{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:01:33Z","timestamp":1787317293373,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with newly diagnosed dilated cardiomyopathy (DCM) and a baseline left ventricular ejection fraction (LVEF) \u226435% generally have a poor prognosis. Early identification of patients who are unlikely to recover LVEF after guideline-directed medical therapy (GDMT) is clinically important for risk stratification, closer follow-up, repeated LVEF assessment, and timely reassessment of guideline-based device therapy eligibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study enrolled 198 patients with newly diagnosed dilated cardiomyopathy (DCM) and baseline left ventricular ejection fraction (LVEF) \u226435%, all of whom received standardized guideline-directed medical therapy (GDMT) for 3\u223c6 months. Baseline and follow-up echocardiographic, electrocardiographic, clinical, and laboratory data were collected. The primary outcome was recovery of LVEF to &amp;gt;35% after treatment. The secondary outcome was the first occurrence of cardiovascular death or rehospitalization for heart failure during follow-up. Multivariable Firth Logistic regression was used to identify independent predictors and to develop a prediction model, which was internally validated using the area under the receiver operating characteristic curve (ROC AUC), the Hosmer\u2013Lemeshow goodness-of-fit test, and decision curve analysis. Cox proportional hazards regression was used to evaluate predictors of long-term prognosis, and time-dependent ROC analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multivariable Firth logistic regression showed that absence of left bundle branch block (LBBB) and higher apolipoprotein A1 (ApoA1) levels were independently associated with LVEF recovery to &amp;gt;35%. The presence of LBBB was strongly associated with a lower likelihood of LVEF recovery (OR\u2009=\u20090.02, 95% CI 0.00\u20130.13,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), whereas higher ApoA1 levels were associated with a greater likelihood of recovery (OR\u2009=\u20091.40 per 10-unit increase, 95% CI 1.06\u20131.86,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.019). A model integrating LBBB, ApoA1, and age demonstrated good discrimination, with ROC AUCs of 0.93 in the training set and 0.88 in the validation set, good calibration, and positive net benefit on decision curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The model may help with early risk stratification, closer surveillance, repeated LVEF assessment, and timely reassessment of guideline-based ICD eligibility. However, external validation is required before routine clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1767079","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:06:23Z","timestamp":1781269583000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of left ventricular ejection fraction recovery after guideline-directed medical therapy in patients with newly diagnosed dilated cardiomyopathy and baseline LVEF \u226435%"],"prefix":"10.3389","volume":"13","author":[{"given":"Yang","family":"Pu","sequence":"first","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, School of Medicine, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaowu","family":"Liu","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ningyue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, School of Medicine, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanqi","family":"Yang","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, School of Medicine, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingming","family":"Zhao","sequence":"additional","affiliation":[{"name":"Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xudong","family":"Li","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, School of Medicine, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfeng","family":"Song","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, School of Medicine, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinling","family":"Fu","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, School of Medicine, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaojie","family":"Shen","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, School of Medicine, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Zhongda Hospital, Southeast University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1016\/S0140-6736(23)01241-2","article-title":"Dilated cardiomyopathy: causes, mechanisms, and current and future treatment approaches","volume":"402","author":"Heymans","year":"2023","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2144","DOI":"10.1002\/ejhf.3076","article-title":"Incidence, risk assessment and prevention of sudden cardiac death in cardiomyopathies","volume":"25","author":"Polovina","year":"2023","journal-title":"Eur J Heart Fail"},{"key":"B3","doi-asserted-by":"publisher","first-page":"3503","DOI":"10.1093\/eurheartj\/ehad194","article-title":"2023 ESC guidelines for the management of cardiomyopathies","volume":"44","author":"Arbelo","year":"2023","journal-title":"Eur Heart J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2883","DOI":"10.1161\/01.CIR.0000100721.52503.85","article-title":"Noninvasive arrhythmia risk stratification in idiopathic dilated cardiomyopathy: results of the marburg cardiomyopathy study","volume":"108","author":"Grimm","year":"2003","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0195-668X(03)00191-X","article-title":"Out-of-hospital cardiac arrest\u2014the relevance of heart failure. 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