Evidence mapPaperPMID 40819913Full record

ArticleOpen heart2025

Differences in the management of heart failure with preserved ejection fraction among physicians from Europe, the Middle East and North Africa: an international survey.

Mohamed H Omer, Anastasia Shchendrygina, Omar Ahmad, Clara Saldarriaga, Sydney Goldfeder de Gracia, Mosaad Alhussain, Najmeddine Echahidi, Suleiman M Kharabsheh, Fakhr Ayoubi, Kamal Alghalayni and 9 more

Abstract readMulticenter StudyComparative Study
In one paragraph

Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

19 authors.

Mohamed H OmerSchool of Medicine, Cardiff University, Cardiff, UK.
Anastasia ShchendryginaIM Sechenov First Moscow State Medical University, Moscow, Russia.ORCID http://orcid.org/0000-0002-8220-0350
Omar AhmadCollege of Medicine, Alfaisal University, Riyadh, Riyadh Province, Saudi Arabia.
Clara SaldarriagaCardioVID Clinic, Pontificia Bolivariana, University of Antioquia, Medellin, Colombia.
Sydney Goldfeder de GraciaCardioVID Clinic, Medellin, Colombia.
Mosaad AlhussainHeart Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Najmeddine EchahidiHeart Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Suleiman M KharabshehHeart Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Fakhr AyoubiCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Kamal AlghalayniCollege of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Jehad AlburaikiCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Bahaa FadelHeart Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Feras BaderCleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Hadi SkouriCardiology Division, Sheikh Shakhbout Medical City, Khalifa University, Abu Dhabi, UAE.
Mohamad HamadeCancer Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Marta Załęska-KocięckaDepartment of Heart Failure and Transplantology, Department Mechanical Circulatory Support and Transplantation, National Institute of Cardiology, Warsaw, Poland.
Federica GuidettiDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Nathan MewtonHeart Failure Department, Clinical Investigation Center, Inserm 1407, CarMeN Inserm 1060, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, University Claude Bernard Lyon, Lyon, France.ORCID http://orcid.org/0000-0002-4526-8129
Dania MohtyCollege of Medicine, Alfaisal University, Riyadh, Riyadh Province, Saudi Arabia dania.mohty@gmail.com.ORCID http://orcid.org/0000-0001-5967-9984

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeart failure with preserved ejection fraction (HFpEF) poses global diagnostic and therapeutic challenges, with potential regional differences in clinical practice that remain underexplored. This study aimed to map physician-reported HFpEF diagnostic and management practices across Europe and the Middle East-North Africa (MENA) region to identify similarities, differences and opportunities for improved care.

methodsAn independent, academically developed survey consisting of 29 questions was designed through expert collaboration to capture detailed information on physician demographics, diagnostic strategies, screening practices, pathophysiological understanding and treatment approaches for HFpEF. The survey was validated by heart failure specialists to ensure relevance and accuracy and distributed widely through professional societies, email and social media channels to reach cardiologists, general practitioners and other physicians involved in heart failure care across Europe and MENA.

resultsA total of 723 physicians participated (77 from MENA, 646 from Europe). The proportion of heart failure specialists was higher in Europe (26%) than in MENA (12%, p<0.001), while general cardiologists comprised a larger share in MENA (81% vs 59%, p<0.001). Natriuretic peptide testing use was lower in MENA (82%) compared with Europe (92%, p=0.023). Pharmacotherapy preferences showed both regional similarities and differences, with SGLT2 inhibitors being the most preferred drug of choice universally. In contrast, there was a higher ranking of mineralocorticoid receptor antagonists in Europe (p=0.007) and greater reported use of angiotensin receptor-neprilysin inhibitors in MENA (p=0.03).

conclusionThis large international survey offers a descriptive mapping of HFpEF care practices across Europe and MENA, revealing overall guideline alignment but also regional differences in diagnostic test use and pharmacotherapy preferences. These findings underscore the need for targeted education, improved diagnostic and therapeutic access and tailored guideline implementation to ensure equitable, evidence-based HFpEF management across diverse healthcare settings.

Indexed as

CardiologistsCardiovascular AgentsHealthcare DisparitiesHeart FailurePractice Patterns, Physicians'Stroke VolumeVentricular Function, LeftAfrica, NorthernEuropeFemaleHealth Care SurveysHumansMaleMiddle AgedMiddle EastSurveys and QuestionnairesCardiovascular AgentsEchocardiographyGlobal HealthHEART FAILUREHeart Failure, DiastolicQuality of Health Care

Identifiers

PMID40819913
PMCPMC12359493

What Socratic holds

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LicenceCC BY-NC
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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.