That is a great question to ask, but a tough one to give a definitive answer to. First of all, have you considered seeing an Advanced Heart Failure doctor with an EF of 25%? That is who I see, and I find that they are very on top of recommended treatment guidelines for heart failure. Also, are you on fluid and sodium restrictions? How complaint are you with these, managing stress, getting exercise (that is safe for you)? All of these factors play a big role in how your heart does over time, and there are advanced therapies depending on if you qualify. I would agree that for most, the damage is irreversible, but that does not mean that you cannot optimize the part of your heart that is not damaged. Remember, you can always get a second opinion as well. If it was me, I would focus on enjoying every moment as heart failure is a terminal diagnosis, and get a clear understanding of what you should be doing to optimize your heart health and remain compliant! I hope this helps! Morgan (heart-failure.net Moderator)