Evidence map›Paper›PMID 28467622›Full record

Observational studyClinical cardiology2017

Prognostic impact of diastolic dysfunction in systolic heart failure-A cross-project analysis from the German Competence Network Heart Failure.

Claus Lüers, Frank Edelmann, Rolf Wachter, Burkert Pieske, Meinhard Mende, Christiane Angermann, Georg Ertl, Hans-Dirk Düngen, Stefan Störk

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

Observational study in Clinical cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
1.6field-weighted citation impact, top 15% 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

12 citing papers in PubMed, 19 citations in OpenAlex.

  1. Prediction of recurrent heart failure hospitalizations and mortality using the echocardiographic Killip score.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
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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

9 authors at 5 institutions in 1 country.

Claus LüersUniversity of Oldenburg, European Medical School Oldenburg-Groningen, Germany.ORCID http://orcid.org/0000-0003-0849-9208
Frank EdelmannDepartment of Cardiology and Pneumology, University of Göttingen, Germany.
Rolf WachterDepartment of Cardiology and Pneumology, University of Göttingen, Germany.
Burkert PieskeDepartment of Cardiology, Campus Virchow, Charité University, Berlin, Germany.
Meinhard MendeClinical Trial Center, University of Leipzig, Germany.
Christiane AngermannComprehensive Heart Failure Center, University of Würzburg, and Department of Internal Medicine Cardiology, University Hospital Würzburg, Germany.
Georg ErtlComprehensive Heart Failure Center, University of Würzburg, and Department of Internal Medicine Cardiology, University Hospital Würzburg, Germany.
Hans-Dirk DüngenDepartment of Cardiology, Campus Virchow, Charité University, Berlin, Germany.
Stefan StörkComprehensive Heart Failure Center, University of Würzburg, and Department of Internal Medicine Cardiology, University Hospital Würzburg, Germany.
University of Würzburg · DECharité - Universitätsmedizin Berlin · DEUniversity of Göttingen · DECarl von Ossietzky Universität Oldenburg · DELeipzig University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe investigated the modifying role and prognostic importance of diastolic dysfunction (DD) in patients with heart failure and systolic dysfunction (SD). HYPOTHESIS: The echocardiographic evaluation of diastolic function in patients with SD provides further prognostic information.

methodsFrom the German Competence Network Heart Failure, 1046 heart failure patients with reduced left ventricular ejection fraction (LVEF; <50%) were echocardiographically studied and followed for a median of 5 years. SD was subdivided into nonsevere (LVEF 36%-49%) and severe (LVEF ≤35%); DD was subdivided into nonsevere (E/E' <15) and severe (E/E' ≥15).

resultsIn general, severe SD was associated with higher hazard ratios (HRs; 2-fold to 3.5-fold) for all endpoints (all-cause death, cardiac death, cardiovascular hospitalization, duration of hospitalization). Patients with severe SD had a 2.5-fold risk of death (95% confidence interval [CI]: 1.84-3.47, P < 0.001), and patients with severe DD showed a 1.8-fold risk (95% CI: 1.17-2.61, P = 0.004). Furthermore, we observed a strong interaction of SD and DD: concomitant severe DD in patients with moderate SD increased risk substantially (HR: 1.73, 95% CI: 1.16-2.6, P = 0.007); by contrast, in patients with severe SD, additional presence of severe DD added little or no risk (HR for interaction: 0.5-1.2).

conclusionsIn heart failure patients with reduced LVEF, the evaluation of diastolic function provides additional prognostic information. Although severe SD generally increased the risk for all endpoints, the degree of DD and its impact as a prognostic marker for overall and cardiovascular mortality appeared of particular relevance in subjects with nonsevere SD.

Indexed as

Ventricular Function, LeftDiastoleEchocardiographyGermanyHeart FailureHumansPrognosisRetrospective StudiesRisk FactorsSeverity of Illness IndexStroke VolumeSystoleTime FactorsVentricular Dysfunction, LeftDiastolic FunctionEchocardiographyEpidemiologyHeart Failure With Preserved Ejection FractionHeart Failure With Reduced Ejection FractionSystolic Function

Identifiers

PMID28467622
PMCPMC6490547
OpenAlexW2610463533

What OpenQuestion holds

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Registered trials

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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.