Women's College Research Institute

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Top ICES paper published by WCRI scientist Dr. Sacha Bhatia

Spring 2017

The Institute for Clinical Evaluative Sciences (ICES) has published a list of the most cited papers in its 25-year history — and the first paper on the list is a landmark paper by Dr. Sacha Bhatia, a WCRI scientist, WCH cardiologist, and director of the Women’s College Hospital Institute for Health System Solutions and Virtual Care. Dr. Bhatia’s paper, “Outcomes of heart failure with preserved ejection fraction in a population-based study,” has been cited 1,074 times since it was published in the New England Journal of Medicine in 2006. The study identified a new form of heart failure that is difficult to diagnose. The hearts of patients with heart failure often enlarge and pump out less blood with each beat than healthy hearts do. In these patients, doctors can diagnose heart failure by measuring ejection fraction (EF), the percentage of blood the heart pumps out with each beat. An EF lower than 40 per cent is considered reduced.

But the researchers found another form of heart failure with which patients have a normal EF measurement, above 50 per cent. This new form, called “preserved ejection fraction” heart failure, has a similar rate of death, but it is easier for doctors to miss when diagnosing, because the EF measurements are misleading. Those affected most are older women and those who have had high blood pressure or diabetes for a long period. The study highlighted the need to include these vulnerable groups in studies and develop new treatments for preserved ejection fraction heart failure.

Also on the ICES top-cited list were two papers by WCH scientists published in The Lancet: one by Dr. Lorraine Lipscombe on diabetes trends in Ontario, in the nineteenth place, and a paper by Dr. Paula Rochon and collaborators on the relationship between certain drugs and congestive heart failure outcomes in elderly patients, which ranked twenty-first.


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