Evidence map›Paper›PMID 38549197›Full record

SynthesisESC heart failure2024

Impact of coronary microvascular dysfunction in heart failure with preserved ejection fraction: a meta-analysis.

Domenico D'Amario, Renzo Laborante, Emiliano Bianchini, Giuseppe Ciliberti, Donato Antonio Paglianiti, Mattia Galli, Attilio Restivo, Davide Stolfo, Rocco Vergallo, Giuseppe M C Rosano and 6 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
11.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
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  4. Microvascular dysfunction and heart failure with preserved ejection fraction.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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  18. Towards a phenotype profiling of the patients with heart failure and preserved ejection fraction.European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 12 institutions in 6 countries.

Domenico D'AmarioDepartment of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
Renzo LaboranteCatholic University of the Sacred Heart, Rome, Italy.
Emiliano BianchiniCatholic University of the Sacred Heart, Rome, Italy.
Giuseppe CilibertiCatholic University of the Sacred Heart, Rome, Italy.
Donato Antonio PaglianitiCatholic University of the Sacred Heart, Rome, Italy.
Mattia GalliMaria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.
Attilio RestivoCatholic University of the Sacred Heart, Rome, Italy.
Davide StolfoDepartment of Cardiothoracovascular, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.
Rocco VergalloCardiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Giuseppe M C RosanoCentre for Clinical & Basic Research, IRCCS San Raffaele Pisana, Rome, Italy.
Filippo CreaCatholic University of the Sacred Heart, Rome, Italy.
Carolyn S P LamNational Heart Centre Singapore, Central Singapore, Singapore.
Lars H LundDepartment of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden.
Marco MetraDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Giuseppe PattiDepartment of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
Gianluigi SavareseDepartment of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden.
Università Cattolica del Sacro Cuore · ITUniversity of the Sacred Heart · JPAzienda Ospedaliero Universitaria Maggiore della Carita · ITAzienda Sanitaria Universitaria Integrata di Trieste · ITKarolinska Institutet · SEKarolinska University Hospital · SEMaria Cecilia Hospital · ITNational University of Singapore · SGOspedale Policlinico San Martino · ITSt George's Hospital · GBSurgical Specialties (Canada) · CAUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro” · IT

Funding

Italian Ministry of Health RF-2021-12375403
6 · The paper itself

Abstract

aimsSeveral mechanisms have been identified in the aetiopathogenesis of heart failure with preserved ejection fraction (HFpEF). Among these, coronary microvascular dysfunction (CMD) may play a key pathophysiological role. We performed a systematic review and meta-analysis to investigate the prevalence, echocardiographic correlates, and prognostic implications of CMD in patients with HFpEF. METHODS AND

resultsA systematic search for articles up to 1 May 2023 was performed. The primary aim was to assess the prevalence of CMD. Secondary aims were to compare key echocardiographic parameters (E/e' ratio, left atrial volume index [LAVi], and left ventricular mass index [LVMi]), clinical outcomes [death and hospitalization for heart failure (HF)], and prevalence of atrial fibrillation (AF) between patients with and without CMD. Meta-regressions according to baseline patient characteristics and study features were performed to explore potential heterogeneity sources. We identified 14 observational studies, enrolling 1138 patients with HFpEF. The overall prevalence of CMD was 58%. Compared with patients without CMD, patients with HFpEF and CMD had larger LAVi [mean difference (MD) 3.85 confidence interval (CI) 1.19-6.5, P < 0.01)], higher E/e' ratio (MD 2.76 CI 1.54-3.97; P < 0.01), higher prevalence of AF (odds ratio 1.61 CI 1.04-2.48, P = 0.03) and higher risk of death or hospitalization for HF [hazard ratio 3.19, CI 1.04-9.57, P = 0.04].

conclusionsCMD is present in little more than half of the patients with HFpEF and is associated with echocardiographic evidence of more severe diastolic dysfunction and a higher prevalence of AF, doubling the risk of death or HF hospitalization.

Indexed as

Heart FailureStroke VolumeCoronary CirculationEchocardiographyGlobal HealthHumansMicrocirculationMicrovesselsPrevalencePrognosisVentricular Function, LeftCoronary microvascular dysfunctionDiastolic dysfunctionHFpEF

Identifiers

PMID38549197
PMCPMC11287310
OpenAlexW4393316036

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.