ArticleJACC. Cardiovascular imaging2018
Epidemiology of Left Ventricular Systolic Dysfunction and Heart Failure in the Framingham Study: An Echocardiographic Study Over 3 Decades.
Article in JACC. Cardiovascular imaging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 119 papers, 2 of them syntheses that pooled it.
What it found
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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.
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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.
Who cites it
119 citing papers in PubMed, 2 syntheses or guidelines pooled it, 217 citations in OpenAlex.
- Prognostic Significance of Nutrition-Associated Markers in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis.Arquivos brasileiros de cardiologia · 2023Pooled it
- Diagnostic value of echocardiographic markers for diastolic dysfunction and heart failure with preserved ejection fraction.Heart failure reviews · 2022Pooled it
- Effects of empagliflozin on functional capacity, LV filling pressure, and cardiac reserves in patients with type 2 diabetes mellitus and heart failure with preserved ejection fraction: a randomized controlled open-label trial.Cardiovascular diabetology · 2025Trial
- Cost Effectiveness of Vericiguat for the Treatment of Chronic Heart Failure with Reduced Ejection Fraction Following a Worsening Heart Failure Event from a US Medicare Perspective.PharmacoEconomics · 2021Trial
- Budget Impact Analysis of Vericiguat for the Treatment of Chronic Heart Failure with Reduced Ejection Fraction Following a Worsening Event.Advances in therapy · 2021Trial
- Left and Right Atrial Strain Across the Heart Failure Continuum: Multifaceted Markers of Subclinical Mechanical Dysfunction and Haemodynamic Burden.Diagnostics (Basel, Switzerland) · 2026Review
- Clinical Presentation and Management of Patients Referred for Transthoracic Echocardiography in Canada's Arctic Region.CJC open · 2026Article
- Article
- Non-invasive classification of stable HFpEF using a deep learning model trained on acoustic features of sustained vowels.Biomedical engineering online · 2026Article
- Heart failure with preserved ejection fraction: current insights and emerging therapeutic directions.The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology · 2026Review
- Associations of Left Atrial Dimension and Ventricular Mass With Long-Term Health Outcomes: Framingham Heart Study.JACC. Advances · 2026Article
- Associations Between Sustained Methamphetamine/Amphetamine Use and Left Ventricular Dysfunction in a Cohort of Women Living With and Without HIV.Journal of the American Heart Association · 2026Article
- Alpha-7 nicotinic acetylcholine receptor: targeting the interplay between inflammation, renin-angiotensin aldosterone system, and nervous system for the novel treatment of heart failure.Frontiers in pharmacology · 2026Review
- Baseline vs. on-treatment heart failure with preserved ejection fraction (HFpEF) in a real world cardio-oncology clinic: observational analysis of cancer therapy-related cardiovascular toxicity incidence and cancer treatment implications.Frontiers in cardiovascular medicine · 2026Article
- Active endothelial and neural regulation of valve biology, health, and disease.Frontiers in cardiovascular medicine · 2026Review
- Review
- Beyond Ejection Fraction: RV Function and Diastolic Markers as Predictors of Kidney Disease.Echocardiography (Mount Kisco, N.Y.) · 2025Article
- Article
- Artificial intelligence in ECG-based diagnosis of low left ventricular ejection fraction: a systematic review and meta-analysis.Biomedical engineering letters · 2025Review
- Exercise Hemodynamics and Sex-Specific Data in Asymptomatic Adults: An Exploratory Pilot Study.Diagnostics (Basel, Switzerland) · 2025Article
59 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
objectivesThe purpose of this study was to describe the temporal trends in prevalence of left ventricular systolic dysfunction (LVSD) in individuals without and with heart failure (HF) in the community over a 3-decade period of observation.
backgroundTemporal trends in the prevalence and management of major risk factors may affect the epidemiology of HF.
methodsWe compared the frequency, correlates, and prognosis of LVSD (left ventricular ejection fraction [LVEF] <50%) among Framingham Study participants without and with clinical HF in 3 decades (1985 to 1994, 1995 to 2004, and 2005 to 2014).
resultsAmong participants without HF (12,857 person-observations, mean age 53 years, 56% women), the prevalence of LVSD on echocardiography decreased (3.38% in 1985 to 1994 vs. 2.2% in 2005 to 2014; p < 0.0001), whereas mean LVEF increased (65% vs. 68%; p < 0.001). The elevated risk associated with LVSD (∼2- to 4-fold risk of HF or death) remained unchanged over time. Among participants with new-onset HF (n = 894, mean age 75 years, 52% women), the frequency of heart failure with preserved ejection fraction (HFpEF) increased (preserved LVEF ≥50%: 41.0% in 1985 to 1994 vs. 56.17% in 2005 to 2014; p < 0.001) and heart failure with reduced ejection fraction (HFrEF) decreased (reduced LVEF <40%: 44.10% vs. 31.06%; p = 0.002), whereas heart failure with midrange LVEF remained unchanged (LVEF 40% to <50%: 14.90% vs. 12.77%; p = 0.66). Cardiovascular mortality associated with HFrEF declined across decades (hazard ratio: 0.61; 95% confidence interval: 0.39 to 0.97), but remained unchanged for heart failure with midrange LVEF and HFpEF. Approximately 47% of the observed increase in LVEF among those without HF and 75% of the rising proportion of HFpEF across decades was attributable to trends in risk factors, especially a decline in the prevalence of coronary heart disease among those with HF.
conclusionsThe profile of HF in the community has changed in recent decades, with a lower prevalence of LVSD and an increased frequency of HFpEF, presumably due to concomitant risk factor trends.
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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.