{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:46:45Z","timestamp":1785768405642,"version":"3.56.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":954,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"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":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>An echocardiographic algorithm derived by machine learning (e\u2032VM) characterizes pre-clinical individuals with different cardiac structure and function, biomarkers, and long-term risk of heart failure (HF). Our aim was the external validation of the e\u2032VM algorithm and to explore whether it may identify subgroups who benefit from spironolactone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The HOMAGE (Heart OMics in AGEing) trial enrolled participants at high risk of developing HF randomly assigned to spironolactone or placebo over 9\u2009months. The e\u2032VM algorithm was applied to 416 participants (mean age 74\u2009\u00b1\u20097\u2009years, 25% women) with available echocardiographic variables (i.e. e\u2032 mean, left ventricular end-diastolic volume and mass indexed by body surface area [LVMi]). The effects of spironolactone on changes in echocardiographic and biomarker variables were assessed across e\u2032VM phenotypes. A majority (&amp;gt;80%) had either a \u2018diastolic changes\u2019 (D), or \u2018diastolic changes with structural remodelling\u2019 (D\/S) phenotype. The D\/S phenotype had the highest LVMi, left atrial volume, E\/e', natriuretic peptide and troponin levels (all p\u2009&amp;lt;\u20090.05). Spironolactone significantly reduced E\/e' and B-type natriuretic peptide (BNP) levels in the D\/S phenotype (p\u2009&amp;lt;\u20090.01), but not in other phenotypes (p\u2009&amp;gt;\u20090.10; pinteraction\u2009&amp;lt;0.05 for both). These interactions were not observed when considering guideline-recommended echocardiographic structural and functional abnormalities. The magnitude of effects of spironolactone on LVMi, left atrial volume and a type I collagen marker was numerically higher in the D\/S phenotype than the D phenotype but the interaction test did not reach significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the HOMAGE trial, the e\u2032VM algorithm identified echocardiographic phenotypes with distinct responses to spironolactone as assessed by changes in E\/e' and BNP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2859","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:25:32Z","timestamp":1681691132000},"page":"1284-1289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A Machine Learning-Derived Echocardiographic Algorithm Identifies People at Risk of Heart Failure with Distinct Cardiac Structure, Function, and Response to Spironolactone: Findings from the HOMAGE Trial"],"prefix":"10.1093","volume":"25","author":[{"given":"Masatake","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Huttin","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]},{"name":"Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Duarte","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arantxa","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Program of Cardiovascular Diseases, CIMA, Universidad de Navarra and IdiSNA , Pamplona ,","place":["Spain"]},{"name":"CIBERCV, Carlos III Institute of Health , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Heymans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University, CARIM School for Cardiovascular Diseases , Maastricht ,","place":["Netherlands"]},{"name":"Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Job A.J.","family":"Verdonschot","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University, CARIM School for Cardiovascular Diseases , Maastricht ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Peter","family":"Brunner-La Rocca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University , Maastricht ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Pellicori","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew L.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital , Cottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Petutschnigg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Campus Virchow Klinikum, Charit\u00e9 University Medicine Berlin and German Centre for Cardiovascular research (DZHK) , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Edelmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Campus Virchow Klinikum, Charit\u00e9 University Medicine Berlin and German Centre for Cardiovascular research (DZHK) , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Cleland","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Rossignol","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]},{"name":"Medical specialties and nephrology dialysis departments, Monaco Princess Grace Hospital and Monaco Private hemodialysis centre , Monaco City ,","place":["Monaco"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Girerd","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the HOMAGE Trial Committees and 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