{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:16:10Z","timestamp":1780096570058,"version":"3.54.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1368,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T00:00:00Z","timestamp":1646697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","award":["SGL021\\1025"],"award-info":[{"award-number":["SGL021\\1025"]}],"id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Imperial College Biomedical Research Centre"},{"name":"Cardiovascular Research Centre and NIHR Biomedical Research Unit at Royal Brompton Hospital"},{"name":"Alexander Jansons Foundation"},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RE\/18\/6\/34217"],"award-info":[{"award-number":["RE\/18\/6\/34217"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/15\/29\/31492"],"award-info":[{"award-number":["FS\/15\/29\/31492"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/ICRF\/21\/26019"],"award-info":[{"award-number":["FS\/ICRF\/21\/26019"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","award":["SGL021\\1025"],"award-info":[{"award-number":["SGL021\\1025"]}],"id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RE\/18\/6\/34217"],"award-info":[{"award-number":["RE\/18\/6\/34217"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/15\/29\/31492"],"award-info":[{"award-number":["FS\/15\/29\/31492"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/ICRF\/21\/26019"],"award-info":[{"award-number":["FS\/ICRF\/21\/26019"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to profile the changes in non-invasive clinical, biochemical, and imaging markers during withdrawal of therapy in patients with recovered dilated cardiomyopathy, providing insights into the pathophysiology of relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Clinical, biochemical, and imaging data from patients during phased withdrawal of therapy in the randomized or single-arm cross-over phases of TRED-HF were profiled. Clinical variables were measured at each study visit and imaging variables were measured at baseline, 16 weeks, and 6 months. Amongst the 49 patients [35% women, mean age 53.6 years (standard deviation 11.6)] who withdrew therapy, 20 relapsed. Increases in mean heart rate [7.6 beats per minute (95% confidence interval, CI, 4.5, 10.7)], systolic blood pressure [6.6 mmHg (95% CI 2.7, 10.5)], and diastolic blood pressure [5.8 mmHg (95% CI 3.1, 8.5)] were observed within 4\u20138 weeks of starting to withdraw therapy. A rise in mean left ventricular (LV) mass [5.1 g\/m2 (95% CI 2.8, 7.3)] and LV end-diastolic volume [3.9 mL\/m2 (95% CI 1.1, 6.7)] and a reduction in mean LV ejection fraction [\u22124.2 (95% CI \u22126.6, \u22121.8)] were seen by 16 weeks, the earliest imaging follow-up. Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) fell immediately after withdrawing beta-blockers and only tended to increase 6 months after beginning therapy withdrawal [mean change in log NT-proBNP at 6 months: 0.2 (95% CI \u22120.1, 0.4)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Changes in plasma NT-proBNP are a late feature of relapse, often months after a reduction in LV function. A rise in heart rate and blood pressure is observed soon after withdrawing therapy in recovered dilated cardiomyopathy, typically accompanied or closely followed by early changes in LV structure and function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13872","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T03:28:32Z","timestamp":1646710112000},"page":"1616-1624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Changes in Clinical and Imaging Variables During Withdrawal of Heart Failure Therapy in Recovered Dilated Cardiomyopathy"],"prefix":"10.1093","volume":"9","author":[{"given":"Brian P.","family":"Halliday","sequence":"first","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Owen","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, London School of Hygiene and Tropical Medicine , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gregson","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, London School of Hygiene and Tropical Medicine , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Vazir","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Wassall","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohya","family":"Khalique","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrit S.","family":"Lota","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upasana","family":"Tayal","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Hammersley","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"Jones","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dudley J.","family":"Pennell","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin R.","family":"Cowie","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]},{"name":"Faculty of Life Sciences & Medicine, King's College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.F.","family":"Cleland","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]},{"name":"Robertson Centre for Biostatistics, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay K.","family":"Prasad","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre, Royal Brompton Hospital, Guy's and St Thomas' NHS Trust and National Heart Lung Institute, Imperial College , London, SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"key":"2026012114232733100_ehf213872-bib-0001","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1016\/j.jacc.2010.11.030","article-title":"Prevalence and prognostic significance of left ventricular reverse remodeling in dilated cardiomyopathy receiving tailored medical treatment","volume":"57","author":"Merlo","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026012114232733100_ehf213872-bib-0002","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1002\/ejhf.1734","article-title":"Predictors of left ventricular remodelling in patients with dilated cardiomyopathy\u2014a cardiovascular magnetic resonance study","volume":"22","author":"Tayal","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"2026012114232733100_ehf213872-bib-0003","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S0140-6736(18)32484-X","article-title":"Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial","volume":"393","author":"Halliday","year":"2019","journal-title":"Lancet"},{"key":"2026012114232733100_ehf213872-bib-0004","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1161\/CIRCULATIONAHA.113.006855","article-title":"Heart failure with recovered ejection fraction: clinical description, biomarkers, and outcomes","volume":"129","author":"Basuray","year":"2014","journal-title":"Circulation"},{"key":"2026012114232733100_ehf213872-bib-0005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/CIRCHEARTFAILURE.116.003123","article-title":"Heart failure with improved ejection fraction: clinical characteristics, correlates of recovery, and survival: results from the valsartan heart failure trial","volume":"9","author":"Florea","year":"2016","journal-title":"Circ Heart Fail"},{"key":"2026012114232733100_ehf213872-bib-0006","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.jchf.2021.03.010","article-title":"Heart rate as a marker of relapse during withdrawal of therapy in recovered dilated cardiomyopathy","volume":"9","author":"Halliday","year":"2021","journal-title":"JACC Heart Fail"},{"key":"2026012114232733100_ehf213872-bib-0007","doi-asserted-by":"crossref","first-page":"271","DOI":"10.3109\/10976640009148691","article-title":"Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance","volume":"2","author":"Bellenger","year":"2000","journal-title":"J Cardiovasc Magn Reson"},{"key":"2026012114232733100_ehf213872-bib-0008","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1016\/j.jacc.2012.01.037","article-title":"Performance of 3-dimensional echocardiography in measuring left ventricular volumes and ejection fraction: a systematic review and meta-analysis","volume":"59","author":"Dorosz","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2026012114232733100_ehf213872-bib-0009","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1093\/eurheartj\/ehi083","article-title":"Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography, cardiac magnetic resonance imaging, unenhanced and contrast-enhanced echocardiography","volume":"26","author":"Hoffmann","year":"2005","journal-title":"Eur Heart J"},{"key":"2026012114232733100_ehf213872-bib-0010","doi-asserted-by":"crossref","DOI":"10.1093\/eurheartj\/ehab663","article-title":"Obesity modifies the energetic phenotype of dilated cardiomyopathy","author":"Rayner","year":"2021","journal-title":"Eur Heart J"},{"key":"2026012114232733100_ehf213872-bib-0011","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1161\/01.CIR.96.7.2190","article-title":"Myocardial phosphocreatine-to-ATP ratio is a predictor of mortality in patients with dilated cardiomyopathy","volume":"96","author":"Neubauer","year":"1997","journal-title":"Circulation"},{"key":"2026012114232733100_ehf213872-bib-0012","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1056\/NEJMoa1110186","article-title":"Truncations of titin causing dilated cardiomyopathy","volume":"366","author":"Herman","year":"2012","journal-title":"N Engl J Med"},{"key":"2026012114232733100_ehf213872-bib-0013","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/ejhf.2063","article-title":"Myocardial remodelling after withdrawing therapy for heart failure in patients with recovered dilated cardiomyopathy: insights from TRED-HF","volume":"23","author":"Halliday","year":"2021","journal-title":"Eur J Heart Fail"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13872","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13872","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/3\/1616\/65668816\/eschf_9_3_1616.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/3\/1616\/65668816\/eschf_9_3_1616.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:29:22Z","timestamp":1769023762000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/9\/3\/1616\/8362425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,8]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,8]]},"published-print":{"date-parts":[[2022,6,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13872","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,6]]},"published":{"date-parts":[[2022,3,8]]},"assertion":[{"value":"2022-01-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}