{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:57:05Z","timestamp":1791230225171,"version":"4.1.0"},"reference-count":40,"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":530,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,6,23]],"date-time":"2024-06-23T00:00:00Z","timestamp":1719100800000},"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":[[2024,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Compared to heart failure (HF) with reduced ejection fraction, HF with preserved ejection fraction (HFpEF), and HF with mildly reduced ejection fraction (HFmrEF) are increasing in prevalence, yet little is known about the geographic variation in patient characteristics, treatments and outcomes among these two HF phenotypes. The aim of this study was to investigate geographic differences in HFpEF and HFmrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted an individual patient analysis of five clinical trials enrolling patients with HFpEF or HFmrEF from North America (NA), Latin America (LA), Western Europe (WE), Central\/Eastern Europe and Russia (CEER), and Asia-Pacific (AP). We compared regions using descriptive statistics and multivariable regression models. Among the 19\u2009959 patients included, 4066 (23.1%) had HFmrEF and 15\u2009353 (76.9%) HFpEF. Regardless of HF phenotype, patients from WE were oldest, and those in CEER youngest. LA had the largest portion of females and NA most black patients. Obesity and diabetes were most prevalent in NA and hypertension and coronary heart disease most common in CEER. Self-reported health status varied strikingly and was the worst in NA and best in AP. Among patients with HFmrEF, rates of the primary composite endpoint (cardiovascular death or HF hospitalization) were: NA 12.56 per 100 patient-years (\/100py), AP 11.67\/100py, CEER 10.12\/100py, LA 8.90\/100py, and WE 8.43\/100py, driven by differences in the rate of HF hospitalization. The corresponding values in HFpEF were 11.47\/100py, 7.80\/100py, 5.47\/100py, 5.92\/100py, and 7.80\/100py, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is substantial geographic variation in patient characteristics, treatment and outcomes among patients with HFpEF and HFmrEF. These findings have implications for interpretation and generalizability of trial results, design and conduct of future trials, and optimization of care for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3352","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T01:19:16Z","timestamp":1719191956000},"page":"1788-1803","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Geographical Variation in Patient Characteristics and Outcomes in Heart Failure with Mildly Reduced and Preserved Ejection Fraction"],"prefix":"10.1093","volume":"26","author":[{"given":"Mingming","family":"Yang","sequence":"first","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Kondo","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"Department of Cardiology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pardeep S.","family":"Jhund","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Antonio","family":"Alcocer-Gamba","sequence":"additional","affiliation":[{"name":"Centro de Estudios Cl\u00ednicos de Quer\u00e9taro (CECLIQ), School of Medicine, Universidad Aut\u00f3noma de Quer\u00e9taro , Quer\u00e9taro ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Jan Willem","family":"Borleffs","sequence":"additional","affiliation":[{"name":"Haga Teaching Hospital , The Hague ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chern-En","family":"Chiang","sequence":"additional","affiliation":[{"name":"General Clinical Research Center and Division of Cardiology, Taipei Veterans General Hospital and National Yang Ming Chiao Tung University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Comin-Colet","sequence":"additional","affiliation":[{"name":"Hospital Universitari de Bellvitge, The Institute of Biomedical Research of Bellvitge (IDIBELL) , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay S.","family":"Desai","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Dobreanu","sequence":"additional","affiliation":[{"name":"University of Medicine, Pharmacy, Science and Technology \u2018G.E. Palade\u2019 , T\u00e2rgu Mure\u015f ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaros\u0142aw","family":"Dro\u017cd\u017c","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Lodz , Lodz ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaling","family":"Han","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command , Shenyang ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan P.","family":"Janssens","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Cardiac Intensive Care, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzvetana","family":"Katova","sequence":"additional","affiliation":[{"name":"Department of Noninvasive Cardiology, National Cardiology Hospital , Sofia ,","place":["Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail N.","family":"Kosiborod","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City , Kansas City, MO ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn S.P.","family":"Lam","sequence":"additional","affiliation":[{"name":"National Heart Center Singapore and Duke-National University of Singapore , Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9la","family":"Merkely","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Budapest ,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinh Nguyen","family":"Pham","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Tam Anh Hospital, Tan Tao University , Tan Duc ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Thierer","sequence":"additional","affiliation":[{"name":"Jefe de Unidad de Insuficiencia Card\u00edaca, Centro de Educati\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas Norberto Quirno (CEMIC) , Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subodh","family":"Verma","sequence":"additional","affiliation":[{"name":"University of Toronto , Toronto, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, 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