A Bibliometric Analysis of Heart Failure with Preserved Ejection Fraction From 2000 to 2021
Introduction
According to Ejection Fraction (EF) values, heart failure(HF) is classified into the following 4 kinds: HF with reduced EF (HFrEF, EF is less than or equal to 40%), HF with improved EF (HFimpEF) (EF is less than or equal to 40% at first, then EF is more than 40%), HF with mid-range EF, (HFmrEF, EF between 40% and 50%), and HF with preserved EF (HFpEF)(EF is more than or equal to50%).1,2 For HFrEF/HFmrEF patients, the guidelines clearly indicate that medication regimens such as Angiotensin converting enzyme inhibitors/Angiotensin receptor-neprilysin inhibitor (ACE-I/ARNI),3, 4, 5 Beta blocker,6,7 Mineralocorticoid receptor antagonist (MRA)8 and Sodium-glucose cotransporter 2 inhibitor (SLGT-2) (Dapagliflozin or Empagliflozin)9,10 could improve the symptoms of patients and reduce the risk of hospitalization and death of patients with HF.
HFpEF is a heterogeneous disease caused by hypertension, diabetes, obesity, coronary artery disease (CAD), chronic kidney disease, other comorbidities, and myocardial amyloidosis.11,12 It has the same signs and symptoms with HF such as dyspnea and lower limb edema, accompanied by structural and/or functional cardiac abnormalities and/or increased natriuretic peptide (NPs), and LVEF ≥ 50%. In HFpEF with sinus rhythm, NT-proBNP > 125pg/mL, BNP > 35pg/mL.When patient has atrial fibrillation (AF), NT-proBNP > 365pg/mL, BNP > 105pg/mL.13,14 HFpEF occurs in 50% of all heart failure patients and is associated with prominent hospitalizations, mortality,15,16 and lower health-related quality of life scores.17 Although the age-specific incidence of HF is declining, the trend of HFpEF is not so obvious compared with HFrEF, and the risk of HFpEF in women is higher than that in men. AF, chronic kidney disease and non-cardiovascular comorbidity are more common in HFpEF, and the proportion of non-cardiovascular disease deaths is higher than that in HFrEF patients,18,19 with the risk of death increasing with the comorbidities burden.20
To date, the recommended treatment is to use diuretics to reduce congestion and improve symptoms, which has been improved in patients with certain HFpEF phenotypes. But there is still no convincing therapy that reduces hospitalizations and mortality.21, 22, 23 The result of EMPEROR-Preserved (Empagliflozin in Patients with Chronic heart failure with Preserved Ejection Fraction)24 showed that SLGT2-Empagliflozin had significant benefits in symptomatic HF patients whose LVEF is greater than 40% and elevated NPs. The role of blood pressure control in preventing HF and reducing other cardiovascular events and HF mortality in patients without generalized baselines is well established. However, the optimal blood pressure target and antihypertensive regimen for patients with HFpEF is unclear.25,26 RAAS antagonists (ACEI, ARB, MRA) may benefit better in patients with an EF approaching 50%.22,27,28
Bibliometric analysis is a literature research method with literature system and bibliometric characteristics as the research objects.29 This approach30 can conduct qualitative and quantitative analysis of literature, evaluate research trends, and show the development frontiers of every fields.31 In addition, the devotion of different countries, institutions, journals, literature, and scholars are compared by this method.32,33 We reviewed the literature on HFpEF based on the Web of Science Core Collection (WOSCC) of Institute for Scientific Information (ISI). CiteSpace (a web-based Java application) is a document visualization analysis software gradually developed for bibliometrics analyses and data visualization,34 which is used to: (1) perform bibliometric analyses of relevant HFpEF-related literature published in the past 20 years; (2) draw visual knowledge maps; (3) display the research status in the HFpEF field; (4) reveal research hotspots and development trends; and (5) provide a reference for future related research.
Section snippets
Data Retrieval and Collection
The database: WOSCC, retrieval strategy: TS = Heart Failure with preserved ejection fraction, Language: English, Document type:Article, Publication Date:2000/01/01-2021/12/31. A total of 6318 articles were retrieved, and the full records and references exported as plain text files were named as download_***.txt. To avoid deviation caused by database update, the data were exported within 1 day (February 19, 2022).
Methods
WOSCC retrieval results were used to conduct statistical analysis on the number of
The Number of Publications and The Analysis of Funding Agencies
Based on the number of publications in each period, we can determine the research development trends and speed of this discipline.36 According to the retrieval strategy, since the 21st century, WOSCC has collected 6318 literatures related to HFpEF, with an average annual publication volume of 287 and a total citation of 78,266 times (self-citation removed). The average citation times of each article was 23.18 times, and the H-index value was 179. H-index is an important indicator of a
Discussion
The WOSCC system is the most famous database of scientific publications regarding many investigations. According to the literature screening strategy mentioned earlier, 6318 literatures about HFpEF in the past 2 decades were extracted from WOSCC, with a total of 91,064 references. The literature funding institutions were mainly at the national level, which indicated that the popularity of this research field continued to increase, and scholars' attention was increasing.
Cooperation between
Limitations
This study has certain limitations. Firstly, the analysis of this study is based on articles from WOSCC database, which is the most widely utilized database of scientific publication, but other databases such as PubMed and Scopus may provide a wider coverage. Secondly, CiteSpace cannot completely replace system retrieval. For example, with the continuous updating of WOSCC literature, the number of documents obtained is different from the actual number of documents, and the number of citations
Conclusion
Through information visualization technology, the research progress, hotpots, and frontiers of HFpEF in the past 2 decades are expounded. These findings provide information for HFpEF investigations and identify potential partners for interested researchers. The study on HFpEF is on the rise, and the number of citations is increasing year by year. Compared with developing countries, developed countries have carried out more HFpEF studies, suggesting that we should strengthen international
Summary
The manuscript summarizes the latest progress, hotspots as well as frontiers, future research development trends and references in this field.
Author Contributions
XueSong Zhang and Yu Zhou designed the study and co-wrote the manuscript. Namin Wei and Xintian Shou collected the data. Shaowei Fan and Yaping You re-examined the data. XueSong Zhang and Yuan Li analyzed the data. Yuanhui Hu reviewed and revised the manuscript. All authors contributed to the article, approved the submitted version, and agree to be held responsible for all aspects of the work.
Authors’ Information
XueSong Zhang, Shaowei Fan and Yaping You are PhD students at Guang 'anmen Hospital, China Academy of Traditional Chinese Medicine, thier main research direction is TCM prevents heart failure.
Yu Zhou and Yuan Li are PhD students at Shanxi University of Chinese Medicine, their main research direction is the basic and clinical research of cardiovascular diseases.
Namin Wei and Xintian Shou are PhD students at Beijing University of Chinese Medicine, their research direction is the basic and
Acknowledgments
The authors acknowledge Home for Researchers editorial team (www.home-for researchers.com) for language editing service.
References (108)
- et al.
Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction
J Am Coll Cardiol
(2014) - et al.
Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction
J Am Coll Cardiol
(2012) - et al.
Variable Contribution of heart failure to quality of life in ambulatory heart failure with reduced, better, or preserved ejection fraction
JACC Heart Fail
(2016) - et al.
Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial
Lancet
(2003) - et al.
Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis
Lancet
(2016) - et al.
Analysis of changing paradigms of management in 179 patients with spinal tuberculosis over a 12-year period and proposal of a new management algorithm
World Neurosurg
(2013) - et al.
Analysis of knowledge bases and research focuses of cerebral ischemia-reperfusion from the perspective of mapping knowledge domain
Brain Res Bull
(2020) - et al.
A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation
J Am Coll Cardiol
(2013) - et al.
An analysis of physicians' reasons for prescribing long-term digitalis therapy in outpatients
J Chronic Dis
(1985) - et al.
Methods of assessing prevalent cardiovascular disease in the cardiovascular health study
Ann Epidemiol
(1995)
Rationale, design, and baseline characteristics of a trial of prevention of cardiovascular and renal disease with fosinopril and pravastatin in nonhypertensive, nonhypercholesterolemic subjects with microalbuminuria (the Prevention of REnal and Vascular ENdstage Disease Intervention Trial [PREVEND IT])
Am J Cardiol
Sex-based differences in heart failure across the ejection fraction spectrum: phenotyping, and prognostic and therapeutic implications
JACC Heart Fail
Non-cardiac comorbidities in heart failure with reduced, mid-range and preserved ejection fraction
Int J Cardiol
Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes
J Am Coll Cardiol
Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial
J Am Coll Cardiol
Natural history of markers of collagen turnover in patients with early diastolic dysfunction and impact of eplerenone
J Am Coll Cardiol
Champion trial rationale and design: the long-term safety and clinical efficacy of a wireless pulmonary artery pressure monitoring system
J Card Fail
Comparison of a radiofrequency-based wireless pressure sensor to swan-ganz catheter and echocardiography for ambulatory assessment of pulmonary artery pressure in heart failure
J Am Coll Cardiol
Endothelial dysfunction in patients with chronic heart failure: systemic effects of lower-limb exercise training
J Am Coll Cardiol
Exercise intolerance in patients with atrial fibrillation: clinical and echocardiographic determinants of exercise capacity
J Am Soc Echocardiogr
Tissue doppler index, E/E', and ischemic stroke in patients with atrial fibrillation and preserved left ventricular ejection fraction
J Neurol Sci
Patient selection in heart failure with preserved ejection fraction clinical trials
J Am Coll Cardiol
Efficacy of beta blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis
Lancet
Incidence of atrial fibrillation and relationship with cardiovascular events, heart failure, and mortality: a community-based study from the netherlands
J Am Coll Cardiol
Heart failure with preserved ejection fraction and atrial fibrillation: vicious twins
J Am Coll Cardiol
Atrial fibrillation in heart failure with preserved, mid-range, and reduced ejection fraction
JACC Heart Fail
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Eur Heart J
2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines
J Am Coll Cardiol
Enalapril for congestive heart failure
N Engl J Med
Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials
JAMA
Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure
Circulation
The cardiac insufficiency bisoprolol study II (CIBIS-II): a randomised trial
Lancet
Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study
Circulation
Eplerenone in patients with systolic heart failure and mild symptoms
N Engl J Med
Dapagliflozin in patients with heart failure and reduced ejection fraction
N Engl J Med
Cardiovascular and renal outcomes with empagliflozin in heart failure
N Engl J Med
A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction
Circulation
How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the heart failure association (HFA) of the european society of cardiology (ESC)
Eur J Heart Fail
Pleural fluid amino-terminal brain natriuretic peptide in patients with pleural effusions
Respir Care
A contemporary appraisal of the heart failure epidemic in Olmsted County, Minnesota, 2000 to 2010
JAMA Intern Med
Evaluation and management of heart failure with preserved ejection fraction
Nat Rev Cardiol
Epidemiology of heart failure with preserved ejection fraction
Nat Rev Cardiol
Clinical practice. Systolic heart failure
N Engl J Med
Spironolactone for heart failure with preserved ejection fraction
N Engl J Med
Sacubitril/Valsartan across the spectrum of ejection fraction in heart failure
Circulation
Empagliflozin in heart failure with a preserved ejection fraction
N Engl J Med
Discontinuations for adverse events attributed to different classes of antihypertensive drugs: meta-analyses of randomized trials
J Hypertens
Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction
N Engl J Med
Differential clinical profiles, exercise responses, and outcomes associated with existing HFpEF definitions
Circulation
Bibliometrics, dermatology and contact dermatitis
Contact Dermatitis
Cited by (10)
A Bibliometric Analysis of Cardioembolic Stroke From 2012 to 2022
2023, Current Problems in CardiologyCitation Excerpt :CiteSpace and VOSviewer software, the computing platform for bibliometric analysis, automatically generate interactive visual networks through analyzing records of scientific publications.13 Because of the powerful prediction function for the research outlook, bibliometric analysis has been widely used in various fields of medical research, including cardiology, oncology, immunology, and public health.14-20 Based on the bibliometric analysis of publications included in the Web of Science Core Collection (WoSCC) database, this study aimed to: (i) uncover the intractable problems and research hotspots related to cardioembolic stroke; (ii) reveal the research trend of cardioembolic stroke over the past decade; (iii) construct a knowledge graph in this field; and (iv) provide valuable insights for future related research.
Global Research Trends on Ventricular Remodeling: A Bibliometric Analysis From 2012 to 2022
2022, Current Problems in CardiologyCitation Excerpt :Bibliometrics can not only track the development trend but also compare the contributions of different countries, institutions, journals, and authors of the research field in a graphically visualized way. As an auxiliary research method, bibliometrics has been applied in various cardiovascular diseases, such as cardio-oncology, heart failure, and heart transplantation.26-29 However, there are currently no articles published on the bibliometric analysis of ventricular remodeling.
Trends and Hotspots in Global Radiomics Research: A Bibliometric Analysis
2024, Technology in Cancer Research and TreatmentInsights into research on myocardial ischemia/reperfusion injury from 2012 to 2021: a bibliometric analysis
2023, European Journal of Medical ResearchGlobal Trends on β-thalassemia Research over 10 Years: A Bibliometric Analysis
2023, Research Square
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Funding: This work was supported by National Natural Science Foundation of China (No.82074409).