{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:10:16Z","timestamp":1771488616878,"version":"3.50.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Emerging evidence suggests an association between non-alcoholic fatty liver disease (NAFLD) and heart failure (HF). We investigated the relationship between NAFLD and left ventricular (LV) functional remodelling in a general population sample without overt cardiac and liver disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We included 481 individuals without significant alcohol consumption who voluntarily underwent an extensive cardiovascular health check. The fatty liver index (FLI) was calculated for each participant, and NAFLD was defined as FLI \u2265 60. All participants underwent 2D transthoracic echocardiography; LV global longitudinal strain (LVGLS) was assessed with speckle-tracking analysis. Univariable and multivariable linear regression models were constructed to investigate the possible association between NAFLD and LVGLS. Seventy-one (14.8%) participants were diagnosed with NAFLD. Individuals with NAFLD exhibited larger LV size and LV mass index than those without NAFLD, although left atrial size and E\/e\u2032 ratio did not differ between groups. Left ventricular global longitudinal strain was significantly reduced in participants with vs. without NAFLD (17.1% \u00b1 2.4% vs. 19.5% \u00b1 3.1%, respectively; P &amp;lt; 0.001). The NAFLD group had a significantly higher frequency of abnormal LVGLS (&amp;lt;16%) than the non-NAFLD group (31.0% vs. 10.7%, respectively; P &amp;lt; 0.001). Multivariable linear regression analysis demonstrated that higher FLI score was significantly associated with impaired LVGLS independent of age, sex, conventional cardiovascular risk factors, and echocardiographic parameters (standardized \u03b2 \u22120.11, P = 0.031).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In the general population without overt cardiac and liver disease, the presence of NAFLD was significantly associated with subclinical LV dysfunction, which may partly explain the elevated risk of HF in individuals with NAFLD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oead108","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T19:59:56Z","timestamp":1697572796000},"source":"Crossref","is-referenced-by-count":5,"title":["Association between non-alcoholic fatty liver disease and subclinical left ventricular dysfunction in the general population"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7084-9830","authenticated-orcid":false,"given":"Kazutoshi","family":"Hirose","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5787-8004","authenticated-orcid":false,"given":"Koki","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"},{"name":"Department of Clinical Laboratory, The University of Tokyo , 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 , Japan {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~show%20%5BAQ%20ID%3DAQ3%20POS%3D12pt%5D~%3E%2D%2D%3E"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco R","family":"Di Tullio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University , New {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~A3B2%20show%20%5BNBsp%5D~%3E%2D%2D%3E York, NY, USA {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~show%20%5BAQ%20ID%3DAQ4%20POS%3D24pt%5D~%3E%2D%2D%3E"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunichi","family":"Homma","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University , New {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~A3B2%20show%20%5BNBsp%5D~%3E%2D%2D%3E York, NY, USA {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~show%20%5BAQ%20ID%3DAQ4%20POS%3D24pt%5D~%3E%2D%2D%3E"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoko","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuriko","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University , New {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~A3B2%20show%20%5BNBsp%5D~%3E%2D%2D%3E York, NY, USA {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~show%20%5BAQ%20ID%3DAQ4%20POS%3D24pt%5D~%3E%2D%2D%3E"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megumi","family":"Hirokawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"},{"name":"Department of Clinical Laboratory, The University of Tokyo , 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 , Japan {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~show%20%5BAQ%20ID%3DAQ3%20POS%3D12pt%5D~%3E%2D%2D%3E"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhiro","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4285-1888","authenticated-orcid":false,"given":"Tomoko","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7616-3477","authenticated-orcid":false,"given":"Masao","family":"Daimon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"},{"name":"International University of Health and Welfare , Tokyo , Japan {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~show%20%5BAQ%20ID%3DAQ5%5D~%3E%2D%2D%3E"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Kurano","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The University of Tokyo , 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 , Japan {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~show%20%5BAQ%20ID%3DAQ3%20POS%3D12pt%5D~%3E%2D%2D%3E"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0714-7182","authenticated-orcid":false,"given":"Issei","family":"Komuro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo Hospital {C}%3C!%2D%2DFONT%3Abold%2D%2D%3E 1 , 7-3-1 Hongo, Bunkyo-ku , Tokyo 113-8655, Japan"},{"name":"International University of Health and Welfare , Tokyo , Japan {C}%3C!%2D%2D%7C%7CrmComment%7C%7C%3C~show%20%5BAQ%20ID%3DAQ5%5D~%3E%2D%2D%3E"},{"name":"Department of Frontier Cardiovascular Science, The University of Tokyo Graduate School of Medicine , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"key":"2023122117362811000_oead108-B1","doi-asserted-by":"crossref","first-page":"e153","DOI":"10.1161\/CIR.0000000000001052","article-title":"Heart disease and stroke statistics-2022 update: a report from the American Heart Association","volume":"145","author":"Tsao","year":"2022","journal-title":"Circulation"},{"key":"2023122117362811000_oead108-B2","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jchf.2019.09.009","article-title":"Clinical phenogroups in heart failure with preserved ejection fraction: detailed phenotypes, prognosis, and response to spironolactone","volume":"8","author":"Cohen","year":"2020","journal-title":"JACC Heart Fail"},{"key":"2023122117362811000_oead108-B3","doi-asserted-by":"crossref","first-page":"2476","DOI":"10.1016\/j.jacc.2017.08.074","article-title":"Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes","volume":"70","author":"Shah","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2023122117362811000_oead108-B4","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.jchf.2018.03.006","article-title":"Temporal trends in the incidence of and mortality associated with heart failure with preserved and reduced ejection fraction","volume":"6","author":"Tsao","year":"2018","journal-title":"JACC Heart Fail"},{"key":"2023122117362811000_oead108-B5","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1161\/ATVBAHA.110.207340","article-title":"Serum gamma-glutamyl transferase and risk of heart failure in the community","volume":"30","author":"Dhingra","year":"2010","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2023122117362811000_oead108-B6","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s12872-020-01444-x","article-title":"Higher fatty liver index is associated with increased risk of new onset heart failure in healthy adults: a nationwide population-based study in Korea","volume":"20","author":"Roh","year":"2020","journal-title":"BMC Cardiovasc Disord"},{"key":"2023122117362811000_oead108-B7","doi-asserted-by":"crossref","first-page":"e021654","DOI":"10.1161\/JAHA.121.021654","article-title":"Nonalcoholic fatty liver disease and risk of heart failure among Medicare beneficiaries","volume":"10","author":"Fudim","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"2023122117362811000_oead108-B8","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jacc.2021.11.007","article-title":"Risk of heart failure in patients with nonalcoholic fatty liver disease: JACC review topic of the week","volume":"79","author":"Mantovani","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2023122117362811000_oead108-B9","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"key":"2023122117362811000_oead108-B10","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease\u2014meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"key":"2023122117362811000_oead108-B11","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/1471-230X-6-33","article-title":"The fatty liver index: a simple and accurate predictor of hepatic steatosis in the general population","volume":"6","author":"Bedogni","year":"2006","journal-title":"BMC Gastroenterol"},{"key":"2023122117362811000_oead108-B12","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1111\/apt.12963","article-title":"Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease","volume":"40","author":"Fedchuk","year":"2014","journal-title":"Aliment Pharmacol Ther"},{"key":"2023122117362811000_oead108-B13","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1097\/HJH.0000000000002716","article-title":"Fatty liver index and left ventricular mass: prospective associations from two independent cohorts","volume":"39","author":"Li","year":"2021","journal-title":"J Hypertens"},{"key":"2023122117362811000_oead108-B14","doi-asserted-by":"crossref","first-page":"e005521","DOI":"10.1161\/CIRCIMAGING.116.005521","article-title":"Global longitudinal strain by echocardiography predicts long-term risk of cardiovascular morbidity and mortality in a low-risk general population: the Copenhagen City Heart Study","volume":"10","author":"Biering-Sorensen","year":"2017","journal-title":"Circ Cardiovasc Imaging"},{"key":"2023122117362811000_oead108-B15","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.jcmg.2018.03.015","article-title":"Diagnosis of nonischemic stage B heart failure in type 2 diabetes mellitus: optimal parameters for prediction of heart failure","volume":"11","author":"Wang","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023122117362811000_oead108-B16","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1093\/eurjpc\/zwac279","article-title":"Aortic valve sclerosis and subclinical LV dysfunction in the general population with normal LV geometry","volume":"30","author":"Yoshida","year":"2023","journal-title":"Eur J Prev Cardiol"},{"key":"2023122117362811000_oead108-B17","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1002\/ejhf.154","article-title":"Prevalence and prognostic value of subclinical left ventricular systolic dysfunction by global longitudinal strain in a community-based cohort","volume":"16","author":"Russo","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2023122117362811000_oead108-B18","volume-title":"Regional Office for the Western Pacific. The Asia-Pacific Perspective: Redefining Obesity and Its Treatment","author":"World Health Organization","year":"2000"},{"key":"2023122117362811000_oead108-B19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"2023122117362811000_oead108-B20","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.echo.2016.01.011","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"29","author":"Nagueh","year":"2016","journal-title":"J Am Soc Echocardiogr"},{"key":"2023122117362811000_oead108-B21","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1186\/s12933-022-01725-z","article-title":"The associations between changes in hepatic steatosis and heart failure and mortality: a nationwide cohort study","volume":"21","author":"Park","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"2023122117362811000_oead108-B22","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1002\/hep.27869","article-title":"Association of nonalcoholic fatty liver disease with subclinical myocardial remodeling and dysfunction: a population-based study","volume":"62","author":"VanWagner","year":"2015","journal-title":"Hepatology"},{"key":"2023122117362811000_oead108-B23","first-page":"466","article-title":"Assessment of subclinical myocardial changes in non-alcoholic fatty liver disease: a case-control study using speckle tracking echocardiography","volume":"43","author":"Zamirian","year":"2018","journal-title":"Iran J Med Sci"},{"key":"2023122117362811000_oead108-B24","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.jacbts.2021.07.010","article-title":"Relationship of nonalcoholic fatty liver disease and heart failure with preserved ejection fraction","volume":"6","author":"Salah","year":"2021","journal-title":"JACC Basic Transl Sci"},{"key":"2023122117362811000_oead108-B25","doi-asserted-by":"crossref","first-page":"e984","DOI":"10.1161\/CIR.0000000000000973","article-title":"Obesity and cardiovascular disease: a scientific statement from the American Heart Association","volume":"143","author":"Powell-Wiley","year":"2021","journal-title":"Circulation"},{"key":"2023122117362811000_oead108-B26","doi-asserted-by":"crossref","first-page":"3439","DOI":"10.1093\/eurheartj\/ehy531","article-title":"Prevalence and correlates of coronary microvascular dysfunction in heart failure with preserved ejection fraction: PROMIS-HFpEF","volume":"39","author":"Shah","year":"2018","journal-title":"Eur Heart J"},{"key":"2023122117362811000_oead108-B27","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1148\/radiol.2019181793","article-title":"Association between nonalcoholic fatty liver disease at CT and coronary microvascular dysfunction at myocardial perfusion PET\/CT","volume":"291","author":"Vita","year":"2019","journal-title":"Radiology"},{"key":"2023122117362811000_oead108-B28","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.jhep.2017.11.023","article-title":"Association of non-alcoholic steatohepatitis with subclinical myocardial dysfunction in non-cirrhotic patients","volume":"68","author":"Lee","year":"2018","journal-title":"J Hepatol"},{"key":"2023122117362811000_oead108-B29","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12933-020-01201-6","article-title":"Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight\/obese Japanese subjects in a general community","volume":"20","author":"Hirose","year":"2021","journal-title":"Cardiovasc Diabetol"},{"key":"2023122117362811000_oead108-B30","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.jhep.2016.04.005","article-title":"Non-alcoholic fatty liver disease and cardiovascular risk: pathophysiological mechanisms and implications","volume":"65","author":"Francque","year":"2016","journal-title":"J Hepatol"},{"key":"2023122117362811000_oead108-B31","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1002\/oby.21879","article-title":"Nonalcoholic steatohepatitis is associated with cardiac remodeling and dysfunction","volume":"25","author":"Simon","year":"2017","journal-title":"Obesity (Silver Spring)"},{"key":"2023122117362811000_oead108-B32","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1093\/ehjci\/jex067","article-title":"Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study","volume":"18","author":"Lancellotti","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023122117362811000_oead108-B33","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s12072-022-10319-6","article-title":"Non-alcoholic fatty liver disease association with structural heart, systolic and diastolic dysfunction: a meta-analysis","volume":"16","author":"Yong","year":"2022","journal-title":"Hepatol Int"},{"key":"2023122117362811000_oead108-B34","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1053\/j.gastro.2015.04.005","article-title":"Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis","volume":"149","author":"Vilar-Gomez","year":"2015","journal-title":"Gastroenterology"},{"key":"2023122117362811000_oead108-B35","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1002\/hep.20420","article-title":"Therapeutic efficacy of an angiotensin II receptor antagonist in patients with nonalcoholic steatohepatitis","volume":"40","author":"Yokohama","year":"2004","journal-title":"Hepatology"},{"key":"2023122117362811000_oead108-B36","doi-asserted-by":"crossref","first-page":"298","DOI":"10.2337\/dc19-0641","article-title":"Empagliflozin effectively lowers liver fat content in well-controlled type 2 diabetes: a randomized, double-blind, phase 4, placebo-controlled trial","volume":"43","author":"Kahl","year":"2020","journal-title":"Diabetes Care"}],"container-title":["European Heart Journal Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjopen\/advance-article-pdf\/doi\/10.1093\/ehjopen\/oead108\/52189833\/oead108.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/3\/6\/oead108\/54703417\/oead108.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/3\/6\/oead108\/54703417\/oead108.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T19:19:19Z","timestamp":1703186359000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjopen\/article\/doi\/10.1093\/ehjopen\/oead108\/7318180"}},"subtitle":[],"editor":[{"given":"Frank A","family":"Flachskampf","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,10,17]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,11,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjopen\/oead108","relation":{},"ISSN":["2752-4191"],"issn-type":[{"value":"2752-4191","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,11]]},"published":{"date-parts":[[2023,10,17]]},"article-number":"oead108"}}