Evidence map›Paper›PMID 32592541›Full record

ArticleESC heart failure2020

Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction.

Jonathan G Howlett, Nakul Sharma, Wendimagegn G Alemayehu, Jason R B Dyck, Todd Anderson, Nowell Fine, Harald Becker, James A White, D Ian Paterson, Richard B Thompson and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 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.

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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Review
  6. Article
  7. Article
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

13 authors.

Jonathan G HowlettCumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.ORCID 0000-0002-0535-9771
Nakul SharmaCumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Wendimagegn G AlemayehuDivision of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
Jason R B DyckDepartment of Paediatrics, University of Alberta, Edmonton, Alberta, Canada.
Todd AndersonCumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Nowell FineCumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Harald BeckerDivision of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
James A WhiteCumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
D Ian PatersonDivision of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
Richard B ThompsonDepartment of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
Gavin Y OuditDivision of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
Mark J HaykowskyFaculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Justin A EzekowitzDivision of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.

Funding

Alberta Innovates-Health Solutions Interdisciplinary Team AHFMR ITG 200801018Ministry of Innovation and Advanced Education AHFMR ITG 200801018
6 · The paper itself

Abstract

aimsThe aim of this study is to determine factors associated with long-term recovery of left ventricular ejection fraction (LVEF) in patients with heart failure with reduced EF (HFrEF) and if further recovery also occurs in this group. METHODS AND

resultsAmong 621 participants enrolled in the Alberta Heart Failure Etiology and Analysis Team (HEART) Study, 316 with Stage C HF underwent comprehensive imaging and biomarker testing at enrolment and at 1-year follow up. Using pre-enrolment data, HF with recovered EF (HFrecEF) was defined as an absolute improvement ≥5% in LVEF from the prior lowest LVEF value, with a final LVEF value > 35% at or prior to study baseline. Participants with all LVEF > 40% were included for comparison. Hospitalization-free survival to 5 years was performed. The median cohort age was 66 years, and time from diagnosis was 4 years; 82% were male patients. Of the 316 patients, 95 (30%) patients had HFrecEF and 56 (18%) patients pHFrEF. On multivariate analysis, only shorter duration of HF was predictive of HFrecEF status. Over 1 year, LVEF increased in the HFrecEF group 4.0% (0.15-7.90, P = 0.042) as compared with persistent HFrEF, who in turn demonstrated higher baseline serum high sensitivity Troponin-T with further increase at follow up 0.55(0.33-0.86, P = 0.011). No change in any parameter in the HFpEF/HFmrEF group at follow up was observed.

conclusionsPatients with HFrecEF demonstrate evidence of additional late improvement in LVEF and unchanged troponin levels, in contrast to those with persistent HFrEF, where LVEF does not improve and serum troponin rises over time. These data help to inform mechanisms relating to late LV remodelling.

Indexed as

Heart FailureVentricular Function, LeftAgedAlbertaFemaleHumansMalePrognosisStroke VolumeTroponinTroponinBiomarkersHeart failureLeft ventricular remodellingTroponin

Identifiers

PMID32592541
PMCPMC7524210

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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.