{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:15:30Z","timestamp":1780647330238,"version":"3.54.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":577,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,3,17]],"date-time":"2024-03-17T00:00:00Z","timestamp":1710633600000},"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":[[2024,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Compensatory mechanisms in heart failure (HF) are triggered to maintain adequate cardiac output. Among them, hyperactivation of the sympathetic nervous system (SNS) is one of the main ones and carries a worse prognosis. The pupillary reflex depends on the SNS, and we can evaluate it through pupillometry. The aim of the study was to compare the differences in pupillary reflex between patients with acute HF and controls and to analyse whether these differences in pupillary reflex may offer a new and easy prognostic factor in such patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We prospectively and consecutively included 107 patients admitted with decompensated HF. Quantitative pupillometry was performed with the NeuroOptics pupillometry during the first 24 h after admission and prior to discharge. The results were compared with those of a group of 100 healthy volunteers who also underwent pupillometry. The maximum baseline pupil size (MBPS) and the minimum pupil diameter (MPD) were measured. Patients with decompensated HF have a higher MBPS (3.64 \u00b1 0.81) and higher MPD (2.60 \u00b1 0.58) than HF patients at discharge and in the control group (P-value = 0.01 and 0.01, respectively). Also, HF patients presented an improvement in pupillometric values at discharge [MBPS (3.47 \u00b1 0.79) and MPD (2.51 \u00b1 0.58)] and showed no differences compared with the control group [MBPS (3.34 \u00b1 0.82) and MPD (2.40 \u00b1 0.53)] (P-value = 0.19 and 0.14, respectively). In addition, MBPS provides a good independent predictor of in-hospital and 1 month mortality in patients admitted with HF. Six patients (5.61%) died during hospital admission, and 11 patients (10.2%) died in the first month after discharge. Also, four patients (3.74%) were readmitted within 1 month of discharge. The receiver operating characteristic (ROC) curve for predicting in-hospital mortality through MBPS was 0.823. No patient with an MBPS &amp;lt; 3.7 mm died. The ROC curve for predicting combined mortality or readmission within the first month for MBPS was 0.698.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pupillometry may be a new, non-invasive, and simple tool to determine the status of SNS, help in the prognostic stratification of acute HF patients, and improve therapeutic management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14746","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T02:39:04Z","timestamp":1710729544000},"page":"1947-1954","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pupil Reflex as a Marker of Activity and Prognosis in Heart Failure: A Longitudinal and Prospective Study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4497-5542","authenticated-orcid":false,"given":"Margarita","family":"Zamorano","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Guadalajara , Calle Donante de Sangre, Guadalajara ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Manuel","family":"Monteagudo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ram\u00f3n y Cajal University Hospital , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ram\u00f3n y Cajal University Hospital , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Rayo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ram\u00f3n y Cajal University Hospital , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ram\u00f3n y Cajal University Hospital , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Castillo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ram\u00f3n y Cajal University Hospital , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ram\u00f3n y Cajal University Hospital , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"de la Villa","sequence":"additional","affiliation":[{"name":"Physiology Unit, Department of Systems Biology, School of Medicine, University of Alcal\u00e1 , Madrid ,","place":["Spain"]},{"name":"Visual Neurophysiology Group-IRYCIS , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0487-1749","authenticated-orcid":false,"given":"Jose Luis","family":"Zamorano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ram\u00f3n y Cajal University Hospital , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,17]]},"reference":[{"key":"2026012113133430600_ehf214746-bib-0001","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.cardfail.2021.01.022","article-title":"Universal definition and classification of heart failure: A report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart 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