{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:15:04Z","timestamp":1768781704841,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,3,2]],"date-time":"2015-03-02T00:00:00Z","timestamp":1425254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2015,4]]},"abstract":"ABSTRACT<\/jats:title>Background<\/jats:title>Optimal medical therapy (OMT<\/jats:styled-content>) for patients with chronic heart failure and a reduced ejection fraction (HF\u2010REF<\/jats:styled-content>) includes angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers, \u03b2\u2010blockers, and mineralocorticoid receptor antagonists, plus a diuretic.<\/jats:p><\/jats:sec>Hypothesis<\/jats:title>We hypothesized that OMT<\/jats:styled-content> is less often prescribed in HF\u2010REF<\/jats:styled-content> patients (\u226435%) with New York Heart Association (NYHA<\/jats:styled-content>) class II<\/jats:styled-content> symptoms compared with those with NYHA<\/jats:styled-content> class III<\/jats:styled-content>\/IV<\/jats:styled-content> symptoms.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a cross\u2010sectional, observational, multicenter survey of hospital\u2010based cardiologists, office\u2010based cardiologists, and general practitioners in Germany.<\/jats:p><\/jats:sec>Results<\/jats:title>Out of a total of 384 patients enrolled, 144 had REF<\/jats:styled-content> \u226435%. Patients with REF<\/jats:styled-content> had NYHA<\/jats:styled-content> class II<\/jats:styled-content> symptoms in 39.6% (n\u2009=\u200957) and NYHA<\/jats:styled-content> class III<\/jats:styled-content>\/IV<\/jats:styled-content> symptoms in 60.4% (n\u2009=\u200987). The REF<\/jats:styled-content>\/NYHA<\/jats:styled-content> class II<\/jats:styled-content> group had a higher proportion of males than the REF<\/jats:styled-content>\/NYHA<\/jats:styled-content> class III<\/jats:styled-content>\/IV<\/jats:styled-content> group. For angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers and \u03b2\u2010blockers, prescription rates were high and comparable between groups. However, prescription rates for mineralocorticoid receptor antagonists were lower compared with other guideline\u2010recommended treatments. Multivariate analyses indicated that OMT<\/jats:styled-content> prescription was reduced for older patients and increased for patients cared for by an office\u2010based cardiologist.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Given the high proportion of patients with reduced left ventricular systolic function but only minor symptoms, HF\u2010REF<\/jats:styled-content> appears to be underdiagnosed, and a higher proportion of patients than are currently recognized could potentially be candidates for OMT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22375","type":"journal-article","created":{"date-parts":[[2015,3,2]],"date-time":"2015-03-02T20:33:32Z","timestamp":1425328412000},"page":"200-207","source":"Crossref","is-referenced-by-count":14,"title":["Treatment of Heart Failure in Real\u2010World Clinical Practice: Findings From the REFLECT\u2010HF<\/scp> Registry in Patients With NYHA<\/scp> Class II<\/scp> Symptoms and a Reduced Ejection Fraction"],"prefix":"10.1002","volume":"38","author":[{"given":"Michael","family":"B\u00f6hm","sequence":"first","affiliation":[{"name":"Internal Medicine Clinic III, Saarland University Medical Center Homburg\/Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Tsch\u00f6pe","sequence":"additional","affiliation":[{"name":"Medical Clinic II, Department of Cardiology and Pulmonology, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jost Henner","family":"Wirtz","sequence":"additional","affiliation":[{"name":"Cardiology Group Practice Dinslaken Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Lokies","sequence":"additional","affiliation":[{"name":"Eickhoff Lokies Cardiology Group Practice Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Turgonyi","sequence":"additional","affiliation":[{"name":"Medical Department Pfizer Ltd. 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Tadworth, Surrey England, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anke M.","family":"Strunz","sequence":"additional","affiliation":[{"name":"Medical Department Pfizer Pharma GmbH Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Tebbe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine, Lippe\u2010Detmold Clinic Detmold Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.10.089"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfr093"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009492"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/21.4.294"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250501"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61913-9"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199605233342101"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs104"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-014-0678-2"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.11.014"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-014-0743-x"},{"key":"e_1_2_7_15_1","first-page":"219","article-title":"The German National Disease Management Guideline \u201cChronic Heart Failure\u201d [article in German]","volume":"137","author":"Weinbrenner S","year":"2012","journal-title":"Dtsch Med Wochenschr."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2008.08.005"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfq049"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.10.007"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-013-0057-9"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.10.071"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.03.050"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.10.125"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.04.064"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.934471"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1493"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft134"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft050"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfn005"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.000709"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22375","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22375","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T20:31:05Z","timestamp":1696365065000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,2]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,4]]}},"alternative-id":["10.1002\/clc.22375"],"URL":"https:\/\/doi.org\/10.1002\/clc.22375","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,2]]}}}