{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:08:19Z","timestamp":1791295699914,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T00:00:00Z","timestamp":1380585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the effects of an NT-proBNP-guided medical management on 18-month outcomes in patients with heart failure (HF) and preserved LVEF (HFpEF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients with HFpEF (LVEF &amp;gt;45%; n = 123) and HF with reduced LVEF (HFrEF; LVEF \u226445%; n = 499) with age \u226560 years, NYHA class \u2265 II, and elevated NT-proBNP (&amp;gt;400 ng\/L or &amp;gt;800 ng\/L depending on age) were randomized to medical therapy titrated only to reduce symptoms to NYHA \u2264II (symptom-guided) or also to reduce NT-proBNP below the inclusion threshold (NT-proBNP-guided) during a 6-month period. Patients were followed for an additional 12 months. Despite similar treatment escalation, NT-proBNP reduction and symptom relief were less in HFpEF than in HFrEF. Hospitalization-free survival at 18 months was worse in HFpEF than in HFrEF (P = 0.02), while survival and HF hospitalization-free survival did not differ. Among HFpEF patients, NT-proBNP reduction and symptom relief were similar in the symptom-guided (n = 59) and NT-proBNP-guided (n = 64) group despite more aggressive treatment in the NT-proBNP-guided group. In contrast to effects in HFrEF, NT-proBNP-guided management tended to worsen 18-month outcomes in HFpEF, with P-values for the interactions between LVEF stratum and management strategy of 0.2 for hospitalization-free survival, 0.03 for survival, and 0.01 for HF hospitalization-free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Outcomes in HFpEF were not better than in HFrEF, and opposite effects of NT-proBNP-guided management were observed in HFpEF compared with HFrEF. These preliminary findings suggest that, in contrast to HFrEF, NT-proBNP-guided therapy may not be beneficial in HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ISRCTN43596477.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjhf\/hft076","type":"journal-article","created":{"date-parts":[[2013,5,8]],"date-time":"2013-05-08T21:56:30Z","timestamp":1368050190000},"page":"1148-1156","source":"Crossref","is-referenced-by-count":64,"title":["N-terminal Pro Brain Natriuretic Peptide-Guided Management in Patients with Heart Failure and Preserved Ejection Fraction: Findings from the Trial of Intensified Versus Standard Medical Therapy in Elderly Patients with Congestive Heart Failure (TIME-CHF)"],"prefix":"10.1093","volume":"15","author":[{"given":"Micha T.","family":"Maeder","sequence":"first","affiliation":[{"name":"Division of Cardiology, University 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\u00a0","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Pfisterer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Peter","family":"Brunner-La Rocca","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital , Basel ,","place":["Switzerland"]},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+) , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the TIME-CHF Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,1,27]]},"reference":[{"key":"2026011921160055900_ejhfhft076-bib-0001","first-page":"803","article-title":"Developed in 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