Importance Heart failure with recovered ejection fraction (HFrecEF) is a recently recognized phenotype of patients with a history of reduced left ventricular ejection fraction (LVEF) that has subsequently normalized. It is unknown whether such LVEF improvement is associated with improvements in health status.

Objective To examine changes in health-related quality of life in patients with heart failure with reduced ejection fraction (HFrEF) whose LVEF normalized, compared with those whose LVEF remains reduced and those with HF with preserved EF (HFpEF).

Design, Setting, and Participants This prospective cohort study was conducted at a tertiary care hospital from November 2016 to December 2018. Consecutive patients seen in a heart failure clinic who completed patient-reported outcome assessments were included. Clinical data were abstracted from the electronic health record. Data analysis was completed from February to December 2020.

Main Outcomes and Measures Changes in Kansas City Cardiomyopathy Questionnaire overall summary score, Visual Analog Scale score, and Patient-Reported Outcomes Measurement Information System domain scores on physical function, fatigue, depression, and satisfaction with social roles over 1-year follow-up.

Results The study group included 319 patients (mean [SD] age, 60.4 [15.5] years; 120 women [37.6%]). At baseline, 212 patients (66.5%) had HFrEF and 107 (33.5%) had HFpEF. At a median follow-up of 366 (interquartile range, 310-421) days, LVEF had increased to 50% or more in 35 patients with HFrEF (16.5%). Recovery of systolic function was associated with heart failure–associated quality-of-life improvement, such that for each 10% increase in LVEF, the Kansas City Cardiomyopathy Questionnaire score improved by an mean (SD) of 4.8 (1.6) points (P = .003). Recovery of LVEF was also associated with improvement of physical function, satisfaction with social roles, and a reduction in fatigue.

Conclusions and Relevance Among patients with HFrEF in this study, normalization of left ventricular systolic function was associated with a significant improvement in health-related quality of life.

重要性 射血分数恢复的心力衰竭 (HFrecEF) 是最近公认的一种表型，患者有左心室射血分数 (LVEF) 降低的病史，随后已恢复正常。目前尚不清楚这种 LVEF 的改善是否与健康状况的改善有关。

目的 检测射血分数降低的心力衰竭 (HFrEF) 患者与 LVEF 持续降低的患者和射血分数保留的心力衰竭 (HFpEF) 患者相比，其 LVEF 正常化的患者健康相关生活质量的变化。

设计、设置和参与者 这项前瞻性队列研究于 2016 年 11 月至 2018 年 12 月在一家三级医院进行。包括在心力衰竭诊所就诊并完成患者报告的结果评估的连续患者。临床数据是从电子健康记录中提取的。数据分析于2020年2月至12月完成。

主要结果和测量指标 堪萨斯城心肌病问卷总体总结评分、视觉模拟量表评分和患者报告结果测量信息系统领域评分在 1 年随访期间对身体功能、疲劳、抑郁和社会角色满意度的变化。

结果 研究组包括 319 名患者（平均 [SD] 年龄，60.4 [15.5] 岁；120 名女性 [37.6%]）。基线时，212 名患者 (66.5%) 患有 HFrEF，107 名患者 (33.5%) 患有 HFpEF。在中位随访 366 天（四分位距，310-421）天时，35 名 HFrEF 患者 (16.5%) 的 LVEF 增加至 50% 或更多。收缩功能的恢复与心力衰竭相关的生活质量改善相关，因此 LVEF 每增加 10%，堪萨斯城心肌病问卷评分平均 (SD) 提高 4.8 (1.6) 分（P  = .003）。LVEF 的恢复还与身体功能的改善、社会角色的满意度和疲劳的减少有关。

结论和相关性 在本研究中的 HFrEF 患者中，左心室收缩功能正常化与健康相关生活质量的显着改善相关。