Evidence map›Paper›PMID 24249049›Full record

Trial reportCirculation. Heart failure2014

Cardiac structure and function in heart failure with preserved ejection fraction: baseline findings from the echocardiographic study of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial.

Amil M Shah, Sanjiv J Shah, Inder S Anand, Nancy K Sweitzer, Eileen O'Meara, John F Heitner, George Sopko, Guichu Li, Susan F Assmann, Sonja M McKinlay and 4 more

2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Heart failure, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 152 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
152citing papers in PubMed, 8 pooled it
20.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00094302 phase3completednot on this map

Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT)

TypeinterventionalSponsorCarelon ResearchRan2006 to 2013Enrolled3,445ConditionsCardiovascular Diseases, Heart Diseases, Heart Failure, CongestiveArmsSpironolactone, Placebo
NCT04128891 phase3withdrawnnot on this mapstarted 2020, after this paper: background citation

PRospectIve Study of Sacubitril/ValsarTan on MyocardIal OxygenatioN and Fibrosis in PatiEnts With Heart Failure and Preserved Ejection Fraction

TypeinterventionalSponsorFlinders UniversityRan2020 to 2024Enrolled0ConditionsHeart Failure With Preserved Ejection FractionArmsSacubitril-Valsartan
3 · Its place in the literature

Who cites it

152 citing papers in PubMed, 8 syntheses or guidelines pooled it, 433 citations in OpenAlex.

  1. Pooled it
  2. Implanted haemodynamic telemonitoring devices to guide management of heart failure: a review and meta-analysis of randomised trials.Clinical research in cardiology : official journal of the German Cardiac Society · 2023
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  4. Pharmacotherapy for hypertension-induced left ventricular hypertrophy.The Cochrane database of systematic reviews · 2021
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92 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 2 countries.

Amil M ShahDivision of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA.
Sanjiv J Shah
Inder S Anand
Nancy K Sweitzer
Eileen O'Meara
John F Heitner
George Sopko
Guichu Li
Susan F Assmann
Sonja M McKinlay
Bertram Pitt
Marc A Pfeffer
Scott D Solomon
TOPCAT Investigators
Minneapolis VA Medical Center · USNational Heart Lung and Blood Institute · USNorthwestern University · USMontreal Heart Institute · CANewYork–Presbyterian Brooklyn Methodist Hospital · USUniversity of Michigan–Ann Arbor · USUW Health University Hospital · US

Funding

Treatment of Preserved Systolic Function with an Aldosterone AntagonistN01HC45207 · NHLBI · NEW ENGLAND RESEARCH INSTITUTES, INC. · PI LI, REBECCA · 2007 to 2014
$18.0M
Systolic & diastolic dysfunction in heart failure and preserved ejection fractionK08HL116792 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SHAH, AMIL M · 2013 to 2017
$735k
ALDOSTERONE ANTAGONISTS FOR THE TREATMENT OF HEART FAILURE WITH PRESER-N01HC45207N01HC045207 · HC · NEW ENGLAND RESEARCH INSTITUTES. INC · PI MCKINLAY, SONJA M · 2004 to 2006
–
NHLBI NIH HHS 1K08HL116792-01A1NHLBI NIH HHS K08 HL116792NHLBI NIH HHS N01 HC045207NHLBI NIH HHS N01 HC45207
6 · The paper itself

Abstract

backgroundHeart failure with preserved ejection fraction (HFpEF) is associated with substantial morbidity and mortality. Existing data on cardiac structure and function in HFpEF suggest significant heterogeneity in this population. METHODS AND

resultsEchocardiograms were obtained from 935 patients with HFpEF (left ventricular ejection fraction ≥45%) enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial before initiation of randomized therapy. Average age was 70±10 years, 49% were women, 14% were of African descent, and comorbidities were highly prevalent. Centralized quantitative analysis in a blinded core laboratory demonstrated a mean left ventricular ejection fraction of 59.3±7.9%, with prevalent concentric left ventricular remodeling (34%) and hypertrophy (43%), and left atrial enlargement (53%). Diastolic dysfunction was present in 66% of gradable participants and was significantly associated with greater left ventricular hypertrophy and a higher prevalence of left atrial enlargement. Doppler evidence of pulmonary hypertension was present in 36%. At least 1 measure of structural heart disease was present in 93% of patients.

conclusionsPatients enrolled in TOPCAT demonstrated heterogeneous patterns of ventricular remodeling, with high prevalence of structural heart disease, including left ventricular hypertrophy and left atrial enlargement, in addition to pulmonary hypertension, each of which has been associated with adverse outcomes in HFpEF. Diastolic function was normal in approximately one third of gradable participants, highlighting the heterogeneity of the cardiac phenotype in this syndrome. These findings deepen our understanding of the TOPCAT trial population and expand our knowledge of the diversity of the cardiac phenotype in HFpEF. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00094302.

Indexed as

EchocardiographyPhenotypeAgedAged, 80 and overDouble-Blind MethodFemaleHeart AtriaHeart FailureHumansHypertension, PulmonaryHypertrophyHypertrophy, Left VentricularIncidenceInternational CooperationMaleMiddle AgedMineralocorticoid Receptor AntagonistsSpironolactonediastolic heart failureechocardiographyheart failurerandomized controlled trialspironolactone

Identifiers

PMID24249049
PMCPMC4467731
OpenAlexW2154395080

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.