Evidence map›Paper›PMID 39212045›Full record

Trial reportCirculation. Heart failure2024

Relationship Between Cardiac Structure and Function With Renal Function Trajectory and Outcomes in Patients With Heart Failure: Insights From the PARAGON-HF Trial.

Henri Lu, Safia Chatur, Sahmin Lee, Riccardo M Inciardi, Martin Abanda, Finnian R Mc Causland, Arzu Kalayci, Kimia Karimi Taheri, Amil M Shah, Maja Cikes and 10 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Circulation. Heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01920711 (A Multicenter, Randomized, Double-blind, Parallel Group, Active-controlled Study to Evaluate the Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

NCT01920711 phase3completednot on this map

A Multicenter, Randomized, Double-blind, Parallel Group, Active-controlled Study to Evaluate the Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients (NYHA Class II-IV) With Preserved Ejection Fraction (PARAGON-HF)

TypeinterventionalSponsorNovartis PharmaceuticalsRan2014 to 2019Enrolled4,822ConditionsHeart Failure With Preserved Ejection FractionArmsLCZ696, Valsartan
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

20 authors.

Henri LuDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-9074-6505
Safia ChaturDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Sahmin LeeDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Riccardo M InciardiDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Martin AbandaDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-0789-9691
Finnian R Mc CauslandDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Arzu KalayciDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0001-8555-5686
Kimia Karimi TaheriDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0003-3453-7933
Amil M ShahDivision of Cardiovascular Medicine, University of Texas Southwestern Medical Center, Dallas (A.M.S.).ORCID 0000-0003-1056-4451
Maja CikesDepartment of Cardiovascular Diseases, University of Zagreb School of Medicine, University Hospital Centre Zagreb, Croatia (M.C.).ORCID 0000-0002-4772-5549
Brian L ClaggettDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-4215-9218
Narayana PrasadDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-6280-2741
Carolyn S P LamNational Heart Centre Singapore and Duke-National University of Singapore, Singapore (C.S.P.L.).ORCID 0000-0003-1903-0018
Eileen O'MearaDepartment of Cardiology, Montreal Heart Institute, Université de Montréal, Québec, QC, Canada (E.O.).
Xiaowen WangDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-5374-7832
John J V McMurrayBritish Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Scotland, United Kingdom (J.J.V.M.).ORCID 0000-0002-6317-3975
Marc A PfefferDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0003-3876-7568
Sheila M HegdeDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0001-8157-8899
Scott D SolomonDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0003-3698-9597
Hicham SkaliDivision of Cardiovascular Medicine, (H.L., S.C., S.L., M.A., A.K., K.K.T., B.L.C., N.P., X.W., M.A.P., S.M.H., S.D.S., H.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-5629-4138

Funding

Mapping the Progression to HFpEF in the Elderly through Longitudinal Changes in Cardiac FunctionR01HL135008 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI Amil M Shah · 2017 to 2026
$11.5M
Noninvasive Cardiovascular Imaging Research Training ProgramT32HL094301 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Marcelo F DI CARLI · 2010 to 2026
$7.8M
NHLBI NIH HHS R01 HL135008NHLBI NIH HHS T32 HL094301
6 · The paper itself

Abstract

backgroundRenal dysfunction is common and associated with a poor prognosis in patients with heart failure. However, the association of cardiac structure and function with decline in kidney function in this population is unknown. We aimed to assess the association between individual measures of cardiac structure and function with changes in renal function and renal outcomes in patients with heart failure with preserved ejection fraction.

methodsPatients enrolled in the PARAGON-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin-Receptor Blockers Global Outcomes in Heart Failure With Preserved Ejection Fraction) echocardiographic substudy were included. The association between each echocardiographic parameter (expressed in standardized units) and changes over time in estimated glomerular filtration rate was calculated with repeated-measures mixed-effect models. Multivariable Cox proportional hazards models were used to identify individual cardiac parameters associated with the composite renal outcome (≥50% decline in estimated glomerular filtration rate relative to baseline, development of end-stage renal disease, or death attributable to renal causes), after adjusting for covariates.

resultsAmong 1097 patients (mean age 74±8 years and 53% women), over a median follow-up of 2.9 years, 28 composite renal events (0.9 per 100 person-years) occurred. Higher left ventricular (LV) mass index and higher E/average e' ratio were associated with significantly more profound annual decline in estimated glomerular filtration rate (for both, -0.4 [95% CI, -0.7 to -0.1] mL/min/1.73 m

conclusionsIn the PARAGON-HF echocardiographic substudy, higher LV mass and filling pressures were independently associated with more profound kidney function decline, and higher LV mass and volume, as well as impaired right ventricular structure and function, were each associated with renal events. Assessing these parameters may help identify patients with heart failure with preserved ejection fraction at higher risk for adverse renal events and indicate potential therapeutic targets. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01920711.

Indexed as

Angiotensin Receptor AntagonistsGlomerular Filtration RateHeart FailureKidneyStroke VolumeAgedAged, 80 and overEchocardiographyFemaleHumansMaleMiddle AgedNeprilysinProspective StudiesTreatment OutcomeVentricular Function, LeftAngiotensin Receptor AntagonistsNeprilysinglomerular filtration rateheart failurekidney diseasekidney failure, chronicprognosis

Identifiers

PMID39212045
PMCPMC13000924

What Socratic holds

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Registered trials

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.