{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:34Z","timestamp":1787018074176,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2018,12,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Heart failure with preserved ejection fraction (HFpEF), traditionally considered a disease of the elderly, may also affect younger patients. However, little is known about HFpEF in the young.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We prospectively enrolled 1203 patients with HFpEF (left ventricular ejection fraction \u226550%) from 11 Asian regions. We grouped HFpEF patients into very young (&lt;55 years of age; n=157), young (55\u201364 years of age; n=284), older (65\u201374 years of age; n=355), and elderly (\u226575 years of age; n=407) and compared clinical and echocardiographic characteristics, quality of life, and outcomes across age groups and between very young individuals with HFpEF and age- and sex-matched control subjects without heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Thirty-seven percent of our HFpEF population was &lt;65 years of age. Younger age was associated with male preponderance and a higher prevalence of obesity (body mass index \u226530 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; 36% in very young HFpEF versus 16% in elderly) together with less renal impairment, atrial fibrillation, and hypertension (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Left ventricular filling pressures and prevalence of left ventricular hypertrophy were similar in very young and elderly HFpEF. Quality of life was better and death and heart failure hospitalization at 1 year occurred less frequently (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) in the very young (7%) compared with elderly (21%) HFpEF. Compared with control subjects, very young HFpEF had a 3-fold higher death rate and twice the prevalence of hypertrophy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Young and very young patients with HFpEF display similar adverse cardiac remodeling compared with their older counterparts and very poor outcomes compared with control subjects without heart failure. Obesity may be a major driver of HFpEF in a high proportion of HFpEF in the young and very young.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.118.034720","type":"journal-article","created":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T14:01:19Z","timestamp":1544450479000},"page":"2763-2773","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":77,"title":["Heart Failure With Preserved Ejection Fraction in the Young"],"prefix":"10.1161","volume":"138","author":[{"given":"Jasper","family":"Tromp","sequence":"first","affiliation":[{"name":"University Medical Center Groningen, Department of Cardiology, the Netherlands (J.T., C.S.P.L.)."},{"name":"National Heart Centre Singapore (J.T., W.T.T., T.-H.K.T., J.Y., C.S.P.L.)."},{"name":"Duke-National University Singapore Medical School (J.T., C.S.P.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Changi General Hospital, Singapore (M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Ting","family":"Tay","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore (J.T., W.T.T., T.-H.K.T., J.Y., C.S.P.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiew-Hwa K.","family":"Teng","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore (J.T., W.T.T., T.-H.K.T., J.Y., C.S.P.L.)."},{"name":"School of Population and Global Health, University of Western Australia, Perth (T.-H.K.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Lieh","family":"Hung","sequence":"additional","affiliation":[{"name":"Mackay Memorial Hospital, Taipei, Taiwan (C.-L.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calambur","family":"Narasimhan","sequence":"additional","affiliation":[{"name":"Care Hospital, Hyderabad, India (C.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wataru","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Nippon Medical School, Tokyo, Japan (W.S.)."},{"name":"National Cerebral and Cardiovascular Centre, Osaka, Japan (W.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lieng Hsi","family":"Ling","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University Singapore and Cardiac Department, National University Health System (L.H.L., T.P.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze Pin","family":"Ng","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University Singapore and Cardiac Department, National University Health System (L.H.L., T.P.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Yap","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore (J.T., W.T.T., T.-H.K.T., J.Y., C.S.P.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.V.","family":"McMurray","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Medical Sciences and School of Medicine, Dentistry and Nursing, University of Glasgow, UK (J.J.V.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Zile","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina, Charleston (M.R.Z.)."},{"name":"Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC (M.R.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Mark","family":"Richards","sequence":"additional","affiliation":[{"name":"National University Heart Centre, Singapore (A.M.R., C.S.P.L.)."},{"name":"Christchurch Heart Institute, University of Otago, New Zealand (A.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inder S.","family":"Anand","sequence":"additional","affiliation":[{"name":"Veterans Affairs Medical Center, Minneapolis, MN (I.S.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn S.P.","family":"Lam","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Department of Cardiology, the Netherlands (J.T., C.S.P.L.)."},{"name":"National Heart Centre Singapore (J.T., W.T.T., T.-H.K.T., J.Y., C.S.P.L.)."},{"name":"Duke-National University Singapore Medical School (J.T., C.S.P.L.)."},{"name":"National University Heart Centre, Singapore (A.M.R., 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