Heart failure with improved ejection fraction (HFimpEF) is a recently recognized phenotype, characterized by an improvement in left ventricular systolic function following an episode of heart failure with reduced ejection fraction (HFrEF).

To identify factors associated with improvement in elft ventricular ejection fraction among patients with HFrEF.

We conducted a prospective study involving patients diagnosed with heart failure and a reduced LVEF (≤ 40%), who were followed for at least six months. Patients were categorized into two groups: those with improved LVEF (defined as an increase from ≤ 40% to > 40%, with a minimum absolute gain of 10%) and those without such improvement. Clinical, biological, echocardiographic, and therapeutic characteristics were compared to identify factors associated with LVEF improvement.

A total of 123 patients with heart failure were included, of whom 70 had reduced LVEF. No gender differences were observed. Hypertension was present in 66% of patients, and 32% had a prior history of left ventricular dysfunction. Improvement in LVEF was observed in 27.1% of cases. In multivariate analysis, younger age (HR: 5.57; 95% CI: 1.79–17.3; P = 0.001), optimal beta-blocker therapy (HR: 2.16; 95% CI: 1.39–5.32; P = 0.0271), and higher baseline LVEF (HR: 1.57; 95% CI: 1.16–4.23; P = 0.0381) were independently associated with LVEF improvement.

Improvement in LVEF among patients with HFrEF is influenced by specific clinical factors and optimized medical therapy. Identifying patients most likely to experience LVEF improvement and ensuring appropriate follow-up may help improve clinical outcomes in heart failure management.