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This may contribute to challenges with efficient enrolment and questions regarding the generalizability of trial findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients with HFmrEF\/HFpEF from a large US healthcare system were identified through a computable phenotype applied in linked imaging and electronic health record databases. We evaluated shared eligibility criteria from five recent\/ongoing HFmrEF\/HFpEF trials (PARAGON-HF, EMPEROR-Preserved, DELIVER, FINE-ARTS, and SPIRRIT-HFpEF) and compared clinical and echocardiographic features as well as outcomes between trial-eligible and trial-ineligible patients. Among 5552 patients with HFpEF\/HFmrEF, 792 (14%) were eligible for trial consideration, having met all criteria assessed. Causes of ineligibility included lack of recent loop diuretics (37%), significant pulmonary disease (24%), reduced estimated glomerular filtration rate (17%), recent stroke\/transient ischaemic attack (13%), or low natriuretic peptides (12%); 53% of ineligible patients had &amp;gt;1 reason for exclusion. Compared with eligible patients, ineligible patients were younger (age 71 vs. 75 years, P &amp;lt; 0.001) with higher rates of coronary artery disease (66% vs. 59%, P &amp;lt; 0.001) and peripheral vascular disease (40% vs. 33%, P &amp;lt; 0.001), but less mitral regurgitation, lower E\/e\u2032 ratio, and smaller left atrial sizes. Both eligible and ineligible patients demonstrated high rates of structural heart disease consistent with HFpEF [elevated left atrial size or left ventricular (LV) hypertrophy\/increased LV mass], although this was slightly higher among eligible patients (95% vs. 92%, P = 0.001). The two cohorts demonstrated similar LV global longitudinal strain along with a similar prevalence of atrial fibrillation\/flutter, hypertension, and obesity. Ineligible patients had similar all-cause mortality (33% vs. 33% at 3 years) to those eligible but lower rates of heart failure hospitalization (20% vs. 28% at 3 years, P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among patients with HFmrEF\/HFpEF from a large health system, approximately one in seven were eligible for major trials based on key criteria applied through a clinical computable phenotype. These findings highlight the large proportion of patients with HFmrEF\/HFpEF ineligible for contemporary trials for whom the generalizability of trial findings may be questioned and further investigation would be beneficial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14777","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T01:48:53Z","timestamp":1715910533000},"page":"2813-2824","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Implications of Trial Eligibility in Patients with Heart Failure with Mildly Reduced or Preserved Ejection Fraction"],"prefix":"10.1093","volume":"11","author":[{"given":"Anthony E.","family":"Peters","sequence":"first","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine , Durham, NC ,","place":["USA"]},{"name":"Duke Clinical Research Institute , Durham, NC 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,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine , Durham, NC ,","place":["USA"]},{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary Michael","family":"Felker","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine , Durham, NC ,","place":["USA"]},{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Mentz","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine , Durham, NC ,","place":["USA"]},{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam D.","family":"DeVore","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine , Durham, NC ,","place":["USA"]},{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"2026012113131915200_ehf214777-bib-0001","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1161\/CIRCULATIONAHA.119.041886","article-title":"Research priorities for heart failure with preserved ejection fraction: National Heart, Lung, and Blood Institute Working Group summary","volume":"141","author":"Shah","year":"2020","journal-title":"Circulation"},{"key":"2026012113131915200_ehf214777-bib-0002","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1093\/eurjhf\/hfq121","article-title":"Epidemiology and clinical 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