Circulation: Heart Failure最新文献

{"title":"Long-Term Trajectories of Left Heart Geometry, Mechanics, and Oxygen Demand After Bariatric Surgery.","authors":"Lisa M D Grymyr, Saied Nadirpour, Eva Gerdts, Bjørn G Nedrebø, Knut Matre, Dana Cramariuc","doi":"10.1161/CIRCHEARTFAILURE.124.012367","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012367","url":null,"abstract":"<p><strong>Background: </strong>The long-term impact of bariatric surgery on cardiac mechanics and energetics has been scarcely documented. We aimed to assess prospectively the 5-year trajectories of left heart geometry, mechanics, and myocardial oxygen (O₂) demand after bariatric surgery.</p><p><strong>Methods: </strong>In the Bariatric Surgery on the West Coast of Norway study, left ventricular (LV) and atrial remodeling was evaluated preoperatively, 6 months, and 1 and 5 years after Roux-en-Y gastric bypass in 102 patients. LV geometry was assessed by the LV mass/height^2.7 and the relative wall thickness, and mechanics by the global longitudinal strain and the midwall shortening. LV myocardial O₂ demand was estimated from the product LV mass×wall stress×heart rate. The left atrial reservoir function was measured by the emptying fraction.</p><p><strong>Results: </strong>After 63 (interquartile range, 62-66) months, LV mass index, global longitudinal strain, myocardial oxygen demand, and left atrial emptying fraction were improved (<i>P</i><0.001) while midwall shortening did not change significantly. Prevalence of normal LV geometry increased from 61% to 82%. In linear mixed-effects models with adjustment for clinical characteristics, improving global longitudinal strain and myocardial O₂ demand over time were associated with female sex and lower body mass index (<i>P</i><0.05). In logistic regression analysis, 5-year presence of abnormal LV geometry, low LV global longitudinal strain, or high myocardial O₂ demand was related to preoperative diabetes, hypertension, and higher body mass index, as well as higher 5-year systolic blood pressure (<i>P</i><0.05; Nagelkerke R²=0.40).</p><p><strong>Conclusions: </strong>Bariatric surgery results in favorable 5-year trajectories of LV geometry, myocardial O₂ demand, and left heart longitudinal mechanics. However, suboptimal postoperative body mass index and blood pressure control promote long-term LV structural disease.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier:: NCT01533142.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012367"},"PeriodicalIF":7.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Meal on Invasive Hemodynamics and Plasma Incretin Levels in Patients With Heart Failure.","authors":"Tania Deis, Kasper Rossing, Mads Ersbøll, William Herrik Nielsen, Birthe Henriksen, Bolette Hartmann, Jens Juul Holst, Caroline Kistorp, Marat Fudim, Jens Peter Goetze, Palle Bekker Jeppesen, Finn Gustafsson","doi":"10.1161/CIRCHEARTFAILURE.124.012630","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012630","url":null,"abstract":"<p><strong>Background: </strong>The importance of gastrointestinal hormones, including the incretins glucagon-like peptide-1 (GLP-1) and GIP (glucose-dependent insulinotropic polypeptide), in heart failure pathophysiology is debated. The postprandial incretin response and its relation to hemodynamic changes in patients with heart failure, however, remains unknown.</p><p><strong>Methods: </strong>A pulmonary artery catheter was placed in 14 patients with chronic heart failure and 10 healthy controls, who subsequently consumed a standardized meal (3.2 MJ). Hemodynamic measures and blood samples were collected over 120 minutes. Bowel wall thickness and superior mesenteric artery blood flow were measured by ultrasound. Gastrointestinal symptoms were assessed through questionnaires.</p><p><strong>Results: </strong>Patients, compared with controls, exhibited an impaired postprandial peak in cardiac index (2.8 versus 4.0 L/min per m², <i>P</i><0.001) and a blunted cardiac index response in the postprandial period (baseline-substracted area under the curve, <i>P</i>=0.030). Patients had higher fasting total GLP-1 levels (14.0 versus 7.5 pmol/L, <i>P</i>=0.015) and a greater postprandial peak (33.5 versus 21.0 pmol/L, <i>P</i>=0.013). Fasting total GLP-1 concentrations correlated with central venous pressure (<i>P</i>=0.025). There was a trend toward a correlation between area under the curve total GLP-1 and cardiac index (<i>P</i>=0.054). There was no change in GIP concentrations. Patients had a higher gastrointestinal symptom burden (<i>P</i>=0.033), and an indigestion score that correlated with peak superior mesenteric artery blood flow (<i>P</i>=0.017).</p><p><strong>Conclusions: </strong>Patients with heart failure showed a blunted cardiac index response to meal intake, elevated total GLP-1 levels that were associated with hemodynamic parameters, and increased gastrointestinal symptom burden.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012630"},"PeriodicalIF":7.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the Global Activity of Heart Transplant.","authors":"Abdelghani El Rafei, Rebecca Cogswell, Fernando A Atik, Andreas Zuckermann, Larry A Allen","doi":"10.1161/CIRCHEARTFAILURE.124.012272","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012272","url":null,"abstract":"<p><p>Heart failure is a global disease with significant morbidity. Heart transplant (HT) can be a lifesaving therapy for select patients with end-stage heart failure. In 2020, over 7000 HTs were performed globally; 90% of HTs were performed in the United States and Western Europe, with only 10% throughout the rest of the world. In this article, we offer an overview of the global landscape of HT, exploring challenges and prospects worldwide. We review HT practices, rates and post-HT outcomes, underscoring the differences between countries within each region. We review limitations hindering HT expansion, such as sociocultural factors, as seen in Japan and Israel; health care funding, in countries like India and South Africa; socioeconomic disparities in access, like the United States; and shortage in organ supply, as seen in China and Saudi Arabia. This review underscores the need to address limitations and highlights opportunities to enhance global HT accessibility, especially in lower- and middle-income countries.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012272"},"PeriodicalIF":7.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroids in Fulminant Myocarditis Associated With Viral Infection.","authors":"Florent Huang, Enrico Ammirati, Maharajah Ponnaiah, Santiago Montero, Nadia Aïssaoui, Albert Ariza Solé, Martin Balik, Eduardo Barge-Caballero, Jeroen J H Bunge, Hergen Buscher, Clément Delmas, Dirk W Donker, Christoph Fisser, Guillaume Franchineau, Justin Fried, Francisco José Hernández-Pérez, Joshua Ihle, Jae-Seung Jung, Teresa Lόpez-Sobrino, Jamie McCanny, Armand Mekontso Dessap, Henrique Muglia, Shinichiro Ohshimo, Sunghoon Park, Romain Persichini, Beatriz Porral, Roberto Roncon-Albuquerque, Alessandro Sionis, Pauline Yeung Ng, Alain Combes, Matthieu Schmidt","doi":"10.1161/CIRCHEARTFAILURE.124.012399","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012399","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012399"},"PeriodicalIF":7.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Social Vulnerability Hotspots in Premature Heart Failure Mortality Across US Counties.","authors":"Akshaya Srikanth Bhagavathula, Edwin Akomaning, Samuel Prince Osei, Miranda Ashley Griechen","doi":"10.1161/CIRCHEARTFAILURE.125.012889","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.012889","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012889"},"PeriodicalIF":7.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Presentation of an Increasingly Recognized Disease: Transthyretin Amyloidosis Presenting With 18F-Fluorodeoxyglucose Uptake on Cardiac Positron Emission Tomography and Focal Late Gadolinium Enhancement on Cardiac Magnetic Resonance.","authors":"Kyla Brezitski, Karen Flores Rosario, Han W Kim, Johana R Fajardo, Michel G Khouri, Salvador Borges-Neto, Ravi Karra","doi":"10.1161/CIRCHEARTFAILURE.124.012002","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012002","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012002"},"PeriodicalIF":7.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter by Lim Regarding Article, \"The Pitfalls in the World of Evidence-Based Medicine: Should IABP Be en-DANGER-ed by the Danger Shock Trial?\"","authors":"Pitt O Lim","doi":"10.1161/CIRCHEARTFAILURE.125.012981","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.012981","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012981"},"PeriodicalIF":7.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucopolysaccharidosis Type IIIA Presenting as Hypertrophic Cardiomyopathy.","authors":"Filippo Pinto E Vairo, Jeffrey B Geske, Ravinder J Singh, Roy B Dyer, Konstantinos C Siontis, Maria O'Connell, Christopher Schmitz, Laura Lambert, Karl J Clark, Kimiyo M Raymond, Joseph J Maleszewski, Tim Wood, Pavel N Pichurin, Eric W Klee, Naveen L Pereira","doi":"10.1161/CIRCHEARTFAILURE.124.012632","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012632","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012632"},"PeriodicalIF":7.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights From Living Myocardial Slices Into Chemotherapy-Induced Cardiotoxicity: A Novel Ex Vivo Tool to Guide Clinical Decision-Making.","authors":"Ilse R Kelters, Jort S A van der Geest, Peter-Paul M Zwetsloot, Maarten Jan Cramer, Manon G van der Meer, Niels P van der Kaaij, Jan Peter van Tintelen, Joost P G Sluijter, Vasco Sampaio-Pinto, Linda W van Laake","doi":"10.1161/CIRCHEARTFAILURE.124.011876","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.011876","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011876"},"PeriodicalIF":7.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Treatment Landscape in Transthyretin Cardiac Amyloidosis.","authors":"Marianna Fontana, John L Berk, Brian Drachman, Pablo Garcia-Pavia, Mazen Hanna, Olivier Lairez, Ronald Witteles","doi":"10.1161/CIRCHEARTFAILURE.124.012112","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012112","url":null,"abstract":"<p><p>The demographics of patients with transthyretin amyloidosis with cardiomyopathy have evolved over the past decade, mostly driven by improved awareness of the disease among clinicians, noninvasive imaging tools for diagnosis, and new, effective treatments. Patients are now diagnosed earlier in their disease course, and treatment is initiated in those with milder disease, leading to improved outcomes. Earlier treatment of patients with milder disease may lead to accelerated disease stabilization and greater preservation of function. In addition, identification of patients with transthyretin amyloidosis with cardiomyopathy at an earlier disease stage translates to healthier study populations at enrollment in clinical trials, with slower disease progression compared with patients in prior trials. In this context, effect sizes between active treatment and placebo arms will likely be smaller than those seen in historic trials, although it is still possible to observe clinically relevant differences. In this review, we discuss how patient characteristics have changed from the ATTR-ACT trial to the more recent APOLLO-B, ATTRibute-CM, and HELIOS-B studies. In addition, we consider how measures of the minimal clinically important difference for particular end points can assist in clinical decision-making and targeting treatment goals. Treatment goals are evolving over time with the need for evidence-based recommendations in this clinical space. Lastly, we address unmet needs and future expectations for the management of transthyretin amyloidosis with cardiomyopathy.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012112"},"PeriodicalIF":7.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}