From the Research
Yes, a patient with reduced ejection fraction (EF) can and often should get an echocardiogram sooner than a year, depending on their clinical situation. The timing of follow-up echocardiograms should be individualized based on several factors including symptom changes, clinical events, medication adjustments, and overall disease progression. For patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF), a follow-up echocardiogram is typically recommended after 3-6 months of optimal medical therapy to assess treatment response, as improvements in EF can occur within months of starting appropriate therapy 1.
Some key factors to consider when deciding on the timing of a follow-up echocardiogram include:
- Symptom changes: patients experiencing worsening symptoms such as increased shortness of breath, edema, or fatigue should have repeat imaging sooner
- Clinical events: hospitalization for heart failure or significant medication changes should prompt earlier reassessment
- Medication adjustments: initiating or titrating medications such as beta-blockers, ACE inhibitors/ARBs, SGLT2 inhibitors, or MRAs should be followed by a repeat echocardiogram to assess treatment response
- Disease progression: patients with a history of coronary disease, atrial fibrillation, or other comorbidities may require more frequent monitoring 2, 3
The rationale for earlier reassessment is that improvements in EF can guide further treatment decisions, including consideration for device therapy like implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy (CRT) 4. Additionally, continued use of renin-angiotensin-aldosterone system inhibitors has been associated with maintaining improved EF 3.
Overall, the decision to perform a follow-up echocardiogram sooner than a year should be based on individual patient factors and clinical judgment, with the goal of optimizing treatment and improving outcomes for patients with reduced ejection fraction.