{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T02:46:57Z","timestamp":1793933217969,"version":"4.8.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T00:00:00Z","timestamp":1670198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Grant-in-Aid for Scientific Research","award":["17K09517"],"award-info":[{"award-number":["17K09517"]}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Newly introduced drugs for heart failure (HF) have been reported to improve the prognosis of HF with preserved ejection fraction (HFpEF) in the lower range of left ventricular ejection fraction (LVEF). We hypothesized that a higher LVEF is related to an unfavourable prognosis in patients with HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We tested this hypothesis by analysing the data from a prospective multicentre cohort study in 255 patients admitted to the hospital due to decompensated HF (LVEF &amp;gt; 40% at discharge). The primary endpoint of this study was a composite outcome of all-cause death and readmission due to HF, and the secondary endpoint was readmission due to HF. LVEF and the mitral E\/e\u2032 ratio were measured using echocardiography. In multicovariate parametric survival time analysis, LVEF [hazard ratio (HR) = 1.046 per 1% increase, P = 0.001], concurrent atrial fibrillation (AF) (HR = 3.203, P &amp;lt; 0.001), and E\/e\u2032 (HR = 1.083 per 1.0 increase, P &amp;lt; 0.001) were significantly correlated with the primary endpoint. In addition to these covariates, angiotensin-converting enzyme inhibitor (ACEI)\/angiotensin receptor blocker (ARB) use was significantly correlated with the secondary endpoint (HR = 0.451, P = 0.008). Diagnostic performance plot analysis demonstrated that the discrimination threshold value for LVEF that could identify patients prone to reaching the primary endpoint was \u226557.2%. The prevalence of AF or E\/e\u2032 ratio did not differ significantly between patients with LVEF \u2265 58% and with 40% &amp;lt; LVEF &amp;lt; 58%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A higher LVEF is independently related to poor prognosis in patients with HFpEF, in addition to concurrent AF and an elevated E\/e\u2032 ratio. ACEI\/ARB use, in contrast, was associated with improved prognosis, especially with regard to readmission due to HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>https:\/\/www.umin.ac.jp\/ctr\/index.htm<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Unique identifier<\/jats:title>\n                    <jats:p>UMIN000017725<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jeac240","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T08:54:18Z","timestamp":1668761658000},"page":"293-300","source":"Crossref","is-referenced-by-count":38,"title":["Unfavourable outcomes in patients with heart failure with higher preserved left ventricular ejection fraction"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1934-6864","authenticated-orcid":false,"given":"Nobuyuki","family":"Ohte","sequence":"first","affiliation":[{"name":"Department of Cardiology, Graduate School of Medical Sciences, Nagoya City University , Nagoya 467-8601 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohei","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Graduate School of Medical Sciences, Nagoya City University , Nagoya 467-8601 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Iwahashi","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Yokohama City University Medical Center , Yokohama , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiharu","family":"Kinugasa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine and Endocrinology 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