Evidence map›Paper›PMID 36114655›Full record

Trial reportEuropean journal of heart failure2023

Characteristics and clinical outcomes of patients with acute heart failure with a supranormal left ventricular ejection fraction.

Bart J van Essen, Jasper Tromp, Jozine M Ter Maaten, Barry H Greenberg, Claudio Gimpelewicz, G Michael Felker, Beth A Davison, Thomas Severin, Peter S Pang, Gad Cotter and 3 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
7.6field-weighted citation impact, top 2% 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

24 citing papers in PubMed, 49 citations in OpenAlex.

  1. Phenotyping Heart Failure: Looking Beyond Left Ventricular Ejection Fraction.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026
    Article
  2. Review
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  14. 2024 update in heart failure.ESC heart failure · 2025
    Review
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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

13 authors at 11 institutions in 7 countries.

Bart J van EssenDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jasper TrompDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jozine M Ter MaatenDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Barry H GreenbergUniversity of California San Diego, San Diego, CA, USA.
Claudio GimpelewiczNovartis Pharma, Basel, Switzerland.
G Michael FelkerDivision of Cardiology, Duke University School of Medicine, Durham, NC, USA.
Beth A DavisonMomentum Research Inc., Chapel Hill, NC, USA.
Thomas SeverinNovartis Pharma, Basel, Switzerland.
Peter S PangDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Gad CotterMomentum Research Inc., Chapel Hill, NC, USA.
John R TeerlinkSection of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California, San Francisco, CA, USA.
Marco MetraCardiology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy.
Adriaan A VoorsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Novartis (Switzerland) · CHUniversity Medical Center Groningen · NLDuke University · USIndiana University – Purdue University Indianapolis · USInserm · FRMomentum Research · USNational University of Singapore · SGSan Francisco VA Medical Center · USSurgical Specialties (Canada) · CAUniversity of California, San Diego · USUniversity of Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimRecent data suggest that guideline-directed medical therapy of patients with heart failure (HF) with reduced ejection fraction (HFrEF) might improve clinical outcomes in patients with HF up to a left ventricular ejection fraction (LVEF) of 55-65%, whereas patients with higher LVEF do not seem to benefit. Recent data have shown that LVEF may have a U-shaped relation with outcome, with poorer outcome also in patients with supranormal values. This suggests that patients with supranormal LVEF may be a distinctive group of patients. METHODS AND

resultsRELAX-AHF-2 was a multicentre, placebo-controlled trial on the effects of serelaxin on 180-day cardiovascular (CV) mortality and worsening HF at day 5 in patients with acute HF. Echocardiograms were performed at hospital admission in 6128 patients: 155 (2.5%) patients were classified as HF with supranormal ejection fraction (HFsnEF; LVEF >65%), 1440 (23.5%) as HF with preserved ejection fraction (HFpEF; LVEF 50-65%), 1353 (22.1%) as HF with mildly reduced ejection fraction (HFmrEF; LVEF 41-49%) and 3180 (51.9%) as HFrEF (LVEF <40%). Patients with HFsnEF compared to HFpEF were more often women, had higher prevalence of non-ischaemic HF, had lower levels of natriuretic peptides, were less likely to be treated with beta-blockers and had higher blood urea nitrogen plasma levels. All-cause mortality was not statistically different between groups, although patients with HFsnEF had the highest numerical rate. A declining trend was seen in the proportion of 180-day deaths due to CV causes from HFrEF (290/359, 80.8%) to HFsnEF (14/24, 58.3%). The reverse was observed with death from non-CV causes. No treatment effect of serelaxin was observed in any of the subgroups.

conclusionsIn this study, only 2.5% of patients were classified as HFsnEF. HFsnEF was primarily characterized by female sex, lower natriuretic peptides and a higher risk of non-CV death.

Indexed as

Heart FailureVentricular Dysfunction, LeftFemaleHumansPrognosisStroke VolumeVasodilator AgentsVentricular Function, LeftVasodilator AgentsAcute heart failureClinical outcomeHeart failure with supranormal ejection fractionSerelaxin

Identifiers

PMID36114655
PMCPMC10092799
OpenAlexW4296163197

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.