Evidence map›Paper›PMID 41711204›Full record

Observational studyESC heart failure2026

Novel biomarkers distinguish heart failure with preserved vs reduced ejection fraction.

Camilla Hage, Annika Mang, Jean-Claude Daubert, Erwan Donal, Peder L Myhre, Cecilia Linde, Lars H Lund

Registry-linked trialAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00774709 (Ancillary Study of the Registry Karolinska-Rennes), which is not on this map. Not yet cited in PubMed.

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

NCT00774709 completednot on this map

Ancillary Study of the Registry Karolinska-Rennes (KaRen) : Prospective Study of Dyssynchrony in Heart Failure With Preserved Ejection Fraction

TypeobservationalSponsorFrench Cardiology SocietyRan2008 to 2012Enrolled90ConditionsHeart Failure
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Camilla HageCardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-4142-2416
Annika MangRoche Diagnostics GmbH, Penzberg, Germany.
Jean-Claude DaubertDépartement de Cardiologie & CIC-IT U 804, Centre Hospitalier Universitaire de Rennes, Rennes, France.
Erwan DonalDépartement de Cardiologie & CIC-IT U 804, Centre Hospitalier Universitaire de Rennes, Rennes, France.ORCID 0000-0003-2677-3389
Peder L MyhreDepartment of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
Cecilia LindeCardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-9039-6023
Lars H LundCardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.

Funding

Fédération Française de Cardiologie/Société Française de Cardiologie, FranceMedtronic Bakken Research Center, Maastricht, The Netherlands
6 · The paper itself

Abstract

introductionHeart failure (HF) with preserved (HFpEF) and reduced (HFrEF) ejection fraction may be driven by different pathophysiologies. We explored novel biomarkers, associations with clinical characteristics, discrimination between LVEF categories and associations with outcomes. METHODS AND

resultsIn HFpEF(n = 76) and HFrEF(n = 36), 19 plasma biomarkers were measured including seven novel research assays for ANGPT2, BMP10, DKK3, FABP3, FGF23, IGFBP7, and MYBPC3. Heart failure with preserved ejection fraction patients were older (73 vs 63 years), more often female (50% vs 14%). All seven novel biomarkers except FABP3 tended to be higher in HFrEF vs HFpEF and associated with worse NYHA class and lower eGFR in both LVEF categories. MYBPC3 and FGF23 (higher in HFrEF) discriminated best between LVEF categories (AUC 85.8 and 80.0 respectively). In HFpEF, higher ANGPT2 was associated with worse right (TAPSE: β = -1.03;P = .04) and left ventricular function (LV-GLS; β = 1.29;P = .03) and left atrial strain (LA-GLS: β = 5.03;P < .001) whereas higher IGFBP7 and MYBPC3 with diastolic dysfunction (E/e': β = 4.09;P = .02 and β = 1.36;P = .01 respectively). All biomarkers except DKK3 were positively associated with the outcome (HFpEF:all-cause death, HF hospitalization;HFrEF: all-cause death, LVAD or heart transplantation). Specifically ANGPT2 [HR 1.45(95% CI 1.00-2.13)] more strongly in HFpEF and IGFBP7 [2.51(0.95-6.64)] more strongly in HFrEFand MYBPC3 [1.62(0.99-2.64)].

conclusionAmong seven novel biomarker assays, higher MYBPC3 (reflecting muscle injury and myopathy) and FGF23 (endothelial dysfunction, oxidative stress) distinguished HFrEF from HFpEF. Higher MYBPC3 was most prognostic in HFrEF while higher ANGPT2 and IGFBP7 (endothelial dysfunction and oxidative stress) in HFpEF. These hypothesis-generating findings support primary cardiomyocyte injury as a driver of HFrEF and systemic inflammation and oxidative stress as a driver of HFpEF. CLINICAL

trial registrationClinicalTrials.gov NCT00774709.

Indexed as

Heart FailureStroke VolumeVentricular Function, LeftAgedBiomarkersFemaleFibroblast Growth Factor-23HumansMaleMiddle AgedPrognosisBiomarkersFGF23 protein, humanFibroblast Growth Factor-23biomarkerHFpEFHFrEFoxidative stresspathophysiologyphenotype

Identifiers

PMID41711204
PMCPMC13228998

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Registered trials

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.