{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:14:41Z","timestamp":1787984081456,"version":"build-2784847793"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":986,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2020M673016"],"award-info":[{"award-number":["2020M673016"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"name":"China National Postdoctoral Program for Innovative Talents","award":["82100273"],"award-info":[{"award-number":["82100273"]}]},{"name":"China National Postdoctoral Program for Innovative Talents","award":["BX20200400"],"award-info":[{"award-number":["BX20200400"]}]},{"name":"Clinical Research Center Project of Department of Science & Technology of Guizhou Province","award":["(2017) 5405"],"award-info":[{"award-number":["(2017) 5405"]}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2020M673016"],"award-info":[{"award-number":["2020M673016"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014718","name":"Innovative Research Group Project of the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100273"],"award-info":[{"award-number":["82100273"]}],"id":[{"id":"10.13039\/100014718","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014718","name":"Innovative Research Group Project of the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["BX20200400"],"award-info":[{"award-number":["BX20200400"]}],"id":[{"id":"10.13039\/100014718","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Liver fibrosis scores (LFSs) are non-invasive and effective tools for estimating cardiovascular risks. To better understand the advantages and limitations of currently available LFSs, we determined to compare the predictive values of LFSs in heart failure with preserved ejection fraction (HFpEF) for primary composite outcome, atrial fibrillation (AF), and other clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This was a secondary analysis of the TOPCAT trial, and 3212 HFpEF patients were enrolled. Five LFSs, namely, non-alcoholic fatty liver disease fibrosis score (NFS), fibrosis-4 score (FIB-4), BARD, aspartate aminotransferase (AST)\/alanine aminotransferase (ALT) ratio, and Health Utilities Index (HUI) scores were adopted. Cox proportional hazard model and competing risk regression model were performed to assess the associations between LFSs and outcomes. The discriminatory power of each LFS was evaluated by calculating the area under the curves (AUCs). During a median follow-up of 3.3 years, a 1-point increase in the NFS [hazard ratio (HR) 1.10; 95% confidence interval (CI) 1.04\u20131.17], BARD (HR 1.19; 95% CI 1.10\u20131.30), and HUI (HR 1.44; 95% CI 1.09\u20131.89) scores was associated with an increased risk of primary outcome. Patients with high levels of NFS (HR 1.63; 95% CI 1.26\u20132.13), BARD (HR 1.64; 95% CI 1.25\u20132.15), AST\/ALT ratio (HR 1.30; 95% CI 1.05\u20131.60), and HUI (HR 1.25; 95% CI 1.02\u20131.53) were at an increased risk of primary outcome. Subjects who developed AF were more likely to have high NFS (HR 2.21; 95% CI 1.13\u20134.32). High levels of NFS and HUI scores were a significant predictor of any hospitalization and hospitalization for heart failure. The AUCs for the NFS in predicting primary outcome (0.672; 95% CI 0.642\u20130.702) and incident of AF (0.678; 95% CI 0.622\u20130.734) were higher than other LFSs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In light of these findings, NFS appears to have superior predictive and prognostic utility compared with AST\/ALT ratio, FIB-4, BARD, and HUI scores. Clinical trial registration: (https:\/\/clinicaltrials.gov). Unique identifier: NCT00094302.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14336","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T01:18:35Z","timestamp":1677806315000},"page":"1771-1780","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Comparison of Liver Fibrosis Scores for Predicting Mortality and Morbidity in Heart Failure with Preserved Ejection Fraction"],"prefix":"10.1093","volume":"10","author":[{"given":"Yalin","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Cardiology, Guizhou Provincial People's Hospital , Guiyang ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yugang","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University , Guangzhou ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University , Guangzhou ,","place":["China"]},{"name":"National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University , Guangzhou ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University , Guangzhou ,","place":["China"]},{"name":"National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-0158","authenticated-orcid":false,"given":"Wengen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University , Guangzhou ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University , Guangzhou ,","place":["China"]},{"name":"National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"2026012114102111600_ehf214336-bib-0001","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart 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