Evidence map›Paper›PMID 41941602›Full record

Trial reportESC heart failure2026

Association between functional Status and cardiac function in chronic heart failure: insights from the C-MIC II Trial.

Marat Fudim, Tamara Kovacevic-Preradovic, Marija Zdravkovic, Sasko Jovev, Nermir Granov, Tanja Popov, Igor Rudez, Petar Vukovic, Velibor Ristic, Annette Holtdirk and 7 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

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

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

17 authors.

Marat FudimDepartment of Medicine, Duke University, 2301 Erwin Road, Durham, NC 27710, USA.
Tamara Kovacevic-PreradovicFaculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
Marija ZdravkovicUniversity Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia.
Sasko JovevUniversity Clinic of Cardiology, Skopje, North Macedonia.
Nermir GranovClinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Tanja PopovInstitute of Cardiovascular Diseases of Vojvodina, Vojvodina, Serbia.
Igor RudezUniversity Hospital Dubrava, Zagreb, Croatia.
Petar VukovicUniversity Belgrade Medical School, Belgrade, Serbia.
Velibor RisticCardiovascular Institute Dedinje, Belgrade, Serbia.
Annette HoltdirkRQM+, Frankfurt, Germany.
Muhammad Shahzeb KhanBaylor Scott and White Health- Heart Hospital Plano, and Baylor Scott and White Research Institute, Dallas, TX, USA.
Faouzi KallelBerlin Heals, Berlin, Germany.
Miodrag PericCardiovascular Institute Dedinje, Belgrade, Serbia.
Javed ButlerUniversity of Mississippi Medical Center, Jackson, MS, USA.ORCID 0000-0003-4267-6933
Stefan D AnkerDepartment of Cardiology (CVK) of German Heart Center Charité, German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany.
Dragana KosevicCardiovascular Institute Dedinje, Belgrade, Serbia.
J Eduardo RameBruce and Robbi Toll Heart and Vascular Institute, Thomas Jefferson University, Philadelphia, PA, USA.

Funding

Berlin HealsFederal Ministry of Research 13GW0548A+B
6 · The paper itself

Abstract

introductionRelationship between changes in cardiac function, functional capacity, and patient-reported health status in heart failure (HF) remains incompletely defined, which may help inform endpoint selection and clarify how distinct clinical domains reflect treatment response.

methodsThis post hoc analysis of the randomized cardiac microcurrent (C-MIC) II trial, which evaluated the efficacy and safety of C-MIC therapy in patients with chronic HF with reduced ejection fraction on optimal guideline-directed medical therapy, included 65 ambulatory patients with non-ischaemic dilated cardiomyopathy, New York Heart Association (NYHA) Class III-IV symptoms, and baseline left ventricular ejection fraction (LVEF) 25-35%. Correlations between changes in Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS), 6-minute walk distance (6MWD), core lab-assessed LVEF (primary measure) and site-assessed LVEF, and peak oxygen uptake (peak VO2) were evaluated at 4 weeks, 2 months, 3 months, 4 months, and 6 months using Pearson coefficients with 95% confidence intervals (CI).

resultsThe mean age was 60.0 ± 9.7 years and baseline LVEF was 29.8 ± 3.3%. Baseline 6MWD was 291.4 ± 61.6 m and KCCQ-OSS was 42.6 ± 22.7. From baseline to 6 months, changes in KCCQ-OSS (n = 63) and 6MWD (n = 61) showed modest correlations with core lab-assessed LVEF (r = 0.39; 95% CI: 0.16-0.58; P = .0015 and r = 0.39; 95% CI: 0.15-0.58; P = .0022, respectively). Changes in KCCQ-OSS and 6MWD correlated strongly (n = 62; r = 0.63; 95% CI: 0.46-0.76; P < .0001). Changes in KCCQ-OSS and 6MWD did not correlate significantly with changes in peak VO2 (P = .06 and P = .30, respectively). Changes in LVEF and peak VO2 (n = 55) demonstrated modest correlation (r = 0.41; 95% CI: 0.16-0.61; P = .002). Baseline correlations with peak VO2 were weak to modest but increased at 6 months for LVEF (n = 59; r = 0.56; 95% CI: 0.35-0.71; P < .0001).

conclusionIn advanced HF, improvements in health status and submaximal functional capacity associate modestly with LVEF, while LVEF correlates more closely with peak VO2. Cardiac function, functional capacity, and health status represent related but distinct domains, supporting multidimensional assessment in HF trials.

Indexed as

Exercise ToleranceFunctional StatusHeart FailureStroke VolumeVentricular Function, LeftChronic DiseaseFemaleFollow-Up StudiesHumansMaleMiddle AgedOxygen ConsumptionFunctional statusHealth statusHeart failureLVEFMicrocurrent therapy

Identifiers

PMID41941602
PMCPMC13126662

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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.