{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:29:53Z","timestamp":1769084993757,"version":"3.49.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1854,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T00:00:00Z","timestamp":1606003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Acutely decompensated heart failure (HF) (ADHF) is a common cause of hospitalization and mortality worldwide. This study explores the epidemiology and prognostic factors of ADHF in Cameroonian patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This was a retrospective study conducted between January 2003 and December 2013 from the medical files of patients followed at the intensive care and cardiovascular units of Douala General Hospital in Cameroon. Clinical, electrocardiographic, echocardiographic, and biological data were collected from 142 patients (58.5% men; mean age 58 \u00b1 14 years) hospitalized for ADHF with reduced ejection fraction (HFrEF), whose left ventricular ejection fraction was &amp;lt;50%, or alternatively whose shortening fraction was &amp;lt;28%, both assessed by echocardiography. The commonest risk factors associated with HFrEF were hypertension (59.2%), diabetes mellitus (16.2%), tobacco use (14.1%), and dyslipidaemia (7.7%), respectively. The major causes of HF in hospitalized patients were hypertensive heart disease (40%, n = 57); hypertrophic cardiomyopathy (33.8%, n = 48); and ischemic heart disease (21.8%, n = 31). The most frequent comorbid conditions were atrial fibrillation (25.4%, n = 36) and chronic kidney disease (18.3%, n = 26). Major biological abnormalities included increased bilirubinemia &amp;gt;12 mg\/L (87.5%, n = 124); hyperuricaemia &amp;gt;70 mg\/L (84.9%, n = 121); elevated serum creatinine (65.6%, n = 93); anaemia (59.1%, n = 84); hyperglycaemia on admission &amp;gt;1.8 g\/L (42.3%, n = 60); and hyponatraemia &amp;lt;135 mEq\/L (26.8%, n = 38). At admission, 33.8% (n = 48) of patients had no pharmacological treatment for HF. The most frequently used therapies upon admission included furosemide (50%, n = 71), angiotensin-converting enzyme inhibitors (ACEIs; 40.1%, n = 57); spironolactone (35.2%, n = 50); digoxin (26%, n = 37); beta-blockers (17.7%, n = 25); angiotensin-receptor blockers (ARBs; 7%, n = 10); and nitrates (7.0%). The overall in-hospital mortality rate was 20.4%. Factors associated with poor prognosis were systolic blood pressure &amp;lt;90 mmHg [odds ratio (OR) 3.88; confidence interval (CI) 1.36\u201311.05, P = 0.011], left ventricular ejection fraction &amp;lt;20% (OR 7.48; CI 2.84\u201319.71, P &amp;lt; 0.001), decreased renal function (OR 1.03; CI 1.00\u20131.05, P = 0.026), dobutamine use for cardiogenic shock (OR 2.74;CI 1.00\u20137.47, P = 0.049), pleural fluid effusion (OR 3.46; CI 1.07\u201311.20, P = 0.038), and prothrombin time &amp;lt;50% (OR 3.60; CI 1.11\u201311.68, P = 0.033). The use of ACEIs\/ARBs was associated with reduced in-hospital mortality rate (OR 0.17; CI 0.02\u20130.81, P = 0.006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hypertensive heart disease, hypertrophic cardiomyopathy, and ischemic heart disease are the commonest causes of HF in this Cameroonian population. ADHF is associated with high in-hospital mortality in Cameroon. Hypotension, severe left ventricular systolic dysfunction, renal function impairment, and dobutamine administration were associated with worst acute HF outcomes. ACEIs\/ARBs use was associated with improved survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13098","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T03:20:17Z","timestamp":1606101617000},"page":"481-488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Epidemiology of Acutely Decompensated Systolic Heart Failure Over the 2003\u20132013 Decade in Douala General Hospital, Cameroon"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6701-8764","authenticated-orcid":false,"given":"Daniel","family":"Lemogoum","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Pharmaceutical Sciences, University of Douala , Douala ,","place":["Cameroon"]},{"name":"Cameroon Heart Institute, Cameroon Heart Foundation , Douala ,","place":["Cameroon"]},{"name":"Department of Cardiology, ULB-Erasme Hospital, Free Brussels University , Brussels ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9licit\u00e9","family":"Kamdem","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmaceutical Sciences, University of Douala , Douala ,","place":["Cameroon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamadou","family":"Ba","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaounde , Yaounde ,","place":["Cameroon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Ngatchou","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmaceutical Sciences, University of Douala , Douala ,","place":["Cameroon"]},{"name":"Cameroon Heart Institute, Cameroon Heart Foundation , Douala ,","place":["Cameroon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Hye Ndindjock","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmaceutical Sciences, University of Douala , Douala ,","place":["Cameroon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anasthase","family":"Dzudie","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaounde , Yaounde ,","place":["Cameroon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Monkam","sequence":"additional","affiliation":[{"name":"Douala General Hospital , Douala ,","place":["Cameroon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidick","family":"Mouliom","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmaceutical Sciences, University of Douala , Douala ,","place":["Cameroon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel P.","family":"Hermans","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, Cliniques Universitaires St-Luc, Universit\u00e9 Catholique de Louvain , Brussels ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2528-9122","authenticated-orcid":false,"given":"Elys\u00e9e Claude","family":"Bika Lele","sequence":"additional","affiliation":[{"name":"Cameroon Heart Institute, Cameroon Heart Foundation , Douala ,","place":["Cameroon"]},{"name":"Unit\u00e9 de Physiologie et de M\u00e9decine des APS, Facult\u00e9 des Sciences, University of Douala , BP: 7064, Douala ,","place":["Cameroon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"van de Borne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, ULB-Erasme Hospital, Free Brussels University , Brussels ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,11,22]]},"reference":[{"key":"2026012114040236300_ehf213098-bib-0001","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1002\/ejhf.813","article-title":"Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry","volume":"19","author":"Chioncel","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026012114040236300_ehf213098-bib-0002","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/nrcardio.2010.165","article-title":"Epidemiology and risk profile of heart failure","volume":"8","author":"Bui","year":"2011","journal-title":"Nat Rev Cardiol"},{"key":"2026012114040236300_ehf213098-bib-0003","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1016\/j.jacc.2019.03.478","article-title":"ACC\/AHA versus ESC guidelines on heart failure: JACC guideline comparison","volume":"73","author":"van derMeer","year":"2019","journal-title":"Am Coll Cardiol"},{"key":"2026012114040236300_ehf213098-bib-0004","first-page":"P9","article-title":"Clinical epidemiology of heart failure: public and private health burden","volume":"19","author":"McMurray","year":"1998","journal-title":"Eur Heart J"},{"key":"2026012114040236300_ehf213098-bib-0005","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1161\/CIR.0000000000000366","article-title":"Executive summary: heart disease and stroke statistics\u20142016 update","volume":"133","author":"Mozaffarian","year":"2016","journal-title":"Circulation"},{"key":"2026012114040236300_ehf213098-bib-0006","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/bcpt.12784","article-title":"Ivabradine: current and future treatment of heart failure","volume":"121","author":"Thorup","year":"2017","journal-title":"Basic Clin Pharmacol Toxicol"},{"key":"2026012114040236300_ehf213098-bib-0007","doi-asserted-by":"crossref","first-page":"244","DOI":"10.21037\/cdt.2019.08.03","article-title":"An overview of heart failure in low- and middle-income countries","volume":"10","author":"Agbor","year":"2020","journal-title":"Cardiovasc Diagn Ther"},{"key":"2026012114040236300_ehf213098-bib-0008","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1001\/archinternmed.2012.3310","article-title":"The causes, treatment, and outcome of acute heart failure in 1006 Africans from 9 countries: results of the sub-Saharan Africa Survey of Heart Failure","volume":"172","author":"Damasceno","year":"2012","journal-title":"Arch Intern Med"},{"key":"2026012114040236300_ehf213098-bib-0009","doi-asserted-by":"crossref","first-page":"94","DOI":"10.7196\/SAMJ.2018.v108i2.12519","article-title":"Clinical characteristics and causes of heart failure, adherence to treatment guidelines, and mortality of patients with acute heart failure: experience at Groote Schuur Hospital, Cape Town, South Africa","volume":"108","author":"Szymanski","year":"2018","journal-title":"S Afr Med J"},{"key":"2026012114040236300_ehf213098-bib-0010","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2174\/1573403X11309020008","article-title":"Heart failure in sub-Saharan Africa","volume":"9","author":"Bloomfield","year":"2013","journal-title":"Curr Cardiol Rev"},{"key":"2026012114040236300_ehf213098-bib-0011","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.ijcard.2017.12.048","article-title":"Heart failure in sub-Saharan Africa: a contemporaneous systematic review and meta-analysis","volume":"257","author":"Agbor","year":"2018","journal-title":"Int J Cardiol"},{"key":"2026012114040236300_ehf213098-bib-0012","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.ejheart.2008.02.009","article-title":"Chronic heart failure, selected risk factors and co-morbidities among adults treated for hypertension in a cardiac referral hospital in Cameroon","volume":"10","author":"Dzudie","year":"2008","journal-title":"Eur J Heart Fail"},{"key":"2026012114040236300_ehf213098-bib-0013","doi-asserted-by":"crossref","first-page":"123","DOI":"10.2147\/VHRM.S2321","article-title":"Heart failure in sub-Saharan Africa: a literature review with emphasis on individuals with diabetes","volume":"4","author":"Kengne","year":"2008","journal-title":"Vasc Health Risk Manag"},{"key":"2026012114040236300_ehf213098-bib-0014","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1093\/eurjhf\/hft073","article-title":"The burden of heart failure in Africa","volume":"15","author":"Cotter","year":"2013","journal-title":"Eur J Heart Fail"},{"key":"2026012114040236300_ehf213098-bib-0015","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.ancard.2005.04.014","article-title":"A new look at adult chronic heart failure in Africa in the age of the Doppler echocardiography: experience of the medicine department at Yaounde General Hospital","volume":"54","author":"Kingue","year":"2005","journal-title":"Ann Cardiol Angeiol"},{"key":"2026012114040236300_ehf213098-bib-0016","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"},{"key":"2026012114040236300_ehf213098-bib-0017","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1161\/CIRCULATIONAHA.109.192666","article-title":"Executive summary: heart disease and stroke statistics\u20142010 update: a report from the American Heart Association","volume":"121","author":"Lloyd-Jones","year":"2010","journal-title":"Circulation"},{"key":"2026012114040236300_ehf213098-bib-0018","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1001\/jama.293.5.572","article-title":"Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis","volume":"293","author":"Fonarow","year":"2005","journal-title":"JAMA"},{"key":"2026012114040236300_ehf213098-bib-0019","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.amjcard.2007.11.061","article-title":"Heart failure incidence and survival (from the Atherosclerosis Risk in Communities study)","volume":"101","author":"Loehr","year":"2008","journal-title":"Am J Cardiol"},{"key":"2026012114040236300_ehf213098-bib-0020","doi-asserted-by":"crossref","first-page":"112","DOI":"10.5830\/CVJA-2016-067","article-title":"Presentation and mortality of patients hospitalized with acute heart failure in Botswana","volume":"28","author":"Mwita","year":"2017","journal-title":"Cardiovasc J Afr"},{"key":"2026012114040236300_ehf213098-bib-0021","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1471-2261-13-54","article-title":"Hypertension awareness, treatment and control in Africa: a systematic review","volume":"13","author":"Kayima","year":"2013","journal-title":"BMC Cardiovasc Disord"},{"key":"2026012114040236300_ehf213098-bib-0022","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/HJH.0000000000001513","article-title":"Prevalence, awareness, treatment, and control of hypertension among rural and urban dwellers of the Far North Region of Cameroon","volume":"36","author":"Lemogoum","year":"2018","journal-title":"J Hypertens"},{"key":"2026012114040236300_ehf213098-bib-0023","first-page":"419","article-title":"Etiologic and nosologic considerations apropos of 574 cases of cardiac decompensation in Conakry","volume":"37","author":"Fofana","year":"1988","journal-title":"Ann Cardiol Angeiol"},{"key":"2026012114040236300_ehf213098-bib-0024","first-page":"253","article-title":"A three-year clinical review of the impact of angiotensin converting enzyme inhibitors on the intra hospital mortality of congestive heart failure in Nigerians","volume":"42","author":"Adewole","year":"1996","journal-title":"Cent Afr J Med"},{"key":"2026012114040236300_ehf213098-bib-0025","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1002\/ejhf.103","article-title":"Renal dysfunction in African patients with acute heart failure","volume":"16","author":"Sani","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2026012114040236300_ehf213098-bib-0026","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.amjcard.2004.06.041","article-title":"Effect of elevated admission serum creatinine and its worsening on outcome in hospitalized patients with decompensated heart failure","volume":"94","author":"Akhter","year":"2004","journal-title":"Am J Cardiol"},{"key":"2026012114040236300_ehf213098-bib-0027","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1093\/eurheartj\/eht386","article-title":"Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis","volume":"35","author":"Damman","year":"2014","journal-title":"Eur Heart J"},{"key":"2026012114040236300_ehf213098-bib-0028","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1016\/j.jacc.2005.11.084","article-title":"Renal impairment and outcomes in heart failure: systematic review and meta-analysis","volume":"47","author":"Smith","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"2026012114040236300_ehf213098-bib-0029","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1093\/eurheartj\/ehi859","article-title":"Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: results of the prospective outcomes study in heart failure (POSH)","volume":"27","author":"Cowie","year":"2006","journal-title":"Eur Heart J"},{"key":"2026012114040236300_ehf213098-bib-0030","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.ejheart.2008.01.011","article-title":"Worsening renal function in patients hospitalized for acute heart failure: clinical implications and prognostic significance","volume":"10","author":"Metra","year":"2008","journal-title":"Eur J Heart Fail"},{"key":"2026012114040236300_ehf213098-bib-0031","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/ejhf.30","article-title":"Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey","volume":"16","author":"vanDeursen","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2026012114040236300_ehf213098-bib-0032","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s00392-017-1137-7","article-title":"Epidemiology of heart failure in Germany: a retrospective database study","volume":"106","author":"St\u00f6rk","year":"2017","journal-title":"Clin Res Cardiol"},{"key":"2026012114040236300_ehf213098-bib-0033","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1056\/NEJMoa031681","article-title":"Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea","volume":"350","author":"Mueller","year":"2004","journal-title":"N Engl J Med"},{"key":"2026012114040236300_ehf213098-bib-0034","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1056\/NEJM199209033271003","article-title":"Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions","volume":"327","author":"The SOLVD Investigators","year":"1992","journal-title":"N Engl J Med"},{"key":"2026012114040236300_ehf213098-bib-0035","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/S0140-6736(03)14284-5","article-title":"Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial","volume":"362","author":"Granger","year":"2003","journal-title":"Lancet"},{"key":"2026012114040236300_ehf213098-bib-0036","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s11739-011-0601-z","article-title":"Prevalence and prognostic role of anaemia in patients with acute heart failure and preserved or depressed ventricular function","volume":"8","author":"Tarantini","year":"2013","journal-title":"Intern Emerg Med"},{"key":"2026012114040236300_ehf213098-bib-0037","doi-asserted-by":"crossref","first-page":"29060","DOI":"10.3390\/ijms161226147","article-title":"Use of inotropic agents in treatment of systolic heart failure","volume":"16","author":"Tariq","year":"2015","journal-title":"Int J Mol Sci"},{"key":"2026012114040236300_ehf213098-bib-0038","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1161\/CIRCHEARTFAILURE.114.001778","article-title":"Clinical characteristics and outcomes of intravenous inotropic therapy in advanced heart failure","volume":"8","author":"Hashim","year":"2015","journal-title":"Circ Heart Fail"},{"key":"2026012114040236300_ehf213098-bib-0039","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S0002-8703(99)70250-4","article-title":"Continuous intravenous dobutamine is associated with an increased risk of death in patients with advanced heart failure: insights from the Flolan International Randomized Survival Trial (FIRST)","volume":"138","author":"O'Connor","year":"1999","journal-title":"Am Heart J"},{"key":"2026012114040236300_ehf213098-bib-0040","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s40256-015-0134-3","article-title":"Dobutamine therapy is associated with worse clinical outcomes compared with nesiritide therapy for acute decompensated heart failure: a systematic review and meta-analysis","volume":"15","author":"Wang","year":"2015","journal-title":"Am J Cardiovasc Drugs"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13098","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13098","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/1\/481\/65798695\/eschf_8_1_481.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/1\/481\/65798695\/eschf_8_1_481.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:04:24Z","timestamp":1769022264000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/8\/1\/481\/8369309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,22]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,11,22]]},"published-print":{"date-parts":[[2021,2,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13098","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,2]]},"published":{"date-parts":[[2020,11,22]]},"assertion":[{"value":"2020-07-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}