{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T06:35:28Z","timestamp":1770532528896,"version":"3.49.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1565,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Development of Therapeutic Dosies Forms Thematic Programme of the University of Debrecen","award":["GINOP-2.3.2-15-2016-00043"],"award-info":[{"award-number":["GINOP-2.3.2-15-2016-00043"]}]},{"name":"Ministry of Innovation and Technology in Hungary","award":["NKFIH-1150-6\/2019"],"award-info":[{"award-number":["NKFIH-1150-6\/2019"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>While sympathetic overactivity in heart failure (HF) with reduced ejection fraction (HFrEF; EF &amp;lt; 40%) is well-documented, it is ill-defined in patients with mildly reduced EF (HFmrEF; EF 40\u201349%). Furthermore, the significance of ischaemic versus non-ischaemic aetiology in sympathetic activation is also unclear and has yet to be studied in HF. Our goal was to compare muscle sympathetic nerve activity (MSNA) in HFmrEF and HFrEF patients and in healthy subjects, as well as to elucidate the influence of the underlying disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Twenty-three HFrEF (age 58 \u00b1 10 years), 33 HFmrEF patients (age 61 \u00b1 10 years), including 11 subjects with non-ischaemic cardiomyopathy in each HF groups and 10 healthy controls (age 55 \u00b1 10 years), were studied. MSNA\u2014detected by peroneal microneurography, continuous arterial pressure, and ECG\u2014was recorded. MSNA frequency (burst\/min) and incidence (burst\/100 cycles) were calculated. Association with the patients' characteristics were assessed, and aetiology-based comparisons were performed. Burst frequency demonstrated a significant stepwise increase in both HFmrEF (41 \u00b1 11 burst\/min) and HFrEF (58 \u00b1 17 burst\/min, P &amp;lt; 0.001) patients as compared with controls (27 \u00b1 9; P &amp;lt; 0.001 for both HF groups). Similarly, burst incidences were 66 \u00b1 17, 82 \u00b1 15, and 36 \u00b1 10 burst\/100 cycles in HFmrEF, HFrEF patients, and in healthy controls, respectively (P &amp;lt; 0.001 for all). Burst frequencies in HF patients showed significant correlation with NT-proBNP levels, and significant inverse correlations with the subjects' mean RR intervals, stroke volumes, pulse pressures, and EF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Muscle sympathetic nerve activity parameters indicated significant sympathetic activation in both HFmrEF and HFrEF patients as compared with healthy controls with no difference in relation to ischaemic versus non-ischaemic aetiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13580","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T18:41:14Z","timestamp":1631040074000},"page":"5112-5120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sympathetic Activation in Heart Failure with Reduced and Mildly Reduced Ejection Fraction: The Role of Aetiology"],"prefix":"10.1093","volume":"8","author":[{"given":"R\u00e9ka","family":"Urbancsek","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, University of Debrecen , M\u00f3ricz Zsigmond k\u00f6r\u00fat 22, Debrecen, 4032 ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Csan\u00e1di","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, University of Debrecen , M\u00f3ricz Zsigmond k\u00f6r\u00fat 22, Debrecen, 4032 ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ildik\u00f3 No\u00e9mi","family":"Forg\u00e1cs","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, University of Debrecen , M\u00f3ricz Zsigmond k\u00f6r\u00fat 22, Debrecen, 4032 ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T\u00edmea Bianka","family":"Papp","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, University of Debrecen , M\u00f3ricz Zsigmond k\u00f6r\u00fat 22, Debrecen, 4032 ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judit","family":"Bocz\u00e1n","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Neurology, University of Debrecen , Debrecen ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judit","family":"Barta","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, University of Debrecen , M\u00f3ricz Zsigmond k\u00f6r\u00fat 22, Debrecen, 4032 ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Csaba","family":"Jenei","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, University of Debrecen , M\u00f3ricz Zsigmond k\u00f6r\u00fat 22, Debrecen, 4032 ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Nagy","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, University of Debrecen , M\u00f3ricz Zsigmond k\u00f6r\u00fat 22, Debrecen, 4032 ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Rudas","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, University of Szeged , Szeged ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"2026012114202662300_ehf213580-bib-0001","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1002\/ejhf.159","article-title":"The middle child in heart failure: heart 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