Abstract
Left ventricular (LV) dilatation reflects adverse remodeling in heart failure with mildly reduced ejection fraction (HFmrEF), but its prognostic role remains uncertain.
In this analysis, 2,154 HFmrEF patients were stratified by LV dilatation. Associations with clinical characteristics, 30-month mortality, and acute decompensation were assessed using Kaplan-Meier survival analysis and Cox regression.
13.5% of patients exhibited LV dilatation, which was associated with male sex (p<0.001), ischemic etiology (p<0.001), lower ejection fraction (p<0.001), and higher NT-proBNP levels (p<0.05). Kaplan-Meier analysis showed reduced survival in patients with LV dilatation (log-rank p<0.05). However, in multivariate Cox regression, LV dilatation was not an independent predictor of 30-month mortality (HR 1.10, 95% CI 0.86–1.41, p=0.458). Significant mortality predictors included age (HR 1.04, p<0.001), CKD (HR 1.38, p=0.001), and anemia (HR 2.18, p<0.001).
LV dilatation in HFmrEF is linked to adverse clinical characteristics and worse unadjusted survival, but it does not independently predict mortality. These findings suggest that LV size alone is an insufficient prognostic marker, reinforcing the need for comprehensive risk stratification in HFmrEF.
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