Characteristics of Patients with Heart Failure Improved Ejection Fraction (HFiEF) in Outpatient Cardiology Clinic Karangasem Regional Hospital

Background: Current heart failure guidelines based on ejection fraction only classify patients as preserved, midrange, and reduced ejection fraction. Meanwhile, there are patients with improved ejection fraction. There are not many studies and data regarding this heart failure subset. Method: Of all chronic heart failure patients who underwent echocardiography examinations in outpatient cardiology clinic Karangasem Regional Hospital from November 2019 to June 2020, 16 patients met the criteria for HFiEF (baseline EF 40% and increased to greater than40% 1 year later). Characteristics of patients with HFiEF were found more in male sex, younger age, with etiologic coronary artery disease, without diabetes mellitus, and without heart rhythm disturbances. All patients have received therapy according to Guideline - Directed Medical Therapy (GDMT) with the mostly used ? - blocker is bisoprolol reaching 50% of the target dose, ACE - inhibitor is ramipril which reached 100% of the target dose, ARB are candesartan and valsartan reaching less than50% of the target dose and MRA is spironolactone which given 50% of the target dose. Conclusion: HFiEF is a subset of HF with different characteristics from HFrEF and HFpEF. Patients with HFiEF have better outcomes than other subsets and therefore require a larger number of studies of these patients to determine appropriate management.