{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T10:18:41Z","timestamp":1791800321232,"version":"4.3.4"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Heart failure with recovered or improved ejection fraction (HFiEF) has been proposed as a new category of HF. Whether HFiEF is clinically distinct from HF with persistently reduced ejection fraction remains to be validated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>Of the 5010 subjects enrolled in the Valsartan Heart Failure Trial (Val-HeFT), 3519 had a baseline left ventricular EF of &lt;35% and a follow-up echocardiographic assessment of EF at 12 months. Of these, 321 (9.1%) patients who had a 12-month EF of &gt;40% constituted the subgroup with HFiEF. EF improved from 28.7\u00b15.6% to 46.5\u00b15.6% in the subgroup with HFiEF and remained reduced (25.2\u00b16.2% and 27.5\u00b17.1%) in the subgroup with HF with reduced ejection fraction. The group with HFiEF had a less severe hemodynamic, biomarker, and neurohormonal profile, and it was treated with a more intense HF medication regimen. Subjects who had higher blood pressure and those treated with a \u03b2-blocker or randomized to valsartan had greater odds of being in the HFiEF group, whereas those with an ischemic pathogenesis, a more dilated left ventricle, and a detectable hs-troponin had lower odds of an improvement in EF. Recovery of the EF to &gt;40% was associated with a better survival compared with persistently reduced EF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Our data support HFiEF as a stratum of HF with reduced ejection fraction with a more favorable outcome, which occurs in a minority of patients with HF with reduced ejection fraction who have a lower prevalence of ischemic heart disease, a less severe hemodynamic, biomarker, and neurohormonal profile, and who are treated with a more intense HF medication regimen.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00336336.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.116.003123","type":"journal-article","created":{"date-parts":[[2016,7,14]],"date-time":"2016-07-14T07:08:38Z","timestamp":1468480118000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":119,"title":["Heart Failure With Improved Ejection Fraction: Clinical Characteristics, Correlates of Recovery, and Survival"],"prefix":"10.1161","volume":"9","author":[{"given":"Viorel G.","family":"Florea","sequence":"first","affiliation":[{"name":"From the Division of Cardiology (V.G.F., I.S.A.) and Center for Chronic Disease Outcomes Research (T.S.R), Minneapolis Veterans Affairs Health Care System, MN; and Department of Medicine, University of Minnesota, Minneapolis (V.G.F., T.S.R., J.N.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas S.","family":"Rector","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (V.G.F., I.S.A.) and Center for Chronic Disease Outcomes Research (T.S.R), Minneapolis Veterans Affairs Health Care System, MN; and Department of Medicine, University of Minnesota, Minneapolis (V.G.F., T.S.R., J.N.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inder S.","family":"Anand","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (V.G.F., I.S.A.) and Center for Chronic Disease Outcomes Research (T.S.R), Minneapolis Veterans Affairs Health Care System, MN; and Department of Medicine, University of Minnesota, Minneapolis (V.G.F., T.S.R., J.N.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay N.","family":"Cohn","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (V.G.F., I.S.A.) and Center for Chronic Disease Outcomes Research (T.S.R), Minneapolis Veterans Affairs Health Care System, MN; and Department of Medicine, University of Minnesota, Minneapolis (V.G.F., T.S.R., J.N.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8807"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2011.03.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.006855"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.12.011"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010713"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.12.053"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.10.005"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1067\/mje.2001.115103"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-6-199903160-00002"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2006.069575"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000054164.99881.00"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.655076"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.508465"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs205"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.001036"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.928846"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.000813"},{"key":"e_1_3_3_19_2","first-page":"VI17","article-title":"Prognostic significance of serial changes in left ventricular ejection fraction in patients with congestive heart failure. The V-HeFT VA Cooperative Studies Group.","volume":"87","author":"Cintron G","year":"1993","unstructured":"Cintron G, Johnson G, Francis G, Cobb F, Cohn JN. Prognostic significance of serial changes in left ventricular ejection fraction in patients with congestive heart failure. The V-HeFT VA Cooperative Studies Group. 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