Evidence map›Paper›PMID 40739496›Full record

ArticleCardiovascular diabetology2025

Microvascular dysfunction across organs in heart failure with preserved ejection fraction: the PROSE-HFpEF case-control study.

Jerremy Weerts, Blanche L M Schroen, Arantxa Barandiarán Aizpurua, Tos T J M Berendschot, Lloyd Brandts, Carroll A B Webers, Sami O Simons, Steven J R Meex, Ronald Henry, Carla J H van der Kallen and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Integrating Senescence and Oxidative Stress in Cardiac Disease.International journal of molecular sciences · 2025
    Review
  4. 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

16 authors.

Jerremy WeertsDepartment of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD, Maastricht, The Netherlands. jerremy.weerts@mumc.nl.
Blanche L M SchroenDepartment of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD, Maastricht, The Netherlands.
Arantxa Barandiarán AizpuruaDepartment of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD, Maastricht, The Netherlands.
Tos T J M BerendschotUniversity Eye Clinic Maastricht, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Lloyd BrandtsDepartment of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Carroll A B WebersUniversity Eye Clinic Maastricht, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Sami O SimonsDepartment of Respiratory Medicine, NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Steven J R MeexDepartment of Clinical Chemistry, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Ronald HenryDepartment of Internal Medicine, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Carla J H van der KallenDepartment of Internal Medicine, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Hans-Peter Brunner-La RoccaDepartment of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD, Maastricht, The Netherlands.
Christian KnackstedtDepartment of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD, Maastricht, The Netherlands.
Stephane R B HeymansDepartment of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD, Maastricht, The Netherlands.
Rudolf A de BoerDepartment of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus MC, Rotterdam, the Netherlands.
Vanessa P M van Empel *Department of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD, Maastricht, The Netherlands.
Alfons J H M Houben *Department of Internal Medicine, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.

Funding

Hartstichting CVON2017-21-SHE PREDICTS HF
6 · The paper itself

Abstract

backgroundSystemic microvascular dysfunction is proposed as a key pathophysiological process in heart failure with preserved ejection fraction (HFpEF). This study compared microvasculature across vascular beds in HFpEF patients and controls.

methodsThis prospective, case-control study included subjects ≥ 60years. HFpEF patients were diagnosed in an expert centre. Controls without HF were selected from the Maastricht Study, a population cohort enriched with diabetes mellitus. Microvascular assessments included central retinal venular/arteriolar calibres (CRVE/CRAE), flicker-light-induced retinal dilation, skin microvascular flowmotion and heat-induced hyperemia, and urinary albumin-to-creatinine ratio (UACR). Group differences were evaluated with confounder-adjustments (age, sex, blood pressure, body mass index, diabetes, haemoglobin, smoking). Interactions with sex and diabetes mellitus were tested, and stratified analyses were performed when significant interactions were present.

resultsMicrovascular assessments were performed in 138 HFpEF patients and 2140 controls. Microvascular differences were present between groups in all vascular beds. However, confounder-adjusted analyses attenuated differences. Confounder-adjusted analyses indicated that HFpEF patients versus controls still had retinal differences: narrower CRVE (- 8.1 μm, p = 0.008) and narrower CRAE trend (- 3.5 μm, p = 0.073), but similar flicker-light-induced retinal venular/arteriolar dilation (- 0.23%, p = 0.392; - 0.18%, p = 0.593, respectively). Confounder-adjusted analyses showed similar skin flowmotion measures (i.e. endothelial power - 0.09log(PU

conclusionsHFpEF patients showed microvascular differences versus controls across all vascular beds studied. However, confounder-adjusted differences remained significant in eyes and kidneys. The findings across multiple organs support that MVD is likely a more systemic process than only local MVD in HFpEF, and possible sex-specific underlying pathophysiology. REGISTRATION: URL: https://onderzoekmetmensen.nl ; Unique identifier: NL7655.

Indexed as

Heart FailureMicrocirculationMicrovesselsRetinal VesselsSkinStroke VolumeVentricular Function, LeftAgedAged, 80 and overAlbuminuriaCase-Control StudiesFemaleHumansMaleMiddle AgedNetherlandsDiastolic heart failureHeart failure with preserved ejection fractionHFpEFMicrocirculationMicrovascular dysfunctionPathophysiologySex differences

Identifiers

PMID40739496
PMCPMC12312529

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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.