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[Comment] Stopping medication for heart failure with improved ejection fraction

Current clinical practice guidelines have identified a new category of heart failure: heart failure with improved ejection fraction.1,2 Multiple observational series on heart failure show improved measures of ventricular function after initial presentation of heart failure with reduced ejection fraction3–6 and improvement in clinical outcomes. What drives ventricular recovery is largely unknown; is it removal of insult (eg, tachycardia or toxins) or a fortuitous response to medical or device therapy? Moreover, the biology of true ventricular recovery, if such an effect occurs, is unknown.