Circulation: Heart Failure最新文献

{"title":"Response by Fonarow et al to Letter Regarding Article, \"Improving Heart Failure Quality of are Over the First Twenty Years: The Get With The Guidelines-Heart Failure Program\".","authors":"Amber B Tang, Stephen J Greene, Gregg C Fonarow","doi":"10.1161/CIRCHEARTFAILURE.126.014533","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.126.014533","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014533"},"PeriodicalIF":8.3,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344027","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 Ragozzino and Mattera et al Regarding Article, \"What Exactly Is Cardiometabolic HFpEF: A Phenotype or an Endotype?\"","authors":"Giovanni Ragozzino, Edi Mattera","doi":"10.1161/CIRCHEARTFAILURE.126.014443","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.126.014443","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014443"},"PeriodicalIF":8.3,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307238","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":"Response by Tonelli et al to Letter Regarding Article \"Mechanisms Behind Dyspnea in Preload Insufficiency\".","authors":"Philippe Haouzi, Adriano R Tonelli","doi":"10.1161/CIRCHEARTFAILURE.126.014596","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.126.014596","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014596"},"PeriodicalIF":8.4,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257434","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 Risbano Regarding Article \"Mechanisms Behind Dyspnea in Preload Insufficiency\".","authors":"Michael G Risbano","doi":"10.1161/CIRCHEARTFAILURE.126.014496","DOIUrl":"10.1161/CIRCHEARTFAILURE.126.014496","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014496"},"PeriodicalIF":8.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bile Acids, Mitochondria, and Myocardial Stiffness: A Shared Mechanism in Fontan Circulation and Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Ashish H Shah, Alexander R Opotowsky, Jack Rychik, Richard A Krasuski","doi":"10.1161/CIRCHEARTFAILURE.126.014293","DOIUrl":"10.1161/CIRCHEARTFAILURE.126.014293","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014293"},"PeriodicalIF":8.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834289","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":"Right Ventricular Contractile Reserve in Heart Failure With Preserved Ejection Fraction.","authors":"Claudia Baratto, Denisa Muraru, Noela Radu, Michele Tomaselli, Mattia Mercurio, Giovanni Battista Perego, Stefano Paleari, Michele Senni, Gianfranco Parati, Luigi P Badano, Sergio Caravita","doi":"10.1161/CIRCHEARTFAILURE.126.014201","DOIUrl":"10.1161/CIRCHEARTFAILURE.126.014201","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014201"},"PeriodicalIF":8.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolerogenic Dendritic Cells Are Pivotal for Pediatric Transplant Operational Tolerance by Restraining Alloreactive T Cells via TGFβRII.","authors":"Wai Yen Yim, Yating Li, Jincheng Hou, Yuqi Chen, Bingchuan Geng, Matiullah Masroor, Zongtao Liu, Yixuan Wang, Nianguo Dong","doi":"10.1161/CIRCHEARTFAILURE.125.014053","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.014053","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014053"},"PeriodicalIF":8.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834347","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":"Short-Term Effects of Ambient Temperature on Acute Heart Failure Decompensation: Phenotype-Specific Risk in a Time-Stratified Case-Crossover Study.","authors":"Takahiro Jimba, Shun Kohsaka, Yasuyuki Shiraishi, Makoto Takei, Kazumasa Harada, Toshiaki Otsuka, Akito Shindo, Takashi Kohno, Hiroki Nakano, Junya Matsuda, Daisuke Kitano, Shigeto Tsukamoto, Shinji Koba, Takeshi Yamamoto, Norihiko Takeda, Morimasa Takayama","doi":"10.1161/CIRCHEARTFAILURE.125.013934","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.013934","url":null,"abstract":"<p><strong>Background: </strong>Acute decompensated heart failure (ADHF) exhibits seasonal variations, yet the short-term effects of ambient temperature, independent of seasonality, remain poorly studied. Moreover, temperature-sensitive exacerbation phenotypes are not well defined, limiting the development of effective preventive strategies. We aimed to investigate the effects of ambient temperature on ADHF admissions and clinical presentation profiles.</p><p><strong>Methods: </strong>We included 26 874 patients with ADHF who had been registered in the Tokyo Cardiovascular Care Unit Network Database between January 2014 and December 2019. The onset date of ADHF leading to hospitalization, along with clinical characteristics such as age, left ventricular function, cause of ADHF, and hemodynamic profile, was assessed by cardiologists at each participating center. Climate data were obtained from an observatory near the admitting hospital. We used a time-stratified case-crossover design with distributed lag nonlinear models to explore the association between ambient temperature and ADHF admissions over lag days 0 to 5, with stratified analyses by the clinical presentations.</p><p><strong>Results: </strong>Exposure to extremely low temperatures (-4.5 °C [first percentile]) increased the risk of ADHF (1.80, 95% CI, 1.40-2.31) when referenced to the temperature of lowest risk (29.0 °C [99th percentile]). The excess risk of lower temperature appeared immediately on the day of exposure (lag 0). This risk was larger in patients aged ≥70 years and otherwise consistent across subgroups. Notably, the temperature-risk relationship differed by hemodynamic profiles; risk for ADHF with hypertension rose at low temperatures, whereas ADHF with low blood pressure showed the opposite pattern, with risk increasing at high temperatures (odds ratio, 6.25 [95% CI, 1.07-36.6] at the 99th percentile).</p><p><strong>Conclusions: </strong>Low ambient temperature increased ADHF risk, especially in older adults, while temperature effects differed by hemodynamic phenotype. Incorporating temperature exposure into risk assessment may enable targeted prevention of climate-related decompensation.</p><p><strong>Registration: </strong>URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000015310; Unique identifier: UMIN000013128.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013934"},"PeriodicalIF":8.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041467","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":"Modest Contribution of Bradykinin to Blood Pressure Reduction by Sacubitril/Valsartan in Chronic Heart Failure.","authors":"Deepak K Gupta, Lynne W Stevenson, Erica M Garner, Christopher Maulion, Hui Nian, Patricia R Wright, Adina F Turcu, Shouzou Wei, Nancy J Brown","doi":"10.1161/CIRCHEARTFAILURE.125.014117","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.014117","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic hypotension can limit sacubitril/valsartan therapy. Neprilysin inhibition may augment vasodilators, such as bradykinin. We hypothesized that bradykinin contributes to blood pressure (BP) lowering with sacubitril/valsartan in stable ambulatory patients with heart failure and reduced ejection fraction <50%.</p><p><strong>Methods: </strong>In a randomized, double-blind crossover trial, participants received intravenous infusion of the bradykinin B2 receptor inhibitor icatibant and a matching placebo for 6 hours following sacubitril/valsartan dosing at acute initiation (n=36) and after 8 weeks of chronic therapy (n=30). The primary end point was maximal change in mean arterial pressure (MAP). Plasma natriuretic peptides, urine cyclic GMP, urine volume, sodium excretion, renal plasma flow, and renovascular resistance were measured.</p><p><strong>Results: </strong>The first dose of sacubitril/valsartan (50 mg) significantly lowered MAP by a mean maximum of ≈10 mm Hg, which was similar during icatibant and placebo. Within 6 hours after the first sacubitril/valsartan dose, plasma ANP (atrial natriuretic peptide [1-28]) and urine cGMP/creatinine increased significantly, whereas B-type NP (1-32) and NT-proBNP (N-terminal pro B-type natriuretic peptide) did not. Icatibant partially blunted the rise in urine cGMP/creatinine, but did not affect other parameters. After 8 weeks of sacubitril/valsartan titrated to maximally tolerated doses, baseline ANP (1-28) remained increased, and baseline MAP and NT-proBNP were decreased compared with before sacubitril/valsartan initiation. MAP decreased further after dose administration of sacubitril/valsartan, and the mean maximal reduction in MAP was significantly attenuated during icatibant compared with placebo (9 versus 12 mm Hg; <i>P</i>=0.013). Icatibant also decreased renal plasma flow and increased renal vascular resistance after chronic dosing, without affecting heart rate, urine volume, urine sodium, cGMP/creatinine, or natriuretic peptides.</p><p><strong>Conclusions: </strong>BP lowering with sacubitril/valsartan occurs with both acute and chronic dosing. ANP (1-28) appears to mediate the initial BP reduction, whereas bradykinin contributes to BP lowering after dosing during chronic therapy. Clarifying these mechanisms may inform clinical management to optimize the benefit of this important heart failure and reduced ejection fraction therapy.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04113109.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014117"},"PeriodicalIF":8.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compensating Heart Failure Cardiologists: Is the RVU Model the Right Model?","authors":"Nir Uriel, Boaz Elad, Yevgeniy Brailovsky, Kevin J Clerkin, Justin A Fried, Nikhil Narang, Dor Lotan, Ilan Richter, Jayant Raikhelkar, Adil Yunis, Ersilia M DeFilippis, Thomas M Cascino, Snehal R Patel, Shashank S Sinha, Jennifer Haythe, Marc E Richmond, Manreet K Kanwar, Gabriel Sayer, Ulrich P Jorde","doi":"10.1161/CIRCHEARTFAILURE.125.013838","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.013838","url":null,"abstract":"<p><p>Physician compensation models in the United States are diverse, shaped by practice settings, specialties, and institutional factors. A notable shift in academic medical centers has been the transition from salary-based compensation to relative value unit (RVU)-based models. While this shift may align compensation with clinical productivity and facilitate budgetary planning, it has profound implications for physician satisfaction, burnout, and clinical practice, particularly in primarily cognitive/nonprocedural based specialties like advanced heart failure (AHF). This article explores the benefits and drawbacks of the RVU model, with a focus on its application in AHF care. The RVU system, designed to measure physician work, practice expenses, and malpractice risk, is associated with efficiency incentives but also risks prioritizing quantity over quality, especially in multidisciplinary fields like AHF. Patients with AHF often have multiple comorbidities requiring extensive management and care coordination across multiple subspecialties, outside of the work effort captured by a clinic visit. The RVU model may undervalue the comprehensive, longitudinal care AHF specialists provide. Through a detailed examination of inpatient and outpatient AHF management, we argue that the RVU model may inadequately capture the full scope of AHF care, which may contribute to systemic challenges, physician burnout, and a decline in interest in AHF subspecialty training. Hence, we call for a reconsideration of AHF physician compensation and productivity measurement that more accurately reflects the full breadth of comprehensive AHF care.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013838"},"PeriodicalIF":8.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627334","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}