society of Cardiology Working Group on myocardial and pericardial diseases","volume":"34","author":"Caforio","year":"2013","journal-title":"Eur Heart J"},{"key":"2026012113160082400_ehf214643-bib-0015","doi-asserted-by":"publisher","first-page":"2256","DOI":"10.1093\/eurheartj\/ehm305","article-title":"Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association","volume":"28","author":"Vardas","year":"2007","journal-title":"Eur Heart J"},{"key":"2026012113160082400_ehf214643-bib-0016","doi-asserted-by":"publisher","first-page":"318","DOI":"10.2307\/2530022","article-title":"Efficient screening of nonnormal regression models","volume":"34","author":"Lawless","year":"1978","journal-title":"Biometrics"},{"key":"2026012113160082400_ehf214643-bib-0017","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1016\/j.jacc.2011.05.033","article-title":"Clinical and demographic predictors of outcomes in recent onset dilated cardiomyopathy: Results of the IMAC (intervention in myocarditis and acute cardiomyopathy)-2 study","volume":"58","author":"McNamara","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026012113160082400_ehf214643-bib-0018","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1002\/ejhf.1461","article-title":"Heart failure in cardiomyopathies: A position paper from the Heart Failure Association of the European Society of Cardiology","volume":"21","author":"Seferovi\u0107","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2026012113160082400_ehf214643-bib-0019","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1016\/j.amjcard.2010.11.033","article-title":"Effect of left ventricular reverse remodeling on long-term prognosis after therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and \u03b2 blockers in patients with idiopathic dilated cardiomyopathy","volume":"107","author":"Hoshikawa","year":"2011","journal-title":"Am J Cardiol"},{"key":"2026012113160082400_ehf214643-bib-0020","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.jcmg.2009.01.012","article-title":"Right atrial volume index in chronic systolic heart failure and prognosis","volume":"2","author":"Sallach","year":"2009","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026012113160082400_ehf214643-bib-0021","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/0002-9149(84)90320-5","article-title":"Factors influencing the one-year mortality of dilated cardiomyopathy","volume":"54","author":"Unverferth","year":"1984","journal-title":"Am J Cardiol"},{"key":"2026012113160082400_ehf214643-bib-0022","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/1471-2261-14-67","article-title":"Plasma NT pro-BNP, hs-CRP and big-ET levels at admission as prognostic markers of survival in hospitalized patients with dilated cardiomyopathy: A single-center cohort study","volume":"14","author":"Li","year":"2014","journal-title":"BMC Cardiovasc Disord"},{"key":"2026012113160082400_ehf214643-bib-0023","doi-asserted-by":"publisher","first-page":"1943","DOI":"10.1016\/j.jacc.2007.02.037","article-title":"Admission B-type natriuretic peptide levels and in-hospital mortality in acute decompensated heart failure","volume":"49","author":"Fonarow","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2026012113160082400_ehf214643-bib-0024","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1161\/01.CIR.0000155616.07901.35","article-title":"High prevalence of viral genomes and multiple viral infections in the myocardium of adults with \u2018idiopathic\u2019 left ventricular dysfunction","volume":"111","author":"K\u00fchl","year":"2005","journal-title":"Circulation"},{"key":"2026012113160082400_ehf214643-bib-0025","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1111\/eci.12772","article-title":"Outcome predictors in dilated cardiomyopathy or myocarditis","volume":"47","author":"Kuethe","year":"2017","journal-title":"Eur J Clin Invest"},{"key":"2026012113160082400_ehf214643-bib-0026","doi-asserted-by":"publisher","first-page":"441","DOI":"10.5603\/CJ.a2020.0088","article-title":"Prevalence and prognostic relevance of myocardial inflammation and cardiotropic viruses in non-ischemic dilated cardiomyopathy","volume":"29","author":"Ka\u017eukauskien\u0117","year":"2022","journal-title":"Cardiol J"},{"key":"2026012113160082400_ehf214643-bib-0027","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1161\/CIRCULATIONAHA.108.769489","article-title":"Predictors of outcome in patients with suspected myocarditis","volume":"118","author":"Kindermann","year":"2008","journal-title":"Circulation"},{"key":"2026012113160082400_ehf214643-bib-0028","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1002\/ejhf.2190","article-title":"Heart Failure Society of America and Japanese Heart Failure Society Position statement on endomyocardial biopsy","volume":"23","author":"Seferovi\u0107","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2026012113160082400_ehf214643-bib-0029","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006832","article-title":"Clinical phenotypes and prognosis of dilated cardiomyopathy caused by truncating variants in the TTN gene","volume":"13","author":"Akhtar","year":"2020","journal-title":"Circ Heart Fail"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/11\/2\/859\/64540157\/eschf_11_2_859.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/11\/2\/859\/64540157\/eschf_11_2_859.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:18:01Z","timestamp":1769019481000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/11\/2\/859\/8271357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,10]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,1,10]]},"published-print":{"date-parts":[[2024,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14643","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4]]},"published":{"date-parts":[[2024,1,10]]},"assertion":[{"value":"2023-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}