Circulation: Heart Failure最新文献

{"title":"Dynamic Volume Loading Using the Hepatojugular Reflux Test to Diagnose the Cause of Hypotension During Impella Supported Cardiogenic Shock.","authors":"Hadi Beaini, Keerthi Gondi, Maryjane Farr, Faris Araj","doi":"10.1161/CIRCHEARTFAILURE.125.013543","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.013543","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013543"},"PeriodicalIF":8.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285706","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":"Long-Term Outcomes After Fontan Conversion Operation: A Comparative Analysis Based on Type of Fontan Connection.","authors":"Amr Moustafa, Zeyad Kholeif, William R Miranda, Heidi M Connolly, Elizabeth H Stephens, Joseph A Dearani, Alexander C Egbe","doi":"10.1161/CIRCHEARTFAILURE.125.012990","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.012990","url":null,"abstract":"<p><strong>Background: </strong>Fontan conversion (FC) is associated with a lower risk of atrial arrhythmias and thromboembolism, but it is unknown whether FC improves long-term survival. The purpose of this study was to assess the impact of FC on transplant-free survival.</p><p><strong>Method: </strong>Adults with Fontan palliation were divided into 3 groups: (1) atriopulmonary Fontan connection; (2) atriopulmonary Fontan and subsequent FC to total cavopulmonary connection (TCPC); (3) TCPC at initial Fontan operation. The risk of death/transplant was compared between the 3 groups using Cox regression analysis.</p><p><strong>Results: </strong>We studied 534 patients (age 27±9 years; males [N=298; 56%]). Patients were divided into atriopulmonary Fontan group (N=199, 37%); FC-TCPC (N=138, 26%); and TCPC (N=197, 37%). The FC-TCPC and TCPC groups have similar 15-year incidence of death/transplant (42% versus 47%; <i>P</i>=0.8), even after excluding the 8% operative mortality in the FC-TCPC group (38% versus 47%; <i>P</i>=0.3). On multivariable analyses, neither FC nor the type of Fontan connection was associated with death/transplant. Rather, the risk factors for death/transplant were older age, hepatorenal dysfunction, heart failure, and higher Fontan pressures. The prevalence and severity of these comorbidities increased with age, suggesting that these factors reflect the duration of Fontan physiology, rather than the type of Fontan connection.</p><p><strong>Conclusions: </strong>These findings, in addition to the high operative mortality associated with FC, suggest that this may not be the optimal treatment option for most adults with atriopulmonary Fontan presenting with Fontan failure. Duration of Fontan physiology rather than the type of Fontan connection may be the main determinant of outcomes.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012990"},"PeriodicalIF":8.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285643","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":"Does Age Matter? SGLT2 Inhibitors in Older Adults With Heart Failure.","authors":"Veronica Daniel, Orly Vardeny","doi":"10.1161/CIRCHEARTFAILURE.125.013595","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.013595","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013595"},"PeriodicalIF":8.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257523","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":"Patients Who Donate Biospecimens for Research Leave a Valuable and Underappreciated Scientific Legacy.","authors":"Kenneth S Campbell","doi":"10.1161/CIRCHEARTFAILURE.125.013242","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.013242","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013242"},"PeriodicalIF":8.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250298","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":"Phenomapping in Heart Failure With Reduced Ejection Fraction to Identify Subpopulations With High Residual Risk: A VICTORIA Substudy.","authors":"Palak Shah, Yinggan Zheng, Burkert Pieske, Vojtech Melenovsky, Carolyn S P Lam, Karen Sliwa, Javed Butler, Justin A Ezekowitz, Christopher R deFilippi, Christopher M O'Connor, Roopinder K Sandhu, Lothar Roessig, Jasper Tromp, Cynthia M Westerhout, Adriaan A Voors, Paul W Armstrong","doi":"10.1161/CIRCHEARTFAILURE.125.013166","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.013166","url":null,"abstract":"<p><strong>Background: </strong>Patients with heart failure and reduced ejection fraction (HFrEF) have a high residual risk for heart failure hospitalizations and cardiovascular death. We aimed to use multimodality data to identify unique HFrEF subgroups with high residual risk.</p><p><strong>Methods: </strong>In this VICTORIA substudy (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction), clinical, electrocardiographic, echocardiographic, quantitative biomarker, and targeted proteomics data were collected. Agglomerative hierarchical clustering was performed using 105 variables to define HFrEF phenogroups. Cox regression estimated the relationship between the HFrEF phenogroups and the primary composite outcome of cardiovascular death or heart failure hospitalization. External validation of the phenogroups was performed in the BIOSTAT-CHF cohort (Biology Study to Tailored Treatment in Chronic Heart Failure). Multinomial logistic regression identified the most important variables in defining the HFrEF phenogroups.</p><p><strong>Results: </strong>There were 564 participants; after clustering, the optimal number of HFrEF phenogroups was 3. Phenogroup 1 was young, well-treated with guideline-directed medical therapy, and least likely to have an implantable cardioverter defibrillator. Phenogroup 2 had the highest prevalence of atrial fibrillation and pathological Q-waves on electrocardiography. Phenogroup 3 was older, had more biventricular dysfunction, and had advanced renal disease. A stepwise increase in risk of the primary composite outcome was observed from HFrEF phenogroup 1 to 3 (hazard ratio, 7.0 [95% CI, 4.1-12.0]; <i>P</i>≤0.01). The phenogroups were externally validated in BIOSTAT-CHF, and phenogroup 3 had similar patient characteristics (eg, older with more significant renal dysfunction) and had the highest event rate at 1 year (41% [95% CI, 38-45]). After multinomial regression, GDF-15 (growth differentiation factor 15) was most important in discriminating the 3 HFrEF phenogroups in both VICTORIA and BIOSTAT-CHF.</p><p><strong>Conclusions: </strong>We identified and externally validated unique HFrEF subpopulations with shared biological characteristics that differentiated residual risk for cardiovascular death or heart failure hospitalization. GDF-15 was the most important protein used to distinguish the 3 HFrEF phenogroups. These findings may inform study entry criteria for future HFrEF trials focused on the development of novel therapeutics.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02861534.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013166"},"PeriodicalIF":8.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243904","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":"Passive Leg Raise Does Not Unmask Diastolic Dysfunction in Adults With Fontan Circulation.","authors":"Jacob Y Cao, C Charles Jain, Alexander C Egbe, Barry A Borlaug, Yogesh N V Reddy, David Celermajer, Rachael Cordina, William R Miranda","doi":"10.1161/CIRCHEARTFAILURE.125.012991","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.012991","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012991"},"PeriodicalIF":8.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243850","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":"Plasma Proteome Analysis Identifies Vascular Endothelial Growth Factor Receptor 1 as a Prognostic Biomarker in Cardiogenic Shock.","authors":"Christian Jung, Alexander Lang, Dragos Duse, Raphael Romano Bruno, Janine Pöss, Georg Wolff, Uta Ceglarek, Uwe Zeymer, Georg Fuernau, Elric Zweck, Steffen Desch, Anne Freund, Berend Isermann, Susanne Pfeiler, Bernhard Wernly, Malte Kelm, Holger Thiele, Nobert Gerdes","doi":"10.1161/CIRCHEARTFAILURE.125.012890","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.012890","url":null,"abstract":"<p><strong>Background: </strong>Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI) leading to poor outcomes. Specific biomarkers, with subsequent validation of their prognostic relevance in CS, are urgently needed to improve therapies and outcomes. Accordingly, the present study investigated the plasma proteome using proximity extension assay technology to identify novel specific biomarkers with subsequent validation of their prognostic relevance in CS.</p><p><strong>Methods: </strong>Using proximity extension assay (Olink Explore, 2942 proteins), the proteomic signature in the plasma of 9 AMI patients without shock and 8 AMI patients with CS (AMICS; exploration cohort) at admission was analyzed. Candidate biomarkers were measured in the plasma of 421 patients with AMICS from the CULPRIT-SHOCK cohort (REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01927549, validation cohort). Their prognostic relevance was assessed for 180-day survival as the primary end point.</p><p><strong>Results: </strong>Proteome profiling was successful for 2925 proteins and identified VEGFR1 (vascular endothelial growth factor receptor 1, also known as Flt1) as elevated in AMICS compared with nonshock AMI in the exploration cohort (<i>P</i><0.001). In patients from the independent validation cohort, nonsurvivors had markedly higher VEGFR1 levels (6.8 versus 3.8 ng/L; <i>P</i><0.001). In Cox regression, VEGFR1 levels were independently associated with a higher 180-day mortality risk even after adjusting for the Simplified Acute Physiology Score II (per ng/L; adjusted hazard ratio, 1.06 [95% CI, 1.03-1.09]; <i>P</i><0.001) and yielded incremental prognostic information in addition to serum lactate levels (<i>P</i><0.001). The levels of VEGFR1 in surviving (30 days; n=29) and nonsurviving (n=21) patients with AMICS were determined at different time points (days 0, 1, and 5) in a third cohort, showing continuously higher levels in nonsurvivors.</p><p><strong>Conclusions: </strong>Plasma proteomic screening identified VEGFR1 as an early biomarker in patients with AMICS that provided independent prognostic information in a large cohort of well-defined patients with AMICS.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012890"},"PeriodicalIF":8.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198569","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":"Significance of Elevated Donor-Derived Cell-Free DNA in Heart Transplant Recipients With Negative Endomyocardial Biopsies: A Dawn of a New Era.","authors":"Cathrine M Moeller, Andrea Fernandez Valledor, Daniel Oren, Salwa Rahman, Julia Baranowska, Adi Hertz, Ersilia M DeFilippis, Changhee Lee, Matthew Regan, Amit Oren, Afsana Rahman, Carolyn Hennecken, Ruben Salazar, Elena M Donald, Dor Lotan, David Majure, Melana Yuzefpolskaya, Paolo C Colombo, Jayant K Raikhelkar, Justin A Fried, Kevin J Clerkin, Farhana Latif, Gabriel T Sayer, Nir Uriel","doi":"10.1161/CIRCHEARTFAILURE.125.012787","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.012787","url":null,"abstract":"<p><strong>Background: </strong>The purpose of the current study was to investigate the clinical implications of elevated donor-derived cell-free DNA (dd-cfDNA) levels in heart transplantation recipients without evidence of rejection observed on endomyocardial biopsy.</p><p><strong>Methods: </strong>We retrospectively analyzed dd-cfDNA samples from all consecutive heart transplantation recipients between 2019 and 2023, excluding those with multiorgan transplants. Each sample was paired with an endomyocardial biopsy (<30 days). A positive biopsy was defined based on International Society for Heart and Lung Transplantation criteria of ≥1R/1B or pAMR >0. Elevated dd-cfDNA was defined as ≥0.12%, with a subanalysis using a threshold of 0.20%. Graft dysfunction was defined as an ejection fraction<50%. We excluded dd-cfDNA samples with concurrent histologically positive biopsy results, focusing on those with positive dd-cfDNA and negative biopsy findings. A mixed model Cox regression approach was applied to assess for mortality and graft dysfunction.</p><p><strong>Results: </strong>Of 643 dd-cfDNA samples from 227 patients, 238 samples (37%) from 110 patients showed positive dd-cfDNA results with negative endomyocardial biopsy. The median age was 56 years, with 27% females and 53% White patients. The median time from heart transplantation to sample collection was 5 months (interquartile range, 3-12). Among the positive samples, the median dd-cfDNA level was 0.24% (interquartile range, 0.16%-0.53%) with 63% exceeding 0.20%. A higher prevalence of prior treated antibody-mediated rejection was observed in the dd-cfDNA positive group (15% versus 5%; <i>P</i>=0.002). Patients with elevated dd-cfDNA results ≥ 0.20% demonstrated a near 5-fold increased risk of mortality (hazard ratio, 4.6 [95% CI, 1.6-13.4]; <i>P</i>=0.005) and a 3-fold risk of graft dysfunction (hazard ratio, 3.4 [95% CI, 1.0-11.9]; <i>P</i>=0.054) compared with those with negative dd-cfDNA.</p><p><strong>Conclusions: </strong>In our cohort, patients with positive dd-cfDNA levels and negative biopsy results had higher rates of adverse outcomes, including graft dysfunction and mortality.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012787"},"PeriodicalIF":8.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191347","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":"Treatment With Myosin Inhibitor in a Patient With Symptomatic Hypertrophic Cardiomyopathy With Isolated Right Ventricular Obstruction.","authors":"Nora Schwegel, Viktoria Santner, Ewald Kolesnik, Johannes Schmid, Gabor G Toth, Nicolas Verheyen","doi":"10.1161/CIRCHEARTFAILURE.125.012801","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.012801","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012801"},"PeriodicalIF":8.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184719","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":"Easing the Strain: Atrial Function After Atrial Shunting.","authors":"Ravi B Patel, Sanjiv J Shah","doi":"10.1161/CIRCHEARTFAILURE.125.013583","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.013583","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013583"},"PeriodicalIF":8.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148233","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}