Work

Sustained Remission of New-onset Heart Failure in Genetic Cardiomyopathy Without Contemporary Four-pillar Therapy: Implications for ‘Personalized Guideline-directed Medical Therapy’

Year: 2026

Type: article

Abstract: A 40-year-old woman with new-onset heart failure with reduced ejection fraction (HFrEF) attributed to a titin-truncating variant achieved remission while being treated with carvedilol, lisinopril (first 4 years), and losartan (for 1 year following lisinopril cessation). The patient never received an angiotensin receptor–neprilysin inhibitor, mineralocorticoid receptor antagonist, or sodium–glucose cotransporter 2 inhibitor. Her left ventricular ejection fraction rose from <25% to >50%, her N-terminal pro-B-type natriuretic peptide level dropped from 1,980 pg/ml to 79 pg/ml, and she regained New York Heart Association I status. Her remission persists more than a decade after condition onset. This case demonstrates that patients with genetic cardiomyopathy can achieve durable remission with a narrower set of medications than quadruple therapy.

Source: US Cardiology Review

DOI: 10.15420/usc.2026.26

Authors: Chinanuekpere Emma Ezeala, Michael Pitonak, Jake Munch, Jennifer T Thibodeau, Mark H Drazner

Institution: The University of Texas Southwestern Medical Center

Language: English

Topic: Heart Failure Treatment and Management

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,146