{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:12:54Z","timestamp":1793844774436,"version":"4.6.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","award":["20170112"],"award-info":[{"award-number":["20170112"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","award":["20140220"],"award-info":[{"award-number":["20140220"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["523\u20102014\u20102336"],"award-info":[{"award-number":["523\u20102014\u20102336"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2013\u201023897\u2010104604\u201023"],"award-info":[{"award-number":["2013\u201023897\u2010104604\u201023"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009240","name":"Sveriges Kommuner och Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009240","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to derive and validate clinically useful clusters of patients with heart failure with preserved ejection fraction (HFpEF; left ventricular ejection fraction \u226550%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We derived a cluster model from 6909 HFpEF patients from the Swedish Heart Failure Registry (SwedeHF) and externally validated this in 2153 patients from the Chronic Heart Failure ESC\u2010guideline based Cardiology practice Quality project (CHECK\u2010HF) registry. In SwedeHF, the median age was 80 [interquartile range 72\u201386] years, 52% of patients were female and most frequent comorbidities were hypertension (82%), atrial fibrillation (68%), and ischaemic heart disease (48%). Latent class analysis identified five distinct clusters: cluster 1 (10% of patients) were young patients with a low comorbidity burden and the highest proportion of implantable devices; cluster 2 (30%) patients had atrial fibrillation, hypertension without diabetes; cluster 3 (25%) patients were the oldest with many cardiovascular comorbidities and hypertension; cluster 4 (15%) patients had obesity, diabetes and hypertension; and cluster 5 (20%) patients were older with ischaemic heart disease, hypertension and renal failure and were most frequently prescribed diuretics. The clusters were reproduced in the CHECK\u2010HF cohort. Patients in cluster 1 had the best prognosis, while patients in clusters 3 and 5 had the worst age\u2010 and sex\u2010adjusted prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Five distinct clusters of HFpEF patients were identified that differed in clinical characteristics, heart failure drug therapy and prognosis. These results confirm the heterogeneity of HFpEF and form a basis for tailoring trial design to individualized drug therapy in HFpEF patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2169","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T03:11:46Z","timestamp":1616987506000},"page":"973-982","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":130,"title":["Identification of distinct phenotypic clusters in heart failure with preserved ejection fraction"],"prefix":"10.1093","volume":"23","author":[{"given":"Alicia","family":"Uijl","sequence":"first","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University  Utrecht The Netherlands"},{"name":"Division of Cardiology, Department of Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Cardiology, Division Heart &amp; Lungs University Medical Center Utrecht, Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Savarese","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilonca","family":"Vaartjes","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Dahlstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Department of Health, Medicine and Caring Sciences Linkoping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper J.","family":"Brugts","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thoraxcenter Erasmus MC University Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard C.M.","family":"Linssen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Group Twente  Almelo and Hengelo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"van Empel","sequence":"additional","affiliation":[{"name":"Department of Cardiology Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Peter","family":"Brunner\u2010La Rocca","sequence":"additional","affiliation":[{"name":"Department of Cardiology Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Folkert W.","family":"Asselbergs","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Division Heart &amp; Lungs University Medical Center Utrecht, Utrecht University  Utrecht The Netherlands"},{"name":"Health Data Research UK London, Institute for Health Informatics, University College London  London UK"},{"name":"Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H.","family":"Lund","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"Heart and Vascular Theme, Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno W.","family":"Hoes","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Koudstaal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Division Heart &amp; 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