Evidence map›Paper›PMID 27009553›Full record

Observational studyCirculation. Heart failure2016

Heart Failure and Midrange Ejection Fraction: Implications of Recovered Ejection Fraction for Exercise Tolerance and Outcomes.

Wilson Nadruz, Erin West, Mário Santos, Hicham Skali, John D Groarke, Daniel E Forman, Amil M Shah

Open access · bronzeAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation. Heart failure, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 3 pooled it
10.3field-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

54 citing papers in PubMed, 3 syntheses or guidelines pooled it, 98 citations in OpenAlex.

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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

7 authors at 2 institutions in 2 countries.

Wilson NadruzFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (W.N., E.W., H.S., J.D.G., A.M.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of University of Porto, Porto, Portugal (M.S.); and Department of Medicine, Section of Geriatric Cardiology, University of Pittsburgh Medical Center, PA (D.E.F.).
Erin WestFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (W.N., E.W., H.S., J.D.G., A.M.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of University of Porto, Porto, Portugal (M.S.); and Department of Medicine, Section of Geriatric Cardiology, University of Pittsburgh Medical Center, PA (D.E.F.).
Mário SantosFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (W.N., E.W., H.S., J.D.G., A.M.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of University of Porto, Porto, Portugal (M.S.); and Department of Medicine, Section of Geriatric Cardiology, University of Pittsburgh Medical Center, PA (D.E.F.).
Hicham SkaliFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (W.N., E.W., H.S., J.D.G., A.M.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of University of Porto, Porto, Portugal (M.S.); and Department of Medicine, Section of Geriatric Cardiology, University of Pittsburgh Medical Center, PA (D.E.F.).
John D GroarkeFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (W.N., E.W., H.S., J.D.G., A.M.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of University of Porto, Porto, Portugal (M.S.); and Department of Medicine, Section of Geriatric Cardiology, University of Pittsburgh Medical Center, PA (D.E.F.).
Daniel E FormanFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (W.N., E.W., H.S., J.D.G., A.M.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of University of Porto, Porto, Portugal (M.S.); and Department of Medicine, Section of Geriatric Cardiology, University of Pittsburgh Medical Center, PA (D.E.F.).
Amil M ShahFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (W.N., E.W., H.S., J.D.G., A.M.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of University of Porto, Porto, Portugal (M.S.); and Department of Medicine, Section of Geriatric Cardiology, University of Pittsburgh Medical Center, PA (D.E.F.). ashah11@partners.org.
Universidade do Porto · PTUniversidade Estadual de Campinas (UNICAMP) · BR

Funding

VARIABILITY, STABILITY & SMOOTHNESS OF WALKINGP30AG024827 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JENNIFER S BRACH · 2004 to 2026
$28.6M
Systolic & diastolic dysfunction in heart failure and preserved ejection fractionK08HL116792 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SHAH, AMIL M · 2013 to 2017
$735k
NHLBI NIH HHS 1K08HL116792-01A1NHLBI NIH HHS K08 HL116792NIA NIH HHS P30 AG024827
6 · The paper itself

Abstract

backgroundEvidence-based therapies for heart failure (HF) differ significantly according to left ventricular ejection fraction (LVEF). However, few data are available on the phenotype and prognosis of patients with HF with midrange LVEF of 40% to 55%, and the impact of recovered systolic function on the clinical features, functional capacity, and outcomes of this population is not known. METHODS AND

resultsWe studied 944 patients with HF who underwent clinically indicated cardiopulmonary exercise testing. The study population was categorized according to LVEF as follows: HF with reduced LVEF (HFrEF; LVEF<40%; n=620); HF with midrange ejection fraction and no recovered ejection fraction (LVEF was consistent between 40% and 55%; n=107); HF with recovered midrange ejection fraction (LVEF, 40%-55% but previous LVEF<40%; n=170); and HF with preserved LVEF (HFpEF; LVEF>55%; n=47). HF with midrange ejection fraction and no recovered ejection fraction and HF with recovered midrange ejection fraction had similar clinical characteristics, which were intermediate between those of HFrEF and HFpEF, and comparable values of predicted peak oxygen consumption and minute-ventilation/carbon dioxide production slope, which were better than HFrEF and similar to HFpEF. After a median of 4.4 (2.9-5.7) years, there were 253 composite events (death, left ventricular assistant device implantation, or transplantation). In multivariable Cox-regression analysis, HF with recovered midrange ejection fraction had lower risk of composite events than HFrEF (hazard ratio, 0.25; 95% confidence interval, 0.13-0.47) and HF with midrange ejection fraction and no recovered ejection fraction (hazard ratio, 0.31; 95% confidence interval, 0.15-0.67), and similar prognosis when compared with HFpEF. In contrast, HF with midrange ejection fraction and no recovered ejection fraction tended to show intermediate risk of outcomes in comparison with HFpEF and HFrEF, albeit not reaching statistical significance in fully adjusted analyses.

conclusionsPatients with HF with midrange LVEF demonstrate a distinct clinical profile from HFpEF and HFrEF patients, with objective measures of functional capacity similar to HFpEF. Within the midrange LVEF HF population, recovered systolic function is a marker of more favorable prognosis.

Indexed as

Exercise ToleranceStroke VolumeVentricular Function, LeftAdultAgedChi-Square DistributionExercise TestFemaleHeart-Assist DevicesHeart FailureHeart TransplantationHumansKaplan-Meier EstimateMaleMiddle AgedMultivariate Analysisheart failure oxygen consumptionventricular ejection fractionventricular function, left

Identifiers

PMID27009553
PMCPMC4807736
OpenAlexW2548312037

What OpenQuestion holds

Textmetadata
LicenceTDM
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.