{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T15:29:57Z","timestamp":1776439797962,"version":"3.51.2"},"reference-count":27,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"crossref","award":["18059186"],"award-info":[{"award-number":["18059186"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2026,3,26]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The restrictive filling pattern of transmitral inflow has been shown to be associated with a poor prognosis in patients with heart failure (HF) with reduced ejection fraction or myocardial infarction. We aimed to investigate the significance of restrictive filling pattern in patients with HF with preserved ejection fraction (HFpEF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 4056 patients with acute decompensated HF in the Kyoto Congestive Heart Failure registry, we analysed 830 patients with HFpEF who had transmitral inflow data available in echocardiography. Patients whose early to late diastolic transmitral flow velocity (E\/A ratio) \u22652 were classified as having a restrictive filling pattern of transmitral inflow. The main outcome measures were all-cause death and HF hospitalisation at 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 830 patients, a restrictive filling pattern was observed in 144 (17.3%) patients, who had higher prevalence of a history of atrial fibrillation and supranormal left ventricular ejection fraction (&gt;65%), and higher brain natriuretic peptide level at discharge. The cumulative 1-year incidence of HF hospitalisation was significantly higher in patients with restrictive filling pattern than those without (31.0% vs 18.1%, p&lt;0.001), while the cumulative 1-year incidence of all-cause death was not different between the two groups (14.2% vs 14.4%, p=0.93). After adjusting for confounding factors, the excess risk of restrictive filling pattern relative to non-restrictive filling pattern remained significant for HF hospitalisation (HR=1.58, 95% CI 1.10 to 2.27, p=0.01), but not for all-cause death (HR=0.92, 95% CI 0.60 to 1.42, p=0.70).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A restrictive filling pattern of transmitral inflow was associated with an increased risk for HF hospitalisation, but not for all-cause death, in patients with acute decompensated HFpEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2026-004093","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T14:35:28Z","timestamp":1776436528000},"page":"e004093","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Restrictive filling pattern of transmitral inflow in acute decompensated heart failure with preserved ejection fraction: insights from the KCHF registry"],"prefix":"10.1136","volume":"13","author":[{"given":"Yutaro","family":"Miyoshi","sequence":"first","affiliation":[{"name":"Kyoto University Graduate School of Medicine Department of Cardiovascular Medicine, Kyoto, Kyoto Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8213-7999","authenticated-orcid":false,"given":"Takao","family":"Kato","sequence":"additional","affiliation":[{"name":"Kyoto University Graduate School of Medicine Department of Cardiovascular Medicine, Kyoto, Kyoto Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Data Science, Hyogo Medical University, Nishinomiya, Hyogo Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neiko","family":"Ozasa","sequence":"additional","affiliation":[{"name":"Kyoto University Graduate School of Medicine Department of Cardiovascular Medicine, Kyoto, Kyoto Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenori","family":"Yaku","sequence":"additional","affiliation":[{"name":"Kyoto University Graduate School of Medicine Department of Cardiovascular Medicine, Kyoto, Kyoto Prefecture, Japan"},{"name":"Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasutaka","family":"Inuzuka","sequence":"additional","affiliation":[{"name":"Cardiology, Shiga Medical Center for Adults, Moriyama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yodo","family":"Tamaki","sequence":"additional","affiliation":[{"name":"Cardiology, Tenri Hospital, Tenri, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Kyoto University Graduate School of Medicine Department of Cardiovascular Medicine, Kyoto, Kyoto Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Kyoto University Graduate School of Medicine Department of Cardiovascular Medicine, Kyoto, Kyoto Prefecture, Japan"},{"name":"Department of Data Science, Hyogo Medical University, Nishinomiya, Hyogo Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kitai","sequence":"additional","affiliation":[{"name":"Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5029-1203","authenticated-orcid":false,"given":"Moritake","family":"Iguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5043-8778","authenticated-orcid":false,"given":"Kazuya","family":"Nagao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Osaka Red Cross Hospital, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Kawase","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Okayama Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Morinaga","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Fukuoka Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Fukuoka Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihito","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2670-7170","authenticated-orcid":false,"given":"Koichiro","family":"Kuwahara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Shinshu Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Matsumoto, Nagano, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koh","family":"Ono","sequence":"additional","affiliation":[{"name":"Kyoto University Graduate School of Medicine Department of Cardiovascular Medicine, Kyoto, Kyoto Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5665-4076","authenticated-orcid":false,"given":"Takeshi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Kyoto University Graduate School of Medicine Department of Cardiovascular Medicine, Kyoto, Kyoto Prefecture, Japan"},{"name":"Cardiology, Hirakata Kosai Hospital, Hirakata, 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