Evidence map›Paper›PMID 27656000›Full record

ArticleCirculation. Heart failure2016

Changes in Left Ventricular Ejection Fraction Predict Survival and Hospitalization in Heart Failure With Reduced Ejection Fraction.

Khadijah Breathett, Larry A Allen, James Udelson, Gordon Davis, Michael Bristow

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Heart failure, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00000560 (Beta-Blocker Evaluation in Survival Trial), which is not on this map. Cited by 61 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 6 pooled it
–field-weighted citation impact
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.

NCT00000560 phase3completednot on this map

Beta-Blocker Evaluation in Survival Trial (BEST)

TypeinterventionalSponsorNational Heart, Lung, and Blood Institute (NHLBI)Ran1994 to 1999ConditionsCardiovascular Diseases, Heart Diseases, Heart Failure, Congestive, Heart FailureArmsadrenergic beta antagonists
3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Active Compression During External Cardioversion of Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025
    Pooled it
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  7. Trial
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  10. Empagliflozin in acute myocardial infarction: the EMMY trial.European heart journal · 2022 · on this map
    Trial
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  15. Chemo-/radiotherapy-induced cardiomyopathy: roles of mitochondria and endoplasmic reticulum.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
    Review
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  20. Clinical phenotypes and outcomes associated with improved left ventricular ejection fraction after biventricular pacing.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Article

1 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

5 authors.

Khadijah BreathettFrom the Division of Cardiology, University of Colorado, Aurora (K.B., L.A.A., M.B.); Division of Cardiology, Tufts Medical Center, Boston, MA (J.U.); and ARCA Biopharma, Westminster, CO (G.D., M.B.). khadijah.breathett@ucdenver.edu.
Larry A AllenFrom the Division of Cardiology, University of Colorado, Aurora (K.B., L.A.A., M.B.); Division of Cardiology, Tufts Medical Center, Boston, MA (J.U.); and ARCA Biopharma, Westminster, CO (G.D., M.B.).
James UdelsonFrom the Division of Cardiology, University of Colorado, Aurora (K.B., L.A.A., M.B.); Division of Cardiology, Tufts Medical Center, Boston, MA (J.U.); and ARCA Biopharma, Westminster, CO (G.D., M.B.).
Gordon DavisFrom the Division of Cardiology, University of Colorado, Aurora (K.B., L.A.A., M.B.); Division of Cardiology, Tufts Medical Center, Boston, MA (J.U.); and ARCA Biopharma, Westminster, CO (G.D., M.B.).
Michael BristowFrom the Division of Cardiology, University of Colorado, Aurora (K.B., L.A.A., M.B.); Division of Cardiology, Tufts Medical Center, Boston, MA (J.U.); and ARCA Biopharma, Westminster, CO (G.D., M.B.).

Funding

Obesity and Cardiovascular Disease: Opportunity for Post-Doctoral TrainingT32HL116276 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI ECKEL, ROBERT H · 2014 to 2018
$1.2M
Addressing Gaps in Longitudinal Heart Failure Pharmacotherapy to Reduce RehospitaK23HL105896 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI ALLEN, LARRY ALEXANDER · 2011 to 2015
$676k
NHLBI NIH HHS K23 HL105896NHLBI NIH HHS T32 HL116276
6 · The paper itself

Abstract

backgroundLeft ventricular remodeling, as commonly measured by left ventricular ejection fraction (LVEF), is associated with clinical outcomes. Although change in LVEF over time should reflect response to therapy and clinical course, serial measurement of LVEF is inconsistently performed in observational settings, and the incremental prognostic value of change in LVEF has not been well characterized. METHODS AND

resultsThe β-Blocker Evaluation of Survival Trial measured LVEF by radionuclide ventriculography at baseline and at 3 and 12 months after randomization. We built a series of multivariable models with 16 clinical parameters plus change in LVEF for predicting 4 major clinical end points, including the trial's primary end point of all-cause mortality. Among 2484 patients with at least 1 follow-up LVEF, change in LVEF was the second most significant predictor (behind baseline creatinine) of all-cause mortality (adjusted hazard ratio for improvement in LVEF by ≥5 U responder versus nonresponder [95% confidence intervals] for all-cause mortality=0.62 [0.52-0.73]). Other end points, including heart failure hospitalization or the composite of all-cause mortality and heart failure hospitalization, yielded similar results. LVEF change ≥5 U was associated with a modest increase in discrimination when added to traditional predictors and was predictive of outcomes in both the bucindolol and placebo treatment groups. LVEF change as a predictor of outcomes was affected by sex and race, with evidence that LVEF improvement is associated with less survival benefit in African Americans and women.

conclusionsSerial evaluation for LVEF change predicts both survival and heart failure hospitalization and provides a dynamic/real-time measure of prognosis in heart failure with reduced LVEF. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00000560.

Indexed as

creatinineheart failurehospitalizationoutcomes researchprognosis

Identifiers

PMID27656000
PMCPMC5082710

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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.