Ito K, Li S, Homma S, et al. - Among patients suffering from heart failure (HF) with reduced left ventricular (LV) ejection fraction (HFrEF) receiving recommended HF treatment, cardiovascular (CV) events were independently predicted by left ventricular enlargement. LV dimensions are recommended to be considered in the risk evaluation.

• Participants were 1,138 HFrEF patients in sinus rhythm who were randomly assigned to warfarin or aspirin therapy in the Warfarin vs Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial.

• An independent association of LV enlargement (whether by diameter or volume) with all-cause death, CV death, and HF hospitalization was evident.

• No link with myocardial infarction or stroke was found.

• The links were independent of LV ejection fraction values, and incremental to them.

• Additional predictive value over LV diameters was offered by LV volumes.