Evidence map›Paper›PMID 37920127›Full record

ArticleESC heart failure2023

Regional differences and coronary microvascular dysfunction in heart failure with preserved ejection fraction.

Mikael Erhardsson, Ulrika Ljung Faxén, Ashwin Venkateshvaran, Sara Svedlund, Antti Saraste, Maria Lagerström Fermer, Li-Ming Gan, Sanjiv J Shah, Jasper Tromp, Carolyn Sp Lam and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.2field-weighted citation impact, top 10% 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

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. 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

12 authors at 8 institutions in 6 countries.

Mikael ErhardssonDepartment of Medicine, Cardiology Unit, Karolinska Institutet, Stockholm, Sweden.
Ulrika Ljung FaxénDepartment of Medicine, Cardiology Unit, Karolinska Institutet, Stockholm, Sweden.
Ashwin VenkateshvaranDepartment of Medicine, Cardiology Unit, Karolinska Institutet, Stockholm, Sweden.
Sara SvedlundDepartment of Clinical Physiology, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Antti SarasteHeart Center, Turku University Hospital, University of Turku, Turku, Finland.
Maria Lagerström FermerEarly Clinical Development, IMED Biotech Unit, AstraZeneca Gothenburg, Sweden.
Li-Ming GanRibocure Pharmaceuticals AB, Sweden, Suzhou Ribo Life Science Co. Ltd., China.
Sanjiv J ShahDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Jasper TrompSaw Swee Hock School of Public Health, National University of Singapore & the National University Health System, Singapore, Singapore.
Carolyn Sp LamNational Heart Centre Singapore, Duke-National University of Singapore, Singapore, Singapore.
Lars H LundDepartment of Medicine, Cardiology Unit, Karolinska Institutet, Stockholm, Sweden.
Camilla HageDepartment of Medicine, Cardiology Unit, Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet · SEKarolinska University Hospital · SENational Heart Centre Singapore · SGAstraZeneca (Sweden) · SENorthwestern University · USSahlgrenska University Hospital · SETurku University Hospital · FIUniversity of Gothenburg · SE

Funding

HeartShare DeCODE-HF: Data translation center to Combine Omics, Deep phenotyping, and Electronic health records for Heart Failure subtypes and treatment targetsU54HL160273 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Abel N. Kho, Yuan Luo · 2021 to 2026
$19.0M
Transition from Risk Factors to Early HF: Prevalence, Pathogenesis, and PhenomicsR01HL127028 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BERTONI, ALAIN GERALD, SHAH, SANJIV J · 2015 to 2018
$6.5M
Study of Cardiac Mechanics in Systemic HypertensionR01HL107577 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI SHAH, SANJIV J · 2011 to 2019
$4.1M
Machine learning for the automated identification and tracking of rare myocardial diseasesR01HL140731 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MACRAE, CALUM A., SHAH, SANJIV J · 2018 to 2021
$2.8M
Precision Medicine for Dilated Cardiomyopathy—Novel Assessment of Cardiac Mechanics via Speckle Tracking Echocardiography to Identify Early PhenotypesR01HL149423 · NHLBI · OHIO STATE UNIVERSITY · PI HERSHBERGER, RAY E., KINNAMON, DANIEL DAVIS · 2019 to 2022
$1.6M
NHLBI NIH HHS U54 HL160273NIH HHS R01 HL107577NIH HHS R01 HL127028NIH HHS R01 HL140731NIH HHS R01 HL149423NIH HHS U54 HL160273
6 · The paper itself

Abstract

aimsIn heart failure with preserved ejection fraction (HFpEF), regional heterogeneity of clinical phenotypes is increasingly recognized, with coronary microvascular dysfunction (CMD) potentially being a common shared feature. We sought to determine the regional differences in clinical characteristics and prevalence of CMD in HFpEF. METHODS AND

resultsWe analysed clinical characteristics and CMD in 202 patients with stable HFpEF (left ventricular ejection fraction ≥40%) in Finland, Singapore, Sweden, and United States in the multicentre PROMIS-HFpEF study. Patients with unrevascularized macrovascular coronary artery disease were excluded. CMD was assessed using Doppler echocardiography and defined as coronary flow reserve (adenosine-induced vs. resting flow) < 2.5. Patients from Singapore had the lowest body mass index yet highest prevalence of hypertension, dyslipidaemia, and diabetes; patients from Finland and Sweden were oldest, with the most atrial fibrillation, chronic kidney disease, and high smoking rates; and those from United States were youngest and most obese. The prevalence of CMD was 88% in Finland, 80% in Singapore, 77% in Sweden, and 59% in the United States; however, non-significant after adjustment for age, sex, N-terminal pro-brain natriuretic peptide, smoking, left atrial reservoir strain, and atrial fibrillation. Associations between CMD and clinical characteristics did not differ based on region (interaction analysis).

conclusionsDespite regional differences in clinical characteristics, CMD was present in the majority of patients with HFpEF across different regions of the world with the lowest prevalence in the United States. This difference was explained by differences in patient characteristics. CMD could be a common therapeutic target across regions.

Indexed as

Atrial FibrillationCoronary Artery DiseaseHeart FailureHumansStroke VolumeUnited StatesVentricular Function, LeftCoronary flow reserveCoronary microvascular dysfunctionHFpEFRegion

Identifiers

PMID37920127
PMCPMC10682847
OpenAlexW4388298515

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.