{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T19:18:20Z","timestamp":1787685500003,"version":"build-2784847793"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":46,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","award":["NNF20OC0060561"],"award-info":[{"award-number":["NNF20OC0060561"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Ambulatory low cardiac output state (LCOS) is a known but poorly described heart failure (HF) phenotype. We aimed to investigate the prevalence, clinical markers, and prognostic importance of ambulatory LCOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive ambulatory patients with HF and reduced left ventricular ejection fraction referred for advanced HF assessment were included. All patients underwent right heart catheterization. Patients with LCOS defined as a cardiac index &amp;lt;1.8\u2005L\/min\/m2 were compared to patients without LCOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 618 patients were included. The mean\u2005\u00b1\u2005SD age was 52.5 \u00b1 12.5 years, and 78% were male. Low cardiac output state was present in 116 patients (19% [95% CI 16 to 22%]). Patients with LCOS presented with more advanced symptoms, lower systolic blood pressure and LVEF, higher N-terminal pro-B-type natriuretic peptide levels, and were less likely to receive treatment with renin-angiotensin system inhibitors (RASi) compared with patients without LCOS. Absence of RASi therapy was strongly associated with LCOS, odds ratio 2.34 [95% CI 1.44 to 3.74], P &amp;lt; .001. While liver function markers were more elevated in patients with LCOS, renal function was similar between groups. Over a median follow-up of five years, LCOS was independently associated with mortality, hazard ratio 1.86 [95% 1.32 to 2.62], P &amp;lt; .001 (adjusted for age, sex, and advanced therapy).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LCOS was observed in 19% of ambulatory patients and was strongly associated with mortality, independent of left-sided filling pressures and advanced therapies. Among other factors, the absence of RASi therapy was highly predictive of LCOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag215","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:39:46Z","timestamp":1787053186000},"source":"Crossref","is-referenced-by-count":0,"title":["Ambulatory low cardiac output state in heart failure: characteristics and outcomes"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4877-5484","authenticated-orcid":false,"given":"Benjamin Lautrup","family":"Hansen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, Copenhagen University Hospital , Blegdamsvej 9, Copenhagen OE 2100 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Deis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, Copenhagen University Hospital , Blegdamsvej 9, Copenhagen 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