{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T08:37:28Z","timestamp":1775032648278,"version":"3.50.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":883,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Korean government","award":["5-20225A0154-00126"],"award-info":[{"award-number":["5-20225A0154-00126"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although various non-invasive cardiac examinations are known to be predictive of long-term outcomes in patients with heart failure (HF), combining them properly would provide synergism. We aimed to show that non-invasive cardiac assessments targeting left ventricular filling pressure (LVFP), left atrial remodelling, and exercise capacity would provide better prognostication in combination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This prospective observational study included consecutive hospitalized stage A\u2013C HF patients evaluated with N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiography including two-dimensional speckle tracking, and cardiopulmonary exercise testing. According to NT-proBNP and echocardiographic semi-quantitative LVFP grading (Echo-LVFP), patients were classified into three LVFP groups: normal range of both Echo-LVFP and NT-proBNP (Group 1), normal range of Echo-LVFP but elevated NT-proBNP (Group 2), and elevated Echo-LVFP and NT-proBNP (Group 3). The adverse outcome was defined as a composite of cardiovascular death, non-fatal acute coronary syndrome, acute stroke, or HF-related hospitalization. Among 224 HF patients (mean age of 63.8 \u00b1 11.6 years, 158 men) analysed, 160 (71.4%) had ischaemic aetiology. During the follow-up of 18.6 \u00b1 9.8 months, event-free survival in Group 2 (n = 56, age of 65.4 \u00b1 12.4) was better than that in Group 3 (n = 45, age of 68.5 \u00b1 11.5) but worse than that in Group 1 (n = 123, mean age of 61.4 \u00b1 10.5) (log-rank P &amp;lt; 0.001). Mechanical left atrial dysfunction (peak longitudinal strain &amp;lt;28%) (adjusted hazard ratio 5.69, 95% confidence interval 1.06\u20134.48) and limited exercise capacity (peak VO2 per +5 mL\/kg\/min) (adjusted hazard ratio 0.63, 95% confidence interval 0.46\u20130.87) were also predictable adverse outcomes. Serial addition of peak VO2 and left atrial strain to the model incrementally enhanced the predictive power of LVFP-based risk stratification for adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The combination of NT-proBNP and Echo-LVFP could be used to predict adverse outcomes in patients with HF of various stages. Left atrial mechanics and exercise capacity are incremental to prognostication. Non-invasive test findings could be strategically combined to provide an integrative profile of cardiac performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14425","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:49:23Z","timestamp":1686703763000},"page":"2567-2576","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Strategic Multimodal Non-Invasive Assessment of Cardiac Performance in Patients with Heart Failure"],"prefix":"10.1093","volume":"10","author":[{"given":"Mi-Jeong","family":"Kim","sequence":"first","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea , Seoul ,","place":["Korea"]},{"name":"Division of Cardiology, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Sun","family":"Cho","sequence":"additional","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea , Seoul ,","place":["Korea"]},{"name":"Division of Cardiology, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-5503","authenticated-orcid":false,"given":"Kyusup","family":"Lee","sequence":"additional","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea , Seoul ,","place":["Korea"]},{"name":"Division of Cardiology, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woojin","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaeryeon","family":"Ohn","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myunhee","family":"Lee","sequence":"additional","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea , Seoul ,","place":["Korea"]},{"name":"Division of Cardiology, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae-Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea , Seoul ,","place":["Korea"]},{"name":"Division of Cardiology, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae-Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea , Seoul ,","place":["Korea"]},{"name":"Division of Cardiology, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahn-Won","family":"Park","sequence":"additional","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea , Seoul ,","place":["Korea"]},{"name":"Division of Cardiology, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"2026012114090674200_ehf214425-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 Failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2026012114090674200_ehf214425-bib-0002","first-page":"e895","article-title":"2022 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