{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T19:16:37Z","timestamp":1784747797722,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100017540","name":"NHLBI Division of Intramural Research","doi-asserted-by":"publisher","award":["5K23HL168152-02"],"award-info":[{"award-number":["5K23HL168152-02"]}],"id":[{"id":"10.13039\/100017540","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017540","name":"Division of Intramural Research","doi-asserted-by":"publisher","award":["5K23HL168152\u201002"],"award-info":[{"award-number":["5K23HL168152\u201002"]}],"id":[{"id":"10.13039\/100017540","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This analysis aims to investigate the relationship between changes in cardiac structure and function and changes in health-related quality of life in patients with heart failure with reduced ejection fraction (HFrEF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The association between echocardiographic measures and Kansas City Cardiomyopathy Questionnaire (KCCQ)-12 scores was examined in HFrEF patients of the EVALUATE-HF trial who were randomized to sacubitril-valsartan or enalapril for 12\u2009weeks followed by 12\u2009weeks of open-label sacubitril-valsartan for both groups. We used linear regression models adjusted for age, sex, treatment assignment at randomization, baseline KCCQ-12 score, baseline echo measurements, and other clinical variables. Among 406 patients (median age 67\u2009years; 25% women), the KCCQ-12 overall summary score (KCCQ-12-OSS) improved by +9 points (95% confidence interval +7 to +11 points) over 24\u2009weeks. Increases in mitral e\u2032 velocities correlated with KCCQ-12-OSS improvement (+2.5 and +2.3 points per standard deviation [SD] increase in septal and lateral e\u2032 velocities, respectively, p\u2009&amp;lt;\u20090.05 for each). Decreases in septal E\/e\u2032 ratio and left atrial volume index (LAVi) also correlated with KCCQ-12-OSS improvement (+3.2 and +2.0 points per SD decrease in septal E\/e\u2032 ratio and LAVi, respectively, p\u2009&amp;lt;\u20090.05 for each). Changes in left ventricular size, ejection fraction, longitudinal strain, and right ventricular function were not associated with changes in KCCQ-12-OSS. Similar associations were observed for other KCCQ-12 domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the EVALUATE-HF trial, increases in mitral e\u2032 velocities and decreases in septal E\/e\u2032 ratio and LAVi were associated with improved KCCQ-12 scores over 24\u2009weeks, after adjusting for treatment assignment. These findings suggest that reductions in left ventricular filling pressures and left atrial size are closely coupled with improved physical function and quality of life in HFrEF patients, which may provide insights into the early benefits of sacubitril-valsartan.<\/jats:p>\n                    <jats:p>Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02874794.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3760","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T09:28:12Z","timestamp":1752830892000},"page":"2582-2593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Changes in Cardiac Structure and Function are Associated with Health-Related Quality of Life in Heart Failure Patients with Reduced Ejection Fraction: Results from the EVALUATE-HF trial"],"prefix":"10.1093","volume":"27","author":[{"given":"Sahmin","family":"Lee","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]},{"name":"Division of Cardiology, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine , Seoul ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L.","family":"Claggett","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Fang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Utah , Salt Lake City, UT ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary F.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Cardiovascular Engineering, Inc , Norwood, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Ward","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceuticals Corporation , East Hanover, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hicham","family":"Skali","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay S.","family":"Desai","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-8899","authenticated-orcid":false,"given":"Sheila M.","family":"Hegde","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"2026021721502526600_ejhf3760-bib-0001","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.ejheart.2005.01.012","article-title":"The impact of chronic heart failure on health-related quality of life data acquired in the baseline phase of the CARE-HF study","volume":"7","author":"Calvert","year":"2005","journal-title":"Eur J Heart Fail"},{"key":"2026021721502526600_ejhf3760-bib-0002","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.amjcard.2006.08.065","article-title":"A propensity matched study of New York Heart Association class and natural history end points in heart failure","volume":"99","author":"Ahmed","year":"2007","journal-title":"Am J Cardiol"},{"key":"2026021721502526600_ejhf3760-bib-0003","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/j.jchf.2022.09.012","article-title":"Functional and symptomatic clinical trial endpoints: The HFC-ARC scientific expert panel","volume":"10","author":"Psotka","year":"2022","journal-title":"JACC Heart Fail"},{"key":"2026021721502526600_ejhf3760-bib-0004","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1001\/jama.1995.03520250075037","article-title":"Linking clinical variables with health-related quality of life. 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