Can Heart Failure Be Reversed? Experts Explain

Heart failure is a global health issue. There is a common notion that heart failures can cause permanent damage and can never be reversed, but is this true? Can heart failure be reversed with the right treatment, and if detected early? Today, we will answer all these questions for you.

To get a better understanding of this, the editorial team of OnlyMyHealth reached out to experts, Dr Sandeep Chopra, Director Cardiology, Fortis Hospital, Ludhiana and Dr Sanjay Bhat, Sr Consultant - Interventional Cardiology, Aster CMI Hospital, Bangalore.

What Experts And Research Say About Reversing Heart Failure

Let us begin by addressing the main question: can heart failure be reversed? “Heart failure cannot always be fully reversed, but in many cases it can be improved or even partly reversed if the cause is found early and treated properly. This is because heart failure is not a single disease but a condition where the heart becomes weak or stiff and cannot pump blood well; depending on the reason, such as blocked arteries, high blood pressure, valve problems, infections, or lifestyle habits, doctors may be able to improve heart function over time with the right care,” explains Dr Bhat. 

According to a 2022 Guideline for the Management of Heart Failure (a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines), a common feature of heart failure, called cardiac remodelling, can sometimes be reversed. It further notes that some possible methods include medical therapy and surgery that improve blood flow to the heart, and implanting devices (pacemakers) to help the heart beat more efficiently.

Shedding more light on this, Dr Chopra says, “Congestive heart failure occurs when the heart becomes too weak or too stiff to pump enough blood for the body’s needs. It is usually a long-term condition. Early diagnosis can make a real difference. With timely treatment and healthy lifestyle changes, heart function may improve. Medicines help the heart pump better. They also reduce strain and prevent further damage.”

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Types Of Heart Failure 

Depending on which part of the heart is not working, there are different types of heart failure. Before diving deep into this, let us tell you what Ejection Fraction (EF) is. It is the amount of blood the heart can pump with each beat. A normal EF range is about 55-60%. The American Heart Association lists the types of heart failure as follows:

1. Left-sided heart failure -In cases of left-sided or left ventricular heart failure, the left side works harder to pump the same amount of blood. There are two types of left-sided heart failure:

• Systolic failure: This is also called heart failure with reduced ejection, or HFrEF. Here, the heart pumps less than or equal to 40% EF.
• Diastolic failure: This is also termed heart failure with preserved ejection, or HFpEF. In this case, the EF is 50% or higher.

2. Right-sided heart failure - Right-sided or right ventricular heart failure happens due to left-sided failure. Here, the right side loses pumping power, and blood backs up in the veins.

3. Biventricular heart failure - Both the left and right sides of the heart are affected in biventricular heart failure. 

Can You Recover From Heart Failure?

Now, let us understand whether it is possible to recover from heart failure or not. “Even when full recovery is not possible, patients can still live longer and healthier lives. The key lies in strict medication adherence, regular follow-ups, physical activity suited to their condition, a low salt diet, weight control and quitting smoking or alcohol if needed,” shares Dr Chopra. 

Adding to this, Dr Bhat shares, “In some cases, especially when heart failure is detected early, the heart muscle can become stronger again. However, in long-term or severe cases, the condition is usually managed rather than cured, and patients may need advanced treatments like devices or even a heart transplant; overall, while complete reversal is not always possible, many people with heart failure can live longer, healthier, and more active lives with early diagnosis, proper treatment, and consistent care.”

What Is The Best Treatment For Heart Failure?

A 2018 study, published in the ESC Heart Failure journal, notes that exercise training can be a form of medication for people with heart failure. Moreover, it notes that heart failure can affect the types of exercises people do and their intensity. It also mentioned that it is important to exercise under the supervision of a cardiologist or a cardiac rehabilitation specialist. Through cardiac rehab, you can learn how to exercise safely while helping your cardiovascular health.

When it comes to treatment, Dr Chopra shares that the underlying cause of heart failure also plays a key role. “If a damaged heart valve is the reason, repairing or replacing it can restore better blood flow and improve pumping ability. Treatments that improve blood supply to the heart muscle or devices like pacemakers can also help the heart beat more efficiently,” he says. 

Adding to this, Dr Bhat explains: “Heart failure is mainly caused by blocked arteries; therefore, treatments like angioplasty or bypass surgery can restore blood flow and help the heart recover. If it is due to high blood pressure or diabetes, controlling these conditions can prevent further damage and sometimes improve heart strength; medicines such as ACE inhibitors, beta-blockers, and diuretics help the heart work more efficiently and reduce symptoms like breathlessness and swelling, and many patients see improvement in their daily life with regular use.”

Apart from these, experts also suggest that a heart transplant is another well-known treatment option. It is a surgical procedure that replaces a failing heart with a healthy donor heart. This procedure is generally reserved for end-stage heart failure, when other treatments fail.  In this regard, mention must be made of the Left Ventricular Assist Device (LVAD). As per the American Heart Association, LVAD helps the heart pump enough blood to the body when it is unable to do so on its own. It is an important treatment option for severe heart failure. 

As per the National Health Service, heart failure is a long-term condition that can't be cured, but treatment can aid in keeping the symptoms under control, usually for many years. It mentions that the main treatments consist of:

• Healthy lifestyle changes.
• Medication.
• Devices implanted in your chest to control your heart rhythm.
• Surgery.

Do’s And Don’ts After A Heart Failure

A 2023 report, published in the American College of Cardiology, suggests that intaking below 2.3 grams of sodium daily provides no significant health benefits for people with heart failure. In fact, the study noted that this may actually raise the risk of other cardiovascular conditions. 

On this note, we ask our expert to shed more light on do’s and don’ts for heart failure patients. Dr Bhat says, “Lifestyle changes also play a very important role, including eating less salt, exercising regularly as advised by a doctor, quitting smoking, limiting alcohol, and managing stress, all of which can support heart health and slow or reverse some damage.”

The American Heart Association shares some additional do’s and don’ts for heart failure patients:

• Daily Fluid Intake – It’s common for heart failure patients to retain fluid in their bodies. Some patients are recommended to limit their liquid intake. However, one must connect with a professional to decide one's daily liquid intake.
• Physical Activity – Regular or moderate-intensity physical activity makes the heart stronger. You can consult your physician and get an activity plan made.
• Sexual Activity – Depending on symptoms and the severity of your heart failure, you can resume or limit your sexual activity. In severe cases, doctors can guide you regarding when it is safe to resume sex.
• Monitoring Weight – Sudden weight gain or loss can be an indication that you’re developing heart failure or that your heart failure is getting worse. Therefore, it is advisable to keep your healthcare professional in the loop regarding weight changes. 

What Is The Survival Rate Of Heart Failure Patients?

A study by the National Institutes of Health looked at data from over 1.5 million patients. Let’s take a look at what it mentions about the general survival trajectory for chronic heart failure:

Conclusion

Heart failure is mainly caused by blocked arteries. Controlling the conditions causing the blockage can prevent further damage and sometimes even improve heart strength, but it cannot be fully reversed. Use of proper medicines, following the right lifestyle and getting the advised medical treatment – all these can help the heart work more efficiently and reduce symptoms such as breathlessness and swelling. 

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