Evidence map›Paper›PMID 36545228›Full record

ArticleEuropean heart journal supplements : journal of the European Society of Cardiology2022

The four pillars of HFrEF therapy: is it time to treat heart failure regardless of ejection fraction?

Kieran F Docherty, Antoni Bayes-Genis, Javed Butler, Andrew J S Coats, Mark H Drazner, Emer Joyce, Carolyn S P Lam

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal supplements : journal of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
–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

19 citing papers in PubMed.

  1. Trial
  2. Review
  3. Review
  4. Review
  5. Article
  6. Article
  7. Review
  8. Review
  9. Article
  10. Review
  11. The Effect of Sacubitril/Valsartan on Supraventricular and Ventricular Arrhythmias in Patients With Heart Failure.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025
    Article
  12. Article
  13. Observational
  14. Review
  15. Article
  16. Article
  17. Myocardial Recovery and Relapse in Heart Failure With Improved Ejection Fraction.Current treatment options in cardiovascular medicine · 2024
    Article
  18. Article
  19. Review
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

7 authors.

Kieran F DochertyBritish Heart Foundation Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
Antoni Bayes-GenisInstitut del Cor, Hospital Universitari Germans Trias i Pujol, CIBERCV, 08916 Badalona, Barcelona, Spain.
Javed ButlerBaylor Scott and White Research Institute, 3434 Live Oak St Ste 501, Dallas, TX 75204, USA.
Andrew J S CoatsWarwick Medical School, University of Warwick, Coventry, CV4 7HL, UK.
Mark H DraznerUniversity of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Cardiology, 5323 Harry Hines Blvd., Dallas, TX 75390-9254, USA.
Emer JoyceDepartment of Cardiology, Mater Misericordiae University Hospital, Eccles St, Dublin 7, D07 R2WY, Ireland.
Carolyn S P LamNational Heart Centre Singapore, Duke-National University of Singapore, 5 Hospital Dr, Singapore 169609, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The syndrome of heart failure (HF) has historically been dichotomized based on clinical trial inclusion criteria into patients with a reduced or preserved left ventricular ejection fraction (LVEF) using a cut-off of above or below 40%. The majority of trial evidence for the benefits of disease-modifying pharmacological therapy has been in patients with HF with reduced ejection fraction (HFrEF), i.e. those with an LVEF ≤40%. Recently, the sodium-glucose co-transporter 2 inhibitors empagliflozin and dapagliflozin have been shown to be the first drugs to improve outcomes in HF across the full spectrum of LVEF. There is, however, growing evidence that the benefits of many of the neurohumoral modulators shown to be beneficial in patients with HFrEF may extend to those with a higher LVEF above 40% but still below the normal range, i.e. HF with mildly reduced ejection fraction (HFmrEF). Whether the benefits of some of these medications also extend to patients with HF and preserved ejection fraction (HFpEF) is an area of ongoing debate. This article will review the evidence for HF treatments across the full spectrum of LVEF, provide an overview of recently updated clinical practice guidelines, and address the question whether it may now be time to treat HF with some therapies regardless of ejection fraction.

Indexed as

Beta-blockerHeart failureLeft ventricular ejection fractionMineralocorticoid receptor antagonistNeprilysin inhibitorRenin-angiotensin systemSodium-glucose co-transporter 2 inhibitor

Identifiers

PMID36545228
PMCPMC9762881

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.