Circulation: Heart Failure最新文献

{"title":"Letter by Xing et al Regarding Article, \"Enhancing Sweat Rate Using a Novel Device for the Treatment of Congestion in Heart Failure\".","authors":"Han Xing, Chengeng Deng, Huihui Zhao","doi":"10.1161/CIRCHEARTFAILURE.124.012466","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012466","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012466"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045202","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":"Pseudo-Severe Mitral Stenosis From Obesity-Related HFpEF and Atrial Myopathy.","authors":"Jenny Jia Ling Cao, William R Miranda, Barry A Borlaug, Yogesh N V Reddy","doi":"10.1161/CIRCHEARTFAILURE.124.012703","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012703","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012703"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051716","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":"Impaired Exercise Capacity in High-Risk Diabetic Cardiomyopathy: The ARISE-HF Cardiopulmonary Exercise Testing Subanalysis.","authors":"W H Wilson Tang, Yuxi Liu, Javed Butler, Stefano Del Prato, Justin A Ezekowitz, Nasrien E Ibrahim, Carolyn S P Lam, Thomas H Marwick, Riccardo Perfetti, Julio Rosenstock, Scott D Solomon, Faiez Zannad, James L Januzzi, Gregory D Lewis","doi":"10.1161/CIRCHEARTFAILURE.124.012200","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012200","url":null,"abstract":"<p><strong>Background: </strong>Objective indices of functional capacity in patients with diabetic cardiomyopathy and stage B heart failure (HF) have not been comprehensively defined. We sought to characterize the cardiopulmonary exercise characteristics of individuals with diabetic cardiomyopathy at high risk for overt HF.</p><p><strong>Methods: </strong>The relationships from cardiopulmonary exercise testing with clinical and laboratory characteristics of participants with diabetic cardiomyopathy were evaluated using baseline data from the ARISE-HF trial (Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure). Cluster phenogroups with different comorbidities and their corresponding functional capacity profiles were identified.</p><p><strong>Results: </strong>Among study participants (n=689), the median (Q1, Q3) peak oxygen uptake and ventilatory efficiency (slope of the ratio of minute ventilation/carbon dioxide production) were 15.7 (interquartile range, 13.0-18.0) mL/kg per minute and 31.2 (interquartile range, 27.2-34.1), respectively. Lower peak oxygen uptake was associated with older age, female sex, higher body mass index, higher N-terminal pro-B-type natriuretic peptide, and an increasing burden of noncardiac comorbid conditions but was not associated with cardiac troponin T or echocardiogram-derived strain, left atrial volume index, E/e', or right ventricular systolic pressure. Elevated left ventricular mass index was the only echocardiographic abnormality associated with lower peak oxygen uptake. Multivariable analysis revealed that female sex, higher body mass index, and no history of dyslipidemia were independently associated with lower baseline peak oxygen uptake. Cluster analysis revealed 3 clusters with profiles of different cardiovascular/exercise parameters and health status profiles.</p><p><strong>Conclusions: </strong>Baseline cardiopulmonary exercise testing data from the ARISE-HF trial highlight predominant associations of extracardiac clinical and demographic variables with significant impairment in exercise capacity despite strict fulfillment of diagnostic criteria for stage B HF.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04083339.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012200"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063964","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":"Biomarkers of RV Dysfunction in HFrEF Identified by Direct Tissue Proteomics: Extracellular Proteins Fibromodulin and Fibulin-5.","authors":"Matěj Běhounek, Denisa Lipcseyová, Ondřej Vít, Petr Žáček, Pavel Talacko, Zuzana Husková, Soňa Kikerlová, Tereza Tykvartová, Peter Wohlfahrt, Vojtěch Melenovský, Jan Beneš, Jiří Petrák","doi":"10.1161/CIRCHEARTFAILURE.124.011984","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.011984","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular dysfunction (RVD) is common in patients with heart failure with reduced ejection fraction, and it is associated with poor prognosis. However, no biomarker reflecting RVD is available for routine clinical use.</p><p><strong>Methods: </strong>Proteomic analysis of myocardium from the left ventricle and right ventricle (RV) of patients with heart failure with reduced ejection fraction with (n=10) and without RVD (n=10) who underwent heart transplantation was performed. Concentrations of 2 ECM (extracellular matrix) proteins with the highest myocardial upregulation in RVD, FMOD (fibromodulin) and FBLN5 (fibulin-5), were assayed in the blood and tested in a separate cohort of patients with heart failure with reduced ejection fraction (n=232) to test for the association of the 2 proteins with RV function and long-term outcomes.</p><p><strong>Results: </strong>Multivariable linear regression revealed that plasma concentrations of both FMOD and FBLN5 were significantly associated with RV function regardless of the RV function assessment method. No association of FMOD or FBLN5 with left ventricular dysfunction, cardiac index, body mass index, diabetes status, or kidney function was found. Plasma levels of FMOD and FBLN5 were significantly associated with patient outcomes (<i>P</i>=0.005; <i>P</i>=0.004). Area under the curve analysis showed that the addition of FBLN5 or FMOD to RV function assessment had a significantly higher area under the curve after 4 years of follow-up (0.653 and 0.631, respectively) compared with RV function alone (0.570; <i>P</i><0.05 for both). Similarly, the combination of MAGGIC (Meta-Analysis Global Group in Chronic Heart Failure) score, FBLN5, and FMOD had a significantly larger area under the curve (0.669) than the combination of MAGGIC score+RVD grade (0.572; <i>P</i>=0.02). The Kaplan-Meier analysis demonstrated that patients with the elevation of both FMOD and FBLN5 (ie, FMOD >64 ng/mL and FMOD >27 ng/mL) had a worse prognosis than those with the elevation of either FBLN5 or FMOD (<i>P</i>=0.03) demonstrating the additive prognostic value of both proteins.</p><p><strong>Conclusions: </strong>Our study proposes that circulating levels of FMOD and FBLN5 may serve as new biomarkers of RVD in patients with heart failure with reduced ejection fraction.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011984"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001115","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":"Impact of Multimorbidity on Mortality in Heart Failure With Mildly Reduced and Preserved Ejection Fraction.","authors":"Mingming Yang, Toru Kondo, Pooja Dewan, Akshay S Desai, Carolyn S P Lam, Martin P Lefkowitz, Milton Packer, Jean L Rouleau, Muthiah Vaduganathan, Michael R Zile, Pardeep S Jhund, Lars Køber, Scott D Solomon, John J V McMurray","doi":"10.1161/CIRCHEARTFAILURE.124.011598","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.011598","url":null,"abstract":"<p><strong>Background: </strong>How different combinations of comorbidities influence risk at the patient level and population level in patients with heart failure with mildly reduced ejection fraction/heart failure with preserved ejection fraction is unknown. We aimed to investigate the prevalence of different combinations of cardiovascular and noncardiovascular comorbidities (ie, multimorbidity) and associated risk of death at the patient level and population level.</p><p><strong>Methods: </strong>Using patient-level data from the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) and PARAGON-HF trial (Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction), we investigated the 5 most common cardiovascular and noncardiovascular comorbidities and the resultant 45 comorbidity pairs. Cox proportional hazard models were used to calculate the population-attributable fractions for all-cause mortality and the relative excess risk due to interaction for each comorbidity pair.</p><p><strong>Results: </strong>Among 6504 participants, 95.2% had at least 2 of the 10 most prevalent comorbidities. The comorbidity pair with the greatest patient-level risk was stroke and peripheral artery disease (adjusted hazard ratio, 1.88 [95% CI, 1.27-2.79]), followed by peripheral artery disease and chronic obstructive pulmonary disease (1.81 [95% CI, 1.31-2.51]), and coronary artery disease and stroke (1.67 [95% CI, 1.33-2.11]). The pair with the highest population-level risk was hypertension and chronic kidney disease (CKD; adjusted population-attributable fraction, 14.8% [95% CI, 9.2%-19.9%]), followed by diabetes and CKD (13.3% [95% CI, 10.6%-16.0%]), and hypertension and diabetes (11.9% [95% CI, 7.1%-16.5%). A synergistic interaction (more than additive risk) was found for the comorbidity pairs of stroke and coronary artery disease (relative excess risk due to interaction, 0.61 [95% CI, 0.13-1.09]), diabetes and CKD (relative excess risk due to interaction, 0.46 [95% CI, -0.15 to 0.77]), and obesity and CKD (relative excess risk due to interaction, 0.24 [95% CI, 0.01-0.46]).</p><p><strong>Conclusions: </strong>The risk associated with comorbidity pairs differs at the patient and population levels in heart failure with mildly reduced ejection fraction/heart failure with preserved ejection fraction. At the population level, hypertension, CKD, and diabetes account for the greatest risk, whereas at the patient level, polyvascular disease and chronic obstructive pulmonary disease are the most important.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011598"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536613","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":"Ubiquity of Multimorbidity: Comorbid Conditions and Mortality in HFpEF.","authors":"Ishan Kamat, Ajith Nair","doi":"10.1161/CIRCHEARTFAILURE.124.012432","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012432","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012432"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536615","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":"Challenges Related to Out-of-Pocket Costs in Heart Failure Management.","authors":"Birju R Rao, Larry A Allen, Alexander T Sandhu, Neal W Dickert","doi":"10.1161/CIRCHEARTFAILURE.124.011584","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.011584","url":null,"abstract":"<p><p>High out-of-pocket costs and financial toxicity related to heart failure treatment are substantial concerns. Two of 4 pillars of guideline-directed medical therapy for heart failure with reduced ejection fraction, for example, carry high costs that may attenuate their uptake. Furthermore, heart failure rarely occurs in isolation. Many patients have other comorbidities that require treatment, further driving up patients' out-of-pocket costs. Developing treatment plans that improve mortality without subjecting patients to financial toxicity can be challenging for several reasons. First, patients with heart failure can accrue out-of-pocket costs from multiple domains and can depend on a variety of insurance and pharmacy-related factors that can make determining patient-specific out-of-pocket cost estimates complicated. Second, strategies to mitigate financial toxicity involve health policy-level interventions and patient-level interventions. These have their own unique sets of challenges. Third, integrating out-of-pocket costs into shared decision-making requires nuanced and challenging discussions about whether a therapy is worth the cost. Though shared decision-making has been advocated, there are little data on how to best conduct these discussions. Health policies like the Inflation Reduction Act of 2022 may provide relief to some patients, and efforts to improve transparency have the potential to be beneficial. Over the long term, policy solutions such as value-based insurance design and patient engagement solutions that emphasize enhancing shared decision-making have important potential to yield durable results.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011584"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522606","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":"<i>RBM20</i> Gene in Patients With Cardiomyopathy: Phenotypic Expression for Loss-of-Function Versus Hotspot Variants.","authors":"Alexis Hermida, Flavie Ader, Gilles Millat, Guillaume Jedraszak, Louis Vogel, Loïc Garçon, Philippe Maury, Floriane Fay, Christophe Beyls, Anne-Claire Bréhin, Laure Champ-Rigot, Claire Dauphin, Benjamin Dauriat, Pascal De Groote, Erwan Donal, Delphine Dupin-Deguine, Laurence Faivre, Alexandre Janin, Antoine Jobbe Duval, Guillaume Jondeau, Mikael Laredo, Isabelle Magnin, Eloi Marijon, Karine Nguyen, Aurélien Palmyre, Alexandre Perani, François Picard, Patricia Reant, Pascale Richard, Caroline Rooryck, François Roubille, Cécile Rouzier, Annick Toutain, Agathe Vernier, Pierre-François Winum, Didier Scarlatti, Frederic Sacher, Momar Diouf, Philippe Chevalier, Philippe Charron, Estelle Gandjbakhch","doi":"10.1161/CIRCHEARTFAILURE.124.012492","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012492","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012492"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001112","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":"Double Trouble: Coronary Aneurysm and Löffler Endocarditis in Hypereosinophilic Syndrome.","authors":"Si-Qi Tang, Hui-Min He, Wei Wu, Yuan-Yuan Zhu, Tong-Hui Wei, Chen Yang, Jun-Yan Qian, Ru-Xuan Chen, Yue Wang, De-Yan Yang","doi":"10.1161/CIRCHEARTFAILURE.124.012230","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012230","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012230"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406055","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":"Macitentan for Heart Failure With Preserved or Mildly Reduced Ejection Fraction and Pulmonary Vascular Disease: Results of the SERENADE Randomized Clinical Trial and Open-Label Extension Study.","authors":"Sanjiv J Shah, Diana Bonderman, Barry A Borlaug, John G F Cleland, Gabriela Lack, Wentao Lu, Adriaan A Voors, Faiez Zannad, Mark T Gladwin","doi":"10.1161/CIRCHEARTFAILURE.123.011381","DOIUrl":"10.1161/CIRCHEARTFAILURE.123.011381","url":null,"abstract":"<p><strong>Background: </strong>Despite favorable hemodynamic and neurohormonal effects, endothelin receptor antagonists have not improved outcomes in patients with heart failure (HF), possibly because they cause fluid retention.</p><p><strong>Methods: </strong>In this randomized, double-blind, multicenter trial (SERENADE [Macitentan in Heart Failure With Preserved Ejection Fraction and Pulmonary Vascular Disease]), we evaluated the effects of an endothelin receptor antagonist, macitentan, in patients with HF, left ventricular ejection fraction ≥40%, and pulmonary vascular disease. After a 4-week placebo run-in (to ensure clinical stability), followed by a 5-week single-blind macitentan run-in, patients who did not exhibit fluid retention were randomized to macitentan or placebo. The primary end point was change in NT-proBNP (N-terminal pro-B-type natriuretic peptide; baseline to 24 weeks); secondary end points included change in KCCQ (Kansas City Cardiomyopathy Questionnaire) clinical summary score (baseline to 24 weeks) and time to worsening HF by 52 weeks.</p><p><strong>Results: </strong>Of 230 patients enrolled, 28 were excluded during the placebo run-in, 60 excluded during the macitentan run-in, and 142 were randomized. Macitentan had no effect on change in NT-proBNP (geometric mean ratio [macitentan/placebo], 1.02 [90% CI, 0.88-1.19]; <i>P</i>=0.79) or on secondary end points (placebo-corrected change in KCCQ clinical summary score, -3.5 [90% CI, -8.2 to +1.2]; <i>P</i>=0.22). Worsening HF occurred in 20 (28%) patients assigned to macitentan and 13 (18%) assigned to placebo (hazard ratio, 1.48 [90% CI, 0.83-2.67]; <i>P</i>=0.24). More macitentan-treated patients developed fluid retention (16 [23%] versus 10 [14%]) and cardiac adverse events (33 [46%] versus 22 [31%]) versus placebo.</p><p><strong>Conclusions: </strong>Despite a novel enrichment trial design to target pulmonary vascular disease and exclude treatment-related fluid retention in patients with HF and preserved/mildly reduced left ventricular ejection fraction, macitentan neither lowered NT-proBNP nor improved HF outcomes.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifiers: NCT03153111 and NCT03714815.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011381"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596359","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}