Evidence map›Paper›PMID 26683218›Full record

ArticleJournal of the American Heart Association2015

Myocardial Fibrosis Quantified by Extracellular Volume Is Associated With Subsequent Hospitalization for Heart Failure, Death, or Both Across the Spectrum of Ejection Fraction and Heart Failure Stage.

Erik B Schelbert, Kayla M Piehler, Karolina M Zareba, James C Moon, Martin Ugander, Daniel R Messroghli, Uma S Valeti, Chung-Chou H Chang, Sanjeev G Shroff, Javier Diez and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 132 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
132citing papers in PubMed, 4 pooled it
15.5field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

132 citing papers in PubMed, 4 syntheses or guidelines pooled it, 233 citations in OpenAlex.

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72 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

16 authors at 11 institutions in 4 countries.

Erik B SchelbertDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA (E.B.S., K.M.Z., C.C.H.C., T.C.W.) UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, PA (E.B.S., K.M.P., K.M.Z., T.C.W.) Clinical and Translational Science Institute, University of Pittsburgh, PA (E.B.S., T.C.W.).
Kayla M PiehlerUPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, PA (E.B.S., K.M.P., K.M.Z., T.C.W.).
Karolina M ZarebaDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA (E.B.S., K.M.Z., C.C.H.C., T.C.W.) UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, PA (E.B.S., K.M.P., K.M.Z., T.C.W.) Department of Medicine, The Ohio State University, Columbus, OH (K.M.Z.).
James C MoonBarts Heart Centre and University College London, London, UK (J.C.M.).
Martin UganderDepartment of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (M.U.).
Daniel R MessroghliDepartment of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany (D.R.M.).
Uma S ValetiCardiology Division, University of Minnesota, Minneapolis, MN (U.S.V.).
Chung-Chou H ChangDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA (E.B.S., K.M.Z., C.C.H.C., T.C.W.) Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA (C.C.H.C.).
Sanjeev G ShroffDepartment of Bioengineering, University of Pittsburgh, PA (S.G.S.).
Javier DiezProgram of Cardiovascular Diseases, Center for Applied Medical Research and University Clinic of Navarra, Pamplona, Spain (J.D.).
Christopher A MillerCentre for Imaging Sciences and Biomedical Imaging Institute, University of Manchester, UK (C.A.M., M.S.).
Matthias SchmittCentre for Imaging Sciences and Biomedical Imaging Institute, University of Manchester, UK (C.A.M., M.S.).
Peter KellmanNational Heart, Lung, and Blood Institute, Bethesda, MD (P.K.).
Javed ButlerCardiology Division, Stony Brook University, Stony Brook, NY (J.B.).
Mihai GheorghiadeCenter for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL (M.G.).
Timothy C WongDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA (E.B.S., K.M.Z., C.C.H.C., T.C.W.) UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, PA (E.B.S., K.M.P., K.M.Z., T.C.W.) Clinical and Translational Science Institute, University of Pittsburgh, PA (E.B.S., T.C.W.).
University of Pittsburgh · USUniversity of Manchester · GBUPMC Health System · USDeutsches Herzzentrum der Charité · DEKarolinska Institutet · SENational Heart Lung and Blood Institute · USNorthwestern University · USStony Brook University · USThe Ohio State University · USUniversity College London · GBUniversity of Minnesota · US

Funding

UNIVERSITY OF PITTSBURGH CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE: BPCAUL1RR024153 · NCRR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2006 to 2011
$73.9M
University of Pittsburgh Clinical and Translational Science InstituteUL1TR000005 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2012 to 2015
$50.8M
Academy of Medical Sciences AMS-SGCL12-MILLERBritish Heart Foundation FS/10/40/28260British Heart Foundation FS/12/56/29723Department of Health DRF-2010-03-98NCATS NIH HHS UL1 TR000005NCRR NIH HHS UL1 RR024153
6 · The paper itself

Abstract

backgroundMyocardial fibrosis (MF) in noninfarcted myocardium may be an interstitial disease pathway that confers vulnerability to hospitalization for heart failure, death, or both across the spectrum of heart failure and ejection fraction. Hospitalization for heart failure is an epidemic that is difficult to predict and prevent and requires potential therapeutic targets associated with outcomes. METHOD AND

resultsWe quantified MF with cardiovascular magnetic resonance extracellular volume fraction (ECV) measures in 1172 consecutive patients without amyloidosis or hypertrophic or stress cardiomyopathy and assessed associations with outcomes using Cox regression. ECV ranged from 16.6% to 47.8%. Over a median of 1.7 years, 111 patients experienced events after cardiovascular magnetic resonance, 55 had hospitalization for heart failure events, and there were 74 deaths. ECV was more strongly associated with outcomes than "nonischemic" MF observed with late gadolinium enhancement, thus ECV quantified MF in multivariable models. Adjusting for age, sex, renal function, myocardial infarction size, ejection fraction, hospitalization status, and heart failure stage, higher ECV was associated with hospitalization for heart failure (hazard ratio 1.77; 95% CI 1.32 to 2.36 for every 5% increase in ECV), death (hazard ratio 1.87 95% CI 1.45 to 2.40) or both (hazard ratio 1.85, 95% CI 1.50 to 2.27). ECV improved classification of persons at risk and improved model discrimination for outcomes (eg, hospitalization for heart failure: continuous net reclassification improvement 0.33, 95% CI 0.05 to 0.66; P=0.02; 0.16, 95% CI 0.01 to 0.33; P=0.02; integrated discrimination improvement 0.037, 95% CI 0.008 to 0.073; P<0.01).

conclusionMF measured by ECV is associated with hospitalization for heart failure, death, or both. MF may represent a principal phenotype of cardiac vulnerability that improves risk stratification. Because MF can be reversible, cells and enzymes regulating collagen could be potential therapeutic targets.

Indexed as

AdultFemaleFibrosisHeart FailureHospitalizationHumansMaleMiddle AgedMyocardiumProportional Hazards ModelsRisk FactorsSeverity of Illness IndexStroke Volumecardiovascular magnetic resonanceextracellular matrixextracellular volume fractionheart failuremyocardial fibrosisT1 mapping

Identifiers

PMID26683218
PMCPMC4845263
OpenAlexW2201505268

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.