Circulation: Heart Failure最新文献

{"title":"From Marker of Risk to Marker of Response: Using Biomarkers to Guide Heart Failure Rehabilitation.","authors":"Leonard Chiu, Ambarish Pandey","doi":"10.1161/CIRCHEARTFAILURE.126.014069","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.126.014069","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":"19 10","pages":"e014069"},"PeriodicalIF":8.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227417","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":"Correction to: Circulating Biomarkers as Predictors of Improvement in Physical Function in Hospitalized Older Adults With Geriatric Syndromes: Findings From the REHAB-HF Trial.","authors":"Abdulla A Damluji, Scott A Bruce, Gordon Reeves, Amy M Pastva, Alain G Bertoni, Robert J Mentz, David J Whellan, Dalane W Kitzman, Christopher R deFilippi","doi":"10.1161/HHF.0000000000000093","DOIUrl":"https://doi.org/10.1161/HHF.0000000000000093","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":"19 10","pages":"e000093"},"PeriodicalIF":8.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227468","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":"Circulating Biomarkers as Predictors of Improvement in Physical Function in Hospitalized Older Adults With Geriatric Syndromes: Findings From the REHAB-HF Trial.","authors":"Abdulla A Damluji, Scott A Bruce, Gordon Reeves, Amy M Pastva, Alain G Bertoni, Robert J Mentz, David J Whellan, Dalane W Kitzman, Christopher R deFilippi","doi":"10.1161/CIRCHEARTFAILURE.125.013251","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.013251","url":null,"abstract":"<p><strong>Background: </strong>Biomarkers in heart failure (HF) provide mechanistic and prognostic insights, but their role in predicting treatment response is less understood. We evaluated whether multiple baseline biomarker profiles from the REHAB-HF trial (Rehabilitation Therapy in Older Acute Heart Failure Patients) could stratify functional improvement following a 12-week physical rehabilitation intervention (RI).</p><p><strong>Methods: </strong>Participants ≥60 years hospitalized with heart failure were randomized to a 12-week outpatient RI or attention control. Functional outcomes included changes in the short physical performance battery and 6-minute walk distance. Blood collected at baseline and 12 weeks was analyzed for cardiac (cTnI and cTnT [cardiac troponin I and T], NT-proBNP [N-terminal pro-B-type natriuretic peptide]), renal (creatinine), and inflammatory (CRP [C-reactive protein]) biomarkers. Associations between baseline biomarker levels and 12-week functional gains by treatment group were evaluated using adjusted linear regression models and machine learning-based decision trees.</p><p><strong>Results: </strong>Baseline biomarker data were available for 242 of 349 participants (69%). Using linear regression, higher cTnI and T were associated with greater 12-week gains in the short physical performance battery and 6-minute walk distance, respectively, among RI participants versus attention control (interaction <i>P</i>=0.040 and 0.032). In the decision tree, analyses combining all biomarkers, CRP emerged as the primary biomarker for both outcomes. Among participants with CRP ≥9.9 mg/L, RI was associated with a +2.4 point (95% CI, 1.8-3.1) greater increase in the short physical performance battery and a +79 m (95% CI, 50-109) greater increase in 6-minute walk distance compared with attention control. In contrast, for those with CRP <9.9 mg/L, the differential benefit of the RI was limited (+0.8 in short physical performance battery [95% CI, 0.1-1.6]; +30 m in 6-minute walk distance [95% CI, -1.0 to 61]). The biomarker levels (except for creatinine) decreased by 12 weeks posthospitalization, but with no differences based on treatment assignment.</p><p><strong>Conclusions: </strong>Higher inflammation, measured by CRP, may identify older adults recently hospitalized for heart failure with the greatest functional benefit from a physical RI. Biomarker profiling may predict the benefits of this treatment.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02196038.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013251"},"PeriodicalIF":8.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917194","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":"Clonal Hematopoiesis of Indeterminate Potential Proteomic Risk Score for Predicting Clinical Outcome in Patients With Heart Failure With Preserved Ejection Fraction.","authors":"Minkwan Kim, Vinayak Subramanian, Hamed Tavolinejad, Mateo Sarmiento Bustamante, Bianca Pourmussa, Douglas L Mann, Ali Javaheri, A Mark Richards, Robert N Doughty, Ernst Rietzschel, Vanessa van Empel, Payman Zamani, Thomas P Cappola, Dan Tong, Stephen Chung, Ambarish Pandey, Julio A Chirinos","doi":"10.1161/CIRCHEARTFAILURE.126.014345","DOIUrl":"10.1161/CIRCHEARTFAILURE.126.014345","url":null,"abstract":"<p><strong>Background: </strong>Clonal hematopoiesis of indeterminate potential (CHIP) is common in heart failure with preserved ejection fraction (HFpEF). However, the proteomic signatures linked to CHIP driver mutations and their prognostic implications in HFpEF remain poorly defined. We aimed to identify plasma protein signatures associated with CHIP driver mutations and to develop and externally validate a CHIP-proteomic risk score (CHIP-ProtRS) for predicting clinical outcomes in HFpEF.</p><p><strong>Methods: </strong>The derivation cohort consisted of 118 TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) participants with available CHIP sequencing and proteomic profiling using the SomaScan platform. Associations between CHIP mutations and circulating proteins were assessed using gene-specific linear regression adjusted for age, with correction for multiple comparisons. Significant proteins were used to derive gene-specific proteomic classifiers using nested cross-validated least absolute shrinkage and selection operator logistic regression. A composite CHIP-ProtRS was generated using least absolute shrinkage and selection operator Cox regression and validated in a composite of 3 independent HFpEF cohorts (n=654). The primary end point was a composite of death and HF hospitalization.</p><p><strong>Results: </strong>In TOPCAT, 30.5% of tested participants carried ≥1 CHIP mutation. Significant protein associations were identified for <i>TET2</i> (7 proteins), <i>DNMT3A</i> (10), and <i>PPM1D</i> (5), all of which were enriched in immune and inflammatory pathways. Gene-specific least absolute shrinkage and selection operator models showed good discrimination for CHIP mutation (area under the curves, 0.752-0.898). The primary end point occurred in 28.0% of the derivation cohort and 34.7% of the validation cohorts. In the Cox-least absolute shrinkage and selection operator combination, only the <i>TET2</i>-derived proteomic signature retained a nonzero coefficient in the CHIP-ProtRS. The CHIP-ProtRS was independently associated with the primary end point after adjustment for age, sex, Meta-Analysis Global Group in Chronic Heart Failure score, NT-proBNP (N-terminal pro-B-type natriuretic peptide), and atrial fibrillation in the derivation (adjusted hazard ratio, 1.42 [95% CI, 1.01-2.00]) and validation cohorts (adjusted hazard ratio, 1.16 [95% CI, 1.01-1.32]).</p><p><strong>Conclusions: </strong>CHIP is associated with alterations in plasma concentrations of immune/inflammatory proteins. A CHIP-ProtRS is independently associated with adverse outcomes in HFpEF, supporting its potential role as a biomarker of risk and underlying pathobiology.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014345"},"PeriodicalIF":8.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011973","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":"Health-Related Quality of Life in Older Patients With Advanced Heart Failure From Before to 2 Years After Heart Transplantation or Long-Term Mechanical Circulatory Support: Findings From the SUSTAIN-IT Study.","authors":"Kathleen L Grady, John A Spertus, Mary Amanda Dew, Tingqing Wu, Scott Silvestry, Maryl Johnson, Eileen Hsich, Brent Lampert, Michael Petty, Salpy V Pamboukian, Andrew Kao, James K Kirklin, Duc Thinh Pham, Justin Hartupee, Margaret Murray, Melana Yuzefpolskaya, Koji Takeda, Jerian Dixon-Evans, Adin-Cristian Andrei","doi":"10.1161/CIRCHEARTFAILURE.125.013871","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.013871","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQOL) is a key consideration among older patients with heart failure considering advanced therapies. We evaluated change in HRQOL from before to 24 months after heart transplantation (HT) or long-term mechanical circulatory support (MCS) among older (60-80 years) patients and identified factors associated with HRQOL changes.</p><p><strong>Methods: </strong>Data for this observational study were collected from 13 US sites via patient self-reported measures (EuroQol-5-dimension-3L visual analog scale score: 0=worst-100=best imaginable health state and dimension scores; Kansas City Cardiomyopathy Questionnaire-12 overall summary score/domain scores: 0-100, higher=better health status; other measures) and a 6-minute walk test. Analyses included multivariable linear mixed-effects models.</p><p><strong>Results: </strong>Of 393 enrollees, 305 underwent surgery: HT with pretransplant MCS (HT MCS)=69, HT without pretransplant MCS (HT non-MCS)=92, and long-term MCS=144. Cohort average age=66.9±4.7 years, 78% male, 83% White, 78% married/partnered, and 71% with >high school education. HT non-MCS and long-term MCS groups experienced significant improvement in average visual analog scale scores within 6 months after surgery, sustained through 24 months of follow-up; the HT MCS group EuroQol-5-dimension-3L baseline visual analog scale score was higher than those of the other 2 groups and did not improve significantly through 24 months of follow-up. The average Kansas City Cardiomyopathy Questionnaire-12 overall summary score improved in all 3 groups (baseline-6 months, sustained through 24 months). Compared with HT non-MCS, the main effect of long-term MCS showed decrements of -11.2 (-17.3 to -5.1; <i>P</i><0.001) points in Kansas City Cardiomyopathy Questionnaire-12 overall summary score and of -9.9 (-16.1 to -3.8; <i>P</i>=0.002) points in EuroQol-5-dimension-3L visual analog scale.</p><p><strong>Conclusions: </strong>HT MCS improvement in HRQOL varied by measure; HT non-MCS and long-term MCS improvement occurred through 24 months, regardless of measure. Domains of HRQOL improved after these surgeries, varying by surgical strategy and postoperative time period. Long-term MCS was associated with a decrease in HRQOL across time. These findings provide important information for patients considering treatment options.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013871"},"PeriodicalIF":8.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011953","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":"Optimizing Screening Intervals for At-Risk Relatives of Dilated Cardiomyopathy Carrying a TTNtv.","authors":"Steven A Muller, Nina J Beelen, Alessia Paldino, Clea Gonzalez-Maniega, Henning Bundgaard, Alex H Christensen, Christoffer R Vissing, Renee Johnson, Daria R Kramarenko, Max F G H M Venner, Eva Del Mestre, Guilielmus H J M Ellenbroek, Fernando Dominiquez, Matteo Dal Ferro, Marco Merlo, Sophie L V M Stroeks, Gianfranco Sinagra, Ahmad S Amin, Diane Fatkin, Pablo Garcia-Pavia, Anneline S J M Te Riele, Job A J Verdonschot","doi":"10.1161/CIRCHEARTFAILURE.125.013822","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.013822","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathy guidelines recommend routine screening of at-risk relatives with dilated cardiomyopathy (DCM). Titin-truncating variants are the most prevalent cause. However, the diagnostic yield of screening is low. Risk-based stratification could optimize screening intervals and resource allocation. This study aims to develop a safe, evidence-based gene-specific longitudinal screening algorithm for DCM development.</p><p><strong>Methods: </strong>We included likely pathogenic/pathogenic titin-truncating variant relatives from 7 centers who underwent cardiac screening. Relatives were stratified based on their baseline clinical phenotype: genotype-positive/phenotype-negative (no left ventricular dysfunction and dilatation) or partial DCM (ie, fulfilling only 1 criterion). DCM development predictors were identified based on follow-up data. Risk profiles were established and used to develop a multistate model to create a longitudinal screening algorithm to safely and effectively monitor titin-truncating variant relatives.</p><p><strong>Results: </strong>Among 413 relatives, follow-up data were available in 301 relatives (median follow-up 5.7 years), of whom 24.6% developed left ventricular dysfunction or dilatation and 17.3% developed DCM. In total, 16 relatives (5.3%) experienced a major adverse cardiac event after DCM diagnosis. Based on the identified risk factors, age ≥30 years, male sex, and partial DCM, 3 distinct profiles were established: (1) relatives with partial DCM, (2) females ≥30 years and males, and (3) female relatives <30 years. A screening algorithm was developed, recommending intervals of 1, 3, and 5 years, optimizing the balance between safety and effectiveness.</p><p><strong>Conclusions: </strong>An evidence-based genotype-specific longitudinal screening algorithm that integrates age, sex, and echocardiographic measurements may improve patient care and improve efficiency of clinical resource allocation.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013822"},"PeriodicalIF":8.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011999","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":"Heart Failure and Neurocognitive Disorders: A Narrative Review.","authors":"Shuantong Lin, Qian Wang, Jiangbei Cao","doi":"10.1161/CIRCHEARTFAILURE.126.014265","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.126.014265","url":null,"abstract":"<p><p>Neurocognitive disorders-including mild cognitive impairment, dementia, and delirium-are common yet often underrecognized in heart failure, impairing self-care and outcomes. These heart failure-related neurocognitive disorders pose a significant public health challenge due to high morbidity and mortality. Despite recent advances, timely detection, prevention, and intervention remain difficult. Most research focuses on pharmacological treatments, with limited attention to nonpharmacological approaches and mental health integration in heart failure care teams. Progress requires collaboration among internal medicine, surgery, nursing, and psychology. This review highlights interconnected pathways-cerebral hypoperfusion, microvascular and endothelial dysfunction, thromboembolic injury, and neuroendocrine-inflammatory activation-and discusses targeted interventions like simplified treatment plans, caregiver involvement, and multidisciplinary referrals.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014265"},"PeriodicalIF":8.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929170","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":"Cardiac Resynchronization Therapy and Circulating Metabolomic Profile in Patients With Advanced Heart Failure.","authors":"Zhiyong Qian, Hon-Chi Lee, Siva K Mulpuru, Ivan Vuckovic, Abhishek J Deshmukh, Christopher V DeSimone, Samuel J Asirvatham, Songnan Wen, Chuanwei Li, Song Zhang, Surendra Dasari, Petras P Dzeja, Ian R Lanza, Bing Yu, Kent R Bailey, Horng H Chen, Yong-Mei Cha","doi":"10.1161/CIRCHEARTFAILURE.125.014148","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.014148","url":null,"abstract":"<p><strong>Background: </strong>It is unknown whether cardiac resynchronization therapy (CRT) improves systemic metabolomic profile by enhancing left ventricular function. The observational cohort study aimed to investigate the effect of CRT on left ventricular ejection fraction (LVEF) and circulating plasma metabolites in patients who had heart failure with reduced LVEF.</p><p><strong>Methods: </strong>We prospectively screened patients with ischemic cardiomyopathy and nonischemic cardiomyopathy who received CRT with a defibrillator for LVEF ≤35% according to current guidelines. Clinical assessment included echocardiography and device interrogation. Blood samples for metabolomic analysis were collected before CRT and at 6-month follow-up. Plasma was subjected to gas chromatography-mass spectrometry and ¹H nuclear magnetic resonance-based metabolomic analysis.</p><p><strong>Results: </strong>Totally 92 patients were enrolled, with a mean age of 67.3±11.3 years (37.0% female). LVEF was significantly improved from 28.9±7.6% at baseline to 36.0±11.3% at 6 months (<i>P</i><0.001) and to 40.1±12.6% at 12 months (<i>P</i><0.001). After CRT, 42 metabolite features were significantly decreased compared with the baseline. The ketone bodies, including 3-hydroxybutyrate (<i>P</i><0.001) and acetone (<i>P</i>=0.01), were reduced. A branched-chain amino acid, isoleucine, was also decreased after CRT (<i>P</i>=0.01). These metabolomic changes were mainly observed in the nonischemic cardiomyopathy group, while the metabolomic profile in the ischemic cardiomyopathy group was characterized by enhanced amino acid oxidation and elevated levels of lactate and pyruvate. The improvement in LVEF positively correlated with the ratio of changes in ketone bodies and isoleucine.</p><p><strong>Conclusions: </strong>CRT may modulate the systemic plasma metabolomic profile, which correlated with improvement in left ventricular function in patients with severe heart failure with reduced ejection fraction.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014148"},"PeriodicalIF":8.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918565","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":"Atrial Fibrillation in Genotyped Dilated Cardiomyopathy: Epidemiology, Risk Factors, and Outcomes: Insights From the SHaRe Registry.","authors":"Iswaree D Balakrishnan, Astrid B M Heymans, Brian Claggett, Garrick C Stewart, Christine E Seidman, Sophie L V M Stroeks, Nina J Beelen, Max F G H M Venner, Anjali T Owens, Sharlene M Day, Adam S Helms, Supriya Shore, Matthew T Wheeler, Alessandra Fornaro, Iacopo Olivotto, Luisa Mestroni, Sadiya S Khan, Gianfranco Sinagra, Marco Merlo, Joseph Rossano, Kimberly Y Lin, Lynne W Stevenson, Upasana Tayal, Matthew R G Taylor, Lisa D Wilsbacher, Sanjay K Prasad, Stephane R B Heymans, Carolyn Y Ho, Victoria N Parikh, Job A J Verdonschot, Neal K Lakdawala","doi":"10.1161/CIRCHEARTFAILURE.125.014322","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.014322","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most common arrhythmia in dilated cardiomyopathy (DCM) and is associated with adverse outcomes. However, the genetic determinants of AF risk and its prognostic significance across genotyped DCM subtypes remain unknown.</p><p><strong>Methods: </strong>In this observational cohort study, we analyzed 3117 genotyped patients with DCM from the SHaRe (Sarcomeric Human Cardiomyopathy Registry). AF prevalence, incidence, and clinical characteristics were assessed by genotype. Patients were classified as genotype-positive [G(+)] if they had a pathogenic or likely pathogenic variant in a DCM-associated gene, and genotype-negative [G(-)] if genetic testing was negative. Factors associated with incident AF were evaluated using Cox regression. AF was modeled as a time-dependent variable to evaluate associations with clinical outcomes.</p><p><strong>Results: </strong>Among 3117 genotyped patients with DCM (mean age, 48±15 years; 39% were female; and 35% were G[+]), 12.3% (n=384) had prevalent AF. Of 2491 patients without prevalent AF and with follow-up, 312 (12.5%) developed AF during a median of 4.5 years (interquartile range, 1.6-9.0). Among 2851 patients with follow-up, cumulative AF prevalence was 23.6%. <i>LMNA</i> had the highest AF incidence (7.6/100 patient-years) and cumulative AF prevalence (56.7%) and was the only genotype independently associated with incident AF compared with that in G(-) patients (hazard ratio, 5.52 [95% CI, 3.84-7.95]; <i>P</i><0.001). <i>TTN</i> had an AF incidence of 2.1 per 100 patient-years and cumulative AF prevalence of 24.4%, comparable to that in G(-) patients. Older age, male sex, and prior heart failure hospitalization were also independently associated with incident AF. AF was independently associated with a higher risk of the composite clinical outcome (hazard ratio, 1.58 [95% CI, 1.29-1.94]; <i>P</i><0.001), including heart failure, ventricular arrhythmias, and all-cause mortality.</p><p><strong>Conclusions: </strong>In this large genotyped DCM cohort, AF burden and incident AF risk varied across genotypes. Only <i>LMNA</i> was associated with an increased risk of incident AF. AF onset was independently associated with adverse outcomes, supporting genotype-guided AF surveillance and management in DCM.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014322"},"PeriodicalIF":8.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918615","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":"Changes in Hemodynamic and Inferior Vena Cava Parameters during Supine and Upright Exercise in a Patient With a Left Ventricular Assisted Device.","authors":"Rebecca Steinberg, Veraprapas Kittipibul, Stuart D Russell, Marat Fudim","doi":"10.1161/CIRCHEARTFAILURE.125.014037","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.014037","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e014037"},"PeriodicalIF":8.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918563","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}