{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:11:25Z","timestamp":1792030285544,"version":"4.4.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":1988,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2020,8,9]],"date-time":"2020-08-09T00:00:00Z","timestamp":1596931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to examine temporal changes in left ventricular (LV) structures and their prognostic impacts in patients with heart failure (HF) and preserved ejection fraction (HFpEF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In the Chronic Heart Failure Analysis and Registry in the Tohoku District-2 (CHART-2) study (n = 10\u2009219), we divided 2698 consecutive HFpEF patients (68.9\u2009\u00b1\u200912.2\u2009years, 32.1% female) into three groups by LV hypertrophy (LVH) and enlargement (LVE) at baseline: (\u2212)LVH\/(\u2212)LVE (n = 989), (+)LVH\/(\u2212)LVE (n = 1448), and (+)LVH\/(+)LVE (n = 261). We examined temporal changes in LV structures and their prognostic impacts during a median 8.7-year follow-up. From (\u2212)LVH\/(\u2212)LVE, (+)LVH\/(\u2212)LVE to (+)LVH\/(+)LVE at baseline, the incidence of the primary outcome, a composite of cardiovascular death or HF admission, significantly increased. Among 1808 patients who underwent echocardiography at both baseline and 1\u2009year, we noted substantial group transitions from baseline to 1\u2009year; the transition rates from (\u2212)LVH\/(\u2212)LVE to (+)LVH\/(\u2212)LVE, from (+)LVH\/(\u2212)LVE to (\u2212)LVH\/(\u2212)LVE, from (+)LVH\/(\u2212)LVE to (+)LVH\/(+)LVE, and from (+)LVH\/(+)LVE to (+)LVH\/(\u2212)LVE were 27% (182\/671), 22% (213\/967), 6% (59\/967), and 26% (44\/170), respectively. In the univariable Cox proportional hazard model, patients who transitioned from (+)LVH\/(\u2212)LVE to (+)LVH\/(+)LVE or remained in (+)LVH\/(+)LVE had the worst subsequent prognosis [hazard ratio (HR) 4.65, 95% confidence interval (CI) 3.09\u20136.99, P\u2009&amp;lt;\u20090.001; HR 4.01, 95% CI 2.85\u20135.65, P\u2009&amp;lt;\u20090.001, respectively], as compared with those who remained in (\u2212)LVH\/(\u2212)LVE. These results were unchanged after adjustment for the covariates including baseline LV ejection fraction (LVEF) and 1-year LVEF change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In HFpEF patients, LV structures dynamically change over time with significant prognostic impacts, where patients who develop LVE with LVH have the worst prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.1945","type":"journal-article","created":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T11:16:58Z","timestamp":1593256618000},"page":"2258-2268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Prognostic Impacts of Dynamic Cardiac Structural Changes in Heart Failure Patients with Preserved Left Ventricular Ejection Fraction"],"prefix":"10.1093","volume":"22","author":[{"given":"Shinsuke","family":"Yamanaka","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Sakata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]},{"name":"Big Data Medicine Center, Tohoku University , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Nochioka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]},{"name":"Big Data Medicine Center, Tohoku University , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Aoyanagi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahide","family":"Fujihashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideka","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Shiroto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine , Sendai ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Sugimura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku 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