{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T11:22:09Z","timestamp":1769080929932,"version":"3.49.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":478,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82205236"],"award-info":[{"award-number":["82205236"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"First Affiliated Hospital of Guangzhou University of Chinese Medicine","award":["[2023]186"],"award-info":[{"award-number":["[2023]186"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82205236"],"award-info":[{"award-number":["82205236"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Patients with heart valvular regurgitation is increasing; early screening of potential patients developing heart failure (HF) is crucial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From 1 November 2019 to 31 October 2023, a total of 509 patients with heart valvular regurgitation hospitalized in the Department of Cardiovascular Disease of the First Affiliated Hospital of Guangzhou University of Traditional Medicine were enrolled. Three hundred fifty-six cases were selected as the training set for modelling, and 153 cases were selected as the validation set for the internal validation of the model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A predictive model of heart failure with the following nine risk factors was developed: atrial fibrillation (AF), pulmonary infection (PI), coronary artery disease (CAD), creatinine (CREA), low-density lipoprotein cholesterol (LDL-C), d-dimer (DDi), left ventricular end-diastolic diameter (LVEDd), mitral regurgitation (MR) and aortic regurgitation (AR). The model was evaluated by the C-index [the training set: area under curve (AUC) 0.937, 95% confidence interval (CI) 0.911\u20130.963; the validation set: AUC 0.928, 95% CI 0.890\u20130.967]. Hosmer\u2013Lemeshow test (the training set: \u03c72 10.908, P = 0.207; the validation set: \u03c72 4.896, P = 0.769) revealed that both the training and validation sets performed well in terms of model differentiation and calibration. Decision curve analysis showed that both the training and validation sets have higher net benefits, indicating that the model has good utility. Ten-fold cross-validation showed that the training set has high similarities with the validation set, which means that the model has good stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The occurrence of heart failure in patients with valvular regurgitation has a significant correlation with AF, PI, CAD, CREA, LDL-C, DDi, LVEDd, MR and AR. Based on these risk factors, a prediction model for heart failure was developed and validated, which showed good differentiation and utility, high accuracy and stability, providing a method for predicting heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14899","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T03:29:48Z","timestamp":1719199788000},"page":"3242-3252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of a Prediction Model for Heart Failure in Patients with Heart Valvular Regurgitation"],"prefix":"10.1093","volume":"11","author":[{"given":"WenKang","family":"Xiao","sequence":"first","affiliation":[{"name":"Guangzhou University of Chinese Medicine , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0818-2489","authenticated-orcid":false,"given":"Jia-Lin","family":"Yuan","sequence":"additional","affiliation":[{"name":"Guangzhou University of Chinese Medicine , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"YunYi","family":"Chen","sequence":"additional","affiliation":[{"name":"Guangzhou University of Chinese Medicine , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GuiPing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease, Beijing University of Chinese Medicine Shenzhen Hospital , Shenzhen ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ChaoQiong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangzhou University of Chinese Medicine , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Shenzhen Traditional Chinese Medicine Hospital , Shenzhen ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9421-1647","authenticated-orcid":false,"given":"ChuangXiong","family":"Hong","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangzhou University of Chinese Medicine , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3463-3542","authenticated-orcid":false,"given":"Taochun","family":"Ye","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangzhou University of Chinese Medicine , Guangzhou ,","place":["China"]},{"name":"Guangdong Clinical Research Academy of Chinese Medicine , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"2026012113143697100_ehf214899-bib-0001","doi-asserted-by":"publisher","first-page":"429","DOI":"10.13201\/j.issn.1001-1439.2022.06.001","article-title":"Advances in the treatment of heart valve disease","volume":"38","author":"Dong","year":"2022","journal-title":"J Clin Cardiol"},{"issue":"1","key":"2026012113143697100_ehf214899-bib-0002","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-021-02154-8","article-title":"Current status and etiology of valvular heart disease in China: a population-based survey","volume":"21","author":"Yang","year":"2021","journal-title":"BMC Cardiovasc Disord"},{"key":"2026012113143697100_ehf214899-bib-0003","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9982569","article-title":"The evolving epidemiology of elderly with degenerative valvular heart disease:the Guangzhou (China) heart study","volume":"2021","author":"He","year":"2021","journal-title":"Biomed Res Int"},{"key":"2026012113143697100_ehf214899-bib-0004","doi-asserted-by":"publisher","first-page":"760","DOI":"10.3760\/cmaj.issn.0253-3758.2018.10.004","article-title":"Chinese guidelines for the diagnosis and treatment of heart failure 2018","volume":"46","author":"Heart Failure Group of Chinese Society of Cardiology of Chinese Medical Association","year":"2018","journal-title":"Chinese J Cardiol"},{"key":"2026012113143697100_ehf214899-bib-0005","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1038\/nrcardio.2016.25","article-title":"Epidemiology and aetiology of heart failure","volume":"13","author":"Ziaeian","year":"2016","journal-title":"Nat Rev Cardiol"},{"key":"2026012113143697100_ehf214899-bib-0006","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1056\/NEJMp078039","article-title":"Rheumatic heart disease in developing countries","volume":"357","author":"Carapetis","year":"2007","journal-title":"N Engl J Med"},{"key":"2026012113143697100_ehf214899-bib-0007","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1056\/NEJMoa065085","article-title":"Prevalence of rheumatic heart disease detected by echocardiographic screening","volume":"357","author":"Marijon","year":"2007","journal-title":"N Engl J Med"},{"key":"2026012113143697100_ehf214899-bib-0008","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of valvular heart diseases: a population-based study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet"},{"key":"2026012113143697100_ehf214899-bib-0009","doi-asserted-by":"publisher","first-page":"e38","DOI":"10.1161\/CIR.0000000000000350","article-title":"Heart disease and stroke statistics\u20142016 update:a report from the American Heart Association","volume":"133","author":"Writing Group Members","year":"2016","journal-title":"Circulation"},{"key":"2026012113143697100_ehf214899-bib-0010","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/j.rec.2022.05.006","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease: developed by the task force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"75","author":"Vahanian","year":"2022","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2026012113143697100_ehf214899-bib-0011","doi-asserted-by":"publisher","first-page":"e72","DOI":"10.1161\/CIR.0000000000000923","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"2026012113143697100_ehf214899-bib-0012","doi-asserted-by":"publisher","first-page":"2126","DOI":"10.1016\/j.jcmg.2018.11.022","article-title":"Do guideline-based indications result in an outcome penalty for patients with severe aortic regurgitation?","volume":"12","author":"de Meester","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026012113143697100_ehf214899-bib-0013","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1016\/j.jacc.2019.01.024","article-title":"Outcomes in chronic hemodynamically significant aortic regurgitation and limitations of current guidelines","volume":"73","author":"Yang","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026012113143697100_ehf214899-bib-0014","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014591","article-title":"Long-term outcomes in patients with mixed aortic valve disease and preserved left ventricular ejection fraction","volume":"9","author":"Isaza","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2026012113143697100_ehf214899-bib-0015","doi-asserted-by":"publisher","first-page":"e895","DOI":"10.1161\/CIR.0000000000001063","article-title":"2022 AHA\/ACC\/HFSA guideline for the Management of Heart Failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"2026012113143697100_ehf214899-bib-0016","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1093\/eurheartj\/ehac504","article-title":"Valvular heart disease: shifting the focus to the myocardium","volume":"44","author":"Ajmone Marsan","year":"2023","journal-title":"Eur Heart J"},{"key":"2026012113143697100_ehf214899-bib-0017","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1136\/heart.84.2.211","article-title":"Timing of aortic valve surgery","volume":"84","author":"Otto","year":"2000","journal-title":"Heart"},{"key":"2026012113143697100_ehf214899-bib-0018","doi-asserted-by":"publisher","first-page":"1854","DOI":"10.1016\/j.jacc.2012.02.093","article-title":"Calcific aortic stenosis: a disease of the valve and the myocardium","volume":"60","author":"Dweck","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2026012113143697100_ehf214899-bib-0019","doi-asserted-by":"publisher","first-page":"e57","DOI":"10.1016\/j.jacc.2014.02.536","article-title":"2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines [published correction appears in J Am Coll Cardiol. 2014 Jun 10;63(22):2489. Dosage error in article text]","volume":"63","author":"Nishimura","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026012113143697100_ehf214899-bib-0020","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1056\/NEJMra1313875","article-title":"Aortic-valve stenosis\u2014from patients at risk to severe valve obstruction","volume":"371","author":"Otto","year":"2014","journal-title":"N Engl J Med"},{"key":"2026012113143697100_ehf214899-bib-0021","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1016\/j.jacc.2015.08.038","article-title":"Arrhythmia-induced cardiomyopathies: mechanisms, recognition, and management","volume":"66","author":"Gopinathannair","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2026012113143697100_ehf214899-bib-0022","doi-asserted-by":"publisher","first-page":"3133","DOI":"10.3390\/ijms16023133","article-title":"Heart failure and atrial fibrillation: from basic science to clinical practice","volume":"16","author":"Ferreira","year":"2015","journal-title":"Int J Mol Sci"},{"key":"2026012113143697100_ehf214899-bib-0023","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.hrthm.2013.12.031","article-title":"Long-term follow-up after atrial fibrillation ablation in patients with impaired left ventricular systolic function: the importance of rhythm and rate control","volume":"11","author":"Nedios","year":"2014","journal-title":"Heart Rhythm"},{"key":"2026012113143697100_ehf214899-bib-0024","doi-asserted-by":"publisher","first-page":"2839","DOI":"10.1161\/01.CIR.0000132470.78896.A8","article-title":"Atrial fibrillation and ventricular dysfunction: a vicious electromechanical cycle","volume":"109","author":"Cha","year":"2004","journal-title":"Circulation"},{"key":"2026012113143697100_ehf214899-bib-0025","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1093\/eurheartj\/ehz786","article-title":"Atrial fibrillation and cardiac fibrosis","volume":"41","author":"Sohns","year":"2020","journal-title":"Eur Heart J"},{"key":"2026012113143697100_ehf214899-bib-0026","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.jchf.2019.03.005","article-title":"Heart failure and atrial Fibrillation, like fire and fury","volume":"7","author":"Carlisle","year":"2019","journal-title":"JACC Heart Fail"},{"key":"2026012113143697100_ehf214899-bib-0027","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1016\/j.jacc.2015.02.009","article-title":"Secondary mitral regurgitation in heart failure: pathophysiology, prognosis, and therapeutic considerations","volume":"65","author":"Asgar","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2026012113143697100_ehf214899-bib-0028","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1002\/ehf2.12287","article-title":"Mitral valve interventions in heart failure","volume":"5","author":"Lavall","year":"2018","journal-title":"ESC Heart Fail"},{"key":"2026012113143697100_ehf214899-bib-0029","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1620\/tjem.255.229","article-title":"Aortic insufficiency causes symptomatic heart failure during left ventricular assist device support","volume":"255","author":"Naganuma","year":"2021","journal-title":"Tohoku J Exp Med"},{"key":"2026012113143697100_ehf214899-bib-0030","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21093167","article-title":"Ischemic heart disease and heart failure:role of coronary ion channels","volume":"21","author":"Severino","year":"2020","journal-title":"Int J Mol Sci"},{"key":"2026012113143697100_ehf214899-bib-0031","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.1161\/01.atv.19.5.1218","article-title":"Presence of oxidized low density lipoprotein in nonrheumatic stenotic aortic valves","volume":"19","author":"Olsson","year":"1999","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2026012113143697100_ehf214899-bib-0032","first-page":"5","article-title":"Involvement of the immune system in human atherogenesis: current knowledge and unanswered questions","volume":"64","author":"Libby","year":"1991","journal-title":"Lab Invest"},{"key":"2026012113143697100_ehf214899-bib-0033","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.933215","article-title":"Edema formation in congestive heart failure and the underlying mechanisms","volume":"9","author":"Abassi","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"2026012113143697100_ehf214899-bib-0034","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1056\/NEJMcibr1913825","article-title":"Unfolding discoveries in heart failure","volume":"382","author":"Walter","year":"2020","journal-title":"N Engl J Med"},{"key":"2026012113143697100_ehf214899-bib-0035","doi-asserted-by":"publisher","DOI":"10.1016\/j.redox.2019.101161","article-title":"Short term Pm2.5 exposure caused a robust lung inflammation, vascular remodeling, and exacerbated transition from left ventricular failure to right ventricular hypertrophy","volume":"22","author":"Yue","year":"2019","journal-title":"Redox Biol"},{"key":"2026012113143697100_ehf214899-bib-0036","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1038\/nrcardio.2017.161","article-title":"The NLRP3 inflammasome in acute myocardial infarction","volume":"15","author":"Toldo","year":"2018","journal-title":"Nat Rev Cardiol"},{"key":"2026012113143697100_ehf214899-bib-0037","doi-asserted-by":"publisher","first-page":"1838","DOI":"10.1378\/chest.06-2077","article-title":"Acute pulmonary embolism is an independent predictor of adverse events in severe decompensated heart failure patients","volume":"131","author":"Darze","year":"2007","journal-title":"Chest"},{"key":"2026012113143697100_ehf214899-bib-0038","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1161\/CIRCHEARTFAILURE.109.892349","article-title":"Venous thromboembolism in hospitalized patients with heart failure: incidence, prognosis, and prevention","volume":"3","author":"Ng","year":"2010","journal-title":"Circ Heart Fail"},{"key":"2026012113143697100_ehf214899-bib-0039","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s11239-014-1101-6","article-title":"D-dimer elevation and adverse outcomes","volume":"39","author":"Halaby","year":"2015","journal-title":"J Thromb Thrombolysis"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/11\/5\/3242\/64514903\/eschf_11_5_3242.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/11\/5\/3242\/64514903\/eschf_11_5_3242.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:16:30Z","timestamp":1769019390000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/11\/5\/3242\/8271232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,24]]},"references-count":39,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,6,24]]},"published-print":{"date-parts":[[2024,10,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14899","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,6,24]]},"assertion":[{"value":"2024-02-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}