{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:18Z","timestamp":1790586018745,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute heart failure (AHF) is a major global health challenge, yet the relationship between New York Heart Association (NYHA) classification and objective markers such as echocardiography, lung ultrasound (LUS), and biomarkers remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective two\u2010center study, patients admitted with AHF (2022\u20102024) underwent echocardiography, 8\u2010zone LUS, ECG, and biomarker sampling. Patients were stratified by NYHA class at enrollment, and associations with clinical, echocardiographic, and LUS measures were analyzed. Participants were invited for an identical follow\u2010up examination 1\u20133 months post\u2010discharge. The main outcome was a 180\u2010day composite of AHF readmission or all\u2010cause mortality evaluated across NYHA classes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 564 patients (mean age 78.2 years; 56.3% male), 23% were classified as NYHA class I\/II, 27% as NYHA class III, and 50% as NYHA class IV. Higher NYHA class at admission was associated with older age, greater comorbidity burden, lower left ventricular ejection fraction, impaired global longitudinal strain, higher E\/e\u2032 ratio, and B\u2010line count (all\n                      <jats:italic>p &lt;<\/jats:italic>\n                      0.05). At follow\u2010up (\n                      <jats:italic>n<\/jats:italic>\n                      = 160), left ventricular systolic function, B\u2010line count, and left atrial size parameters were similar across baseline NYHA class. Atrial functional parameters (peak atrial longitudinal and contraction strain) remained lower with increasing NYHA class at admission (both\n                      <jats:italic>p &lt;<\/jats:italic>\n                      0.05). NYHA class at admission was not associated with the 180\u2010days outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this prospective study of hospitalized AHF patients, higher NYHA class at admission was associated with greater cardiac dysfunction, B\u2010line burden, and comorbidity burden, but these differences largely resolved at follow\u2010up. NYHA class at admission did not significantly predict the composite outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70634","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:19:41Z","timestamp":1790039981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac Structure and Function and Pulmonary Congestion Across New York Heart Association Classes in Patients With Acute Heart Failure"],"prefix":"10.1111","volume":"43","author":[{"given":"Ali Hikmat","family":"Al\u2010Rubai","sequence":"first","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip Soeskov","family":"Davidovski","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Espersen","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Stanchev","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Maria","family":"Adam","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayat","family":"Khoraizat","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristoffer Grundtvig","family":"Skaarup","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Dons","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Christensen","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Durukan","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ema","family":"Rastoder","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Section, Department of Medicine Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Sengel\u00f8v","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrine Feldballe","family":"Bernholm","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup 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Reimer","family":"Jensen","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Cardiology Copenhagen University Hospital \u2010 Herlev and Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam Femerling","family":"Langhoff","sequence":"additional","affiliation":[{"name":"Cardiovascular Non\u2010Invasive Imaging Research Laboratory Department of Cardiology Copenhagen University Hospital \u2010 Herlev &amp; Gentofte Hospital  Hellerup Denmark"},{"name":"Center For Translational Cardiology and Pragmatic Randomized Trials Department of Biomedical Sciences Faculty 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