{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T19:47:31Z","timestamp":1775072851632,"version":"3.50.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","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":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Patients with heart failure (HF) with improved ejection fraction (HFimpEF) may face residual risks of clinical events that are comparable to those experienced by patients with HF whose left ventricular ejection fraction (LVEF) has consistently been above 40%. However, little is known about the clinical course of patients with HFimpEF during hospitalization for HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      DELIVER randomized patients with HF and LVEF &gt;40% to dapagliflozin or placebo, including HFimpEF (LVEF previously \u226440%). We evaluated all HF hospitalizations adjudicated by the clinical endpoints committee with available data for determination of in\u2010hospital course. Complicated hospitalization was defined as any hospitalization requiring intensive care unit stay, intravenous vasopressors\/inotropes\/vasodilators, invasive or non\u2010invasive ventilation, mechanical fluid removal, ultrafiltration, or mechanical circulatory support. LVEF changes were extracted using a validated GPT\u20103.5, a large language model, via a secure private endpoint. Of the 6263 patients enrolled in DELIVER, 1151 (18%) had HFimpEF. During a median follow\u2010up of 2.3\u2009years, there were 224 total HF hospitalizations in 144 patients with HFimpEF and 985 in 603 patients with LVEF consistently &gt;40%. Patients with HFimpEF experienced higher rates of complicated HF hospitalization as compared with patients with LVEF consistently &gt;40% (39% vs. 27%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among those who experienced a first HF hospitalization, there was no significant difference in length of stay or in\u2010hospital mortality between patients with HFimpEF versus LVEF consistently &gt;40%. In a subset of participants who had at least one LVEF measurement available during HF hospitalization, 66% of those with HFimpEF and 29% of patients with LVEF consistently &gt;40% experienced a reduction in their LVEF to \u226440% from the time of enrolment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In the entire DELIVER cohort, dapagliflozin reduced total uncomplicated and complicated HF hospitalizations, irrespective of HFimpEF status (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u22650.30).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among patients hospitalized for HF in DELIVER, those with HFimpEF experienced a more adverse in\u2010hospital clinical course, necessitating higher resource utilization beyond standard diuretic therapy compared with patients with HF and LVEF consistently &gt;40%, but had similar in\u2010hospital mortality. Treatment benefits of dapagliflozin were not modified by hospitalization type.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3410","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T01:54:37Z","timestamp":1726797277000},"page":"2532-2540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["In\u2010hospital course of patients with heart failure with improved ejection fraction in the\n                    <scp>DELIVER<\/scp>\n                    trial"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1883-0654","authenticated-orcid":false,"given":"Maria A.","family":"Pabon","sequence":"first","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian L.","family":"Claggett","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safia","family":"Chatur","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Siqueira","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Marti\u2010Castellote","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudolf A.","family":"de Boer","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke University Medical Center  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvio E.","family":"Inzucchi","sequence":"additional","affiliation":[{"name":"Yale School of Medicine  New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikhail N.","family":"Kosiborod","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, University of Missouri\u2010Kansas City  Kansas City MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn S.P.","family":"Lam","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore and Duke\u2010National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Martinez","sequence":"additional","affiliation":[{"name":"Universidad Nacional de C\u00f3rdoba  Cordoba Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjiv J.","family":"Shah","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akshay S.","family":"Desai","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pardeep S.","family":"Jhund","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.V.","family":"McMurray","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orly","family":"Vardeny","sequence":"additional","affiliation":[{"name":"Minneapolis VA Center for Care Delivery and Outcomes Research University of Minnesota  Minneapolis MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,9,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.709"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.757596"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010022\u201002102\u20109"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.006855"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.1325"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.824"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.a2017.0103"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2912"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2206286"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467\u20109868.00259"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2022.03.046"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14635"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.11.019"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2023.06.022"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ\u201018\u20100881"}],"container-title":["European Journal of Heart 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