Circulation: Heart Failure最新文献

{"title":"High-Dose vs. Standard-Dose Influenza Vaccine in Heart Failure: A Prespecified Analysis of the DANFLU-2 Trial.","authors":"Kristoffer Grundtvig Skaarup, Niklas Dyrby Johansen, Daniel Modin, Matthew M Loiacono, Rebecca C Harris, Marine Dufournet, Carsten Schade Larsen, Lykke Larsen, Lothar Wiese, Michael Dalager-Pedersen, Brian L Claggett, Katja Vu Bartholdy, Katrine Feldballe Bernholm, Julie Inge-Marie Borchsenius, Filip Søskov Davidovski, Lise Witten Davodian, Maria Dons, Lisa Steen Duus, Caroline Espersen, Frederik Holme Fussing, Anne Marie Reimer Jensen, Nino Emanuel Landler, Adam Cadovius Femerling Langhoff, Mats Christian Højbjerg Lassen, Anne Bjerg Nielsen, Camilla Ikast Ottosen, Morten Sengeløv, Scott D Solomon, Martin J Landray, Gunnar H Gislason, Lars Køber, Pradeesh Sivapalan, Cyril Jean-Marie Martel, Jens Ulrik Stæhr Jensen, Alexandre Mebazaa, Tor Biering-Sørensen","doi":"10.1161/CIRCHEARTFAILURE.125.013678","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.125.013678","url":null,"abstract":"<p><p><b>Background:</b> Influenza contributes substantially to disease burden in individuals with heart failure (HF) and is an established trigger of cardiovascular (CV) and HF events. Standard-dose inactivated influenza vaccine (SD-IIV) is recommended for HF, though immune responses may be attenuated. High-dose IIV (HD-IIV) was developed to enhance immunogenicity, but its effectiveness compared with SD-IIV against hospitalization for influenza and CV disease by HF status remains uncertain. <b>Methods:</b> This was a prespecified analysis of a pragmatic, prospective, individually randomized, open-label trial with registry-based endpoint-evaluation conducted in Denmark across the 2022/2023 to 2024/2025 influenza seasons. Citizens ≥65 years were randomized 1:1 to HD-IIV or SD-IIV. Outcomes included hospitalization for influenza-related illness, laboratory-confirmed influenza (LCI), any CV disease, cardio-respiratory disease, and HF, assessed by HF status. Effect of HD-IIV vs. SD-IIV in reducing risk of outcomes assessed was expressed as risk ratios (RR). <b>Results:</b> The trial randomized 332,438 participants (48.6% female, mean age 73.7±5.8 years), including 10,410 with HF at baseline (27.4% female, mean age 76.0±6.3 years). Overall, HD-IIV was associated with a statistically significant lower incidence of hospitalization for influenza-related illness, LCI, cardio-respiratory disease, CV disease, and HF compared with SD-IIV. In participants with HF, effect estimates were similar: RR for influenza-related hospitalization was 0.48 (95%CI, 0.20-1.06; p_interaction=0.64), for LCI hospitalization 0.55 (95%CI, 0.29-1.02; p_interaction=0.59), for cardio-respiratory hospitalization 0.89 (95%CI, 0.77-1.02; p_interaction=0.34), for CV hospitalization 0.86 (95%CI, 0.72-1.02; p_interaction=0.34), and for HF hospitalization 0.82 (95%CI, 0.61-1.11; p_interaction=0.83). Findings were consistent across HF subgroups by disease duration, recency of hospitalization, most recent N-terminal pro-B-type natriuretic peptide, and presence of device therapy. <b>Conclusions:</b> In this prespecified exploratory analysis of the largest individually randomized influenza vaccine trial ever conducted, HD-IIV was associated with lower rates of influenza and CV hospitalizations compared with SD-IIV, with effect estimates similar across HF status at baseline and HF subgroups.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945070","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":"Natriuretic Peptide Cut Points for Heart Failure Classification in Individuals With and Without Obesity.","authors":"Mandana Chitsazan, Juhi K Parekh, Leah B Kosyakovsky, Sophie M Nemeth, Emily S Lau, James L Januzzi, Thomas J Wang, Daniel Levy, Chiadi E Ndumele, Elizabeth Selvin, Christie Ballantyne, Bruce M Psaty, John S Gottdiener, Jorge R Kizer, Christopher R deFilippi, Norrina B Allen, Rudolf A de Boer, Sanjiv J Shah, Jennifer E Ho","doi":"10.1161/CIRCHEARTFAILURE.125.013112","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.013112","url":null,"abstract":"<p><strong>Background: </strong>The 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America guidelines introduced elevated natriuretic peptide (NP) levels as a criterion for defining stage B heart failure (HF), or pre-HF, to identify individuals at greatest risk for future HF. Given the known NP deficiency in obesity, we aimed to assess whether a single NP cut point would disproportionately up-classify individuals with versus without obesity to stage B HF.</p><p><strong>Methods: </strong>Participants free of HF from 5 community-based cohorts were included. We examined the reclassification of individuals to stage B HF using the 2022 versus 2013 guidelines, stratified by obesity class. Cox proportional hazards models were used to assess the association of NPs with incident HF across obesity classes.</p><p><strong>Results: </strong>Among 32 735 participants, 35% had normal weight, 40% were overweight, 17% had obesity class 1, and 8% had obesity class 2/3. When applying the 2022 versus 2013 criteria, the proportion of individuals up-classified to stage B HF using the NP criterion was 62% among those with normal weight, 51% for those overweight, 47% for individuals with obesity class 1, and 42% for individuals with obesity class 2/3. Over a median follow-up of 13 years, 3077 HF events occurred. Both higher NP and body mass index were associated with greater HF risk, as expected (<i>P</i><0.0001 for both). Importantly, body mass index modified the association of NP with HF risk, such that higher NP concentration was associated with greater HF risk among individuals with lower body mass index. The optimal NT-proBNP (N-terminal pro-B-type natriuretic peptide) cut point to predict future HF risk was lower among individuals with obesity (80 pg/mL; 95% CI, 53-121) compared with normal-weight individuals (109 pg/mL; 95% CI, 80-157).</p><p><strong>Conclusions: </strong>The application of a single NP cut point resulted in fewer individuals with obesity being up-classified to stage B HF compared with normal-weight individuals. Adjusting NP cut points for individuals with obesity may improve the accuracy of HF risk stratification.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013112"},"PeriodicalIF":8.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882227","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":"Efficacy and Safety of SGLT2 Inhibitors in Heart Failure: Observational Evidence in Geriatric Patients AGING-HF.","authors":"Abdelhakim Hacil, Yara Antakly Hanon, Audrey Lacour, Jean-Philippe David, Tesnim Khalifa, Matthieu Piccoli, Aude Clemencin, Patrick Assayag, Jean-Sebastien Vidal, Olivier Hanon","doi":"10.1161/CIRCHEARTFAILURE.125.012794","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.012794","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have shown beneficial effects in heart failure (HF) management, but data on their use in geriatric populations with high comorbidity remain limited. This observational study aimed to assess the real-world efficacy and safety of SGLT2i in elderly patients with HF.</p><p><strong>Methods: </strong>This prospective multicenter study included 496 patients hospitalized for acute heart failure across 3 geriatric units. The mean age was 90 years, and the mean Charlson Comorbidity Index score was 8.2. Participants were divided into 2 groups: the SGLT2i group (n=260) receiving SGLT2i (empagliflozin or dapagliflozin) alongside standard HF treatment, and the Control group (n=236) receiving only standard HF treatment. The primary outcomes were all-cause mortality, HF rehospitalizations, and adverse events over 1 year.</p><p><strong>Results: </strong>SGLT2i use was associated with lower risks of all-cause mortality (hazard ratio, 0.67 [95% CI, 0.46-0.98]; <i>P</i>=0.031), HF rehospitalization (hazard ratio, 0.64 [95% CI, 0.42-0.97]; <i>P</i>=0.037), and the composite outcome (hazard ratio, 0.60 [95% CI, 0.44-0.82]; <i>P</i>=0.001) at 1 year, after multivariable adjustment. No significant interaction was observed between left ventricular ejection fraction status and SGLT2i use (<i>P</i> for interaction=0.12). Although urinary and genital infections were more frequently reported in the SGLT2i group, treatment discontinuation remained low (2.7%).</p><p><strong>Conclusions: </strong>In this elderly population with high comorbidity, SGLT2i therapy was associated with substantial reductions in mortality and HF rehospitalization, and showed good tolerability and an acceptable safety profile.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012794"},"PeriodicalIF":8.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882226","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":"Sarcopenia Assessment Using Fully Automated Deep Learning Predicts Cardiac Allograft Survival in Heart Transplant Recipients.","authors":"Frederick M Lang, Jianfei Liu, Kevin J Clerkin, Elissa A Driggin, Andrew J Einstein, Gabriel T Sayer, Koji Takeda, Nir Uriel, Ronald M Summers, Veli K Topkara","doi":"10.1161/CIRCHEARTFAILURE.125.012805","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.012805","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is associated with adverse outcomes in patients with end-stage heart failure. Muscle mass can be quantified via manual segmentation of computed tomography images, but this approach is time-consuming and subject to interobserver variability. We sought to determine whether fully automated assessment of radiographic sarcopenia by deep learning would predict heart transplantation outcomes.</p><p><strong>Methods: </strong>This retrospective study included 164 adult patients who underwent heart transplantation between January 2013 and December 2022. A deep learning-based tool was utilized to automatically calculate cross-sectional skeletal muscle area at the T11, T12, and L1 levels on chest computed tomography. Radiographic sarcopenia was defined as skeletal muscle index (skeletal muscle area divided by height squared) in the lowest sex-specific quartile.</p><p><strong>Results: </strong>The study population had a mean age of 53±14 years and was predominantly male (75%) with a nonischemic cause (73%). Mean skeletal muscle index was 28.3±7.6 cm²/m² for females versus 33.1±8.1 cm²/m² for males (<i>P</i><0.001). Cardiac allograft survival was significantly lower in heart transplant recipients with versus without radiographic sarcopenia at T11 (90% versus 98% at 1 year, 83% versus 97% at 3 years, log-rank <i>P</i>=0.02). After multivariable adjustment, radiographic sarcopenia at T11 was associated with an increased risk of cardiac allograft loss or death (hazard ratio, 3.86 [95% CI, 1.35-11.0]; <i>P</i>=0.01). Patients with radiographic sarcopenia also had a significantly increased hospital length of stay (28 [interquartile range, 19-33] versus 20 [interquartile range, 16-31] days; <i>P</i>=0.046).</p><p><strong>Conclusions: </strong>Fully automated quantification of radiographic sarcopenia using pretransplant chest computed tomography successfully predicts cardiac allograft survival. By avoiding interobserver variability and accelerating computation, this approach has the potential to improve candidate selection and outcomes in heart transplantation.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012805"},"PeriodicalIF":8.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882228","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":"Performance of Creatinine and Cystatin C-Based Equations to Estimate Glomerular Filtration Rate Among Patients With Heart Failure.","authors":"John Roth, John C Lieske, Sandra M Herrmann, A M Arruda-Olson, Joerg Herrmann, Wendy McCallum, Timothy S Larson, Andrew D Rule, Silvia M Titan","doi":"10.1161/CIRCHEARTFAILURE.125.013014","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.013014","url":null,"abstract":"<p><strong>Background: </strong>The performance of estimated glomerular filtration rate (eGFR) among patients with heart failure (HF) may be worse than in the general population due to a higher prevalence of confounding factors affecting creatinine and cystatin C. Studies in this area are scarce and not stratified by type of HF. We evaluated the performance of current creatinine and cystatin C equations (eGFRcr, eGFRcys, and eGFRcrcys) compared with measured GFR (mGFR) among patients with HF stratified by ejection fraction.</p><p><strong>Methods: </strong>We pulled data on Mayo Clinic patients with an mGFR performed for clinical indications from 2011 to 2023, with serum creatinine and cystatin C measured within 7 days and an echocardiogram performed up to 1 year before the mGFR date. HF was identified by the presence of <i>International Classification of Diseases</i> codes within 1 year before the mGFR and subgrouped into ejection fraction (EF) ≥50% (HFEF≥50%, n=182) or <50% (HFEF<50%, n=115) and compared with no-HF controls (n=1871). CKD-EPI (and EKFC) eGFRcr, eGFRcys, and eGFRcrcys equations were calculated and compared for bias (mGFR minus eGFR) and accuracy (1-P30, proportion of people with ≥30% difference between eGFR and mGFR). CIs were generated by bootstrapping.</p><p><strong>Results: </strong>The HF groups were characterized by older age, higher proportion of males, more diabetes, higher creatinine, and higher cystatin C than controls. In terms of bias, eGFRcr overestimated mGFR to a greater extent in both HF groups compared with controls, whereas eGFRcys and eGFRcrcys showed similar bias in both HF groups and controls. In the HF groups, cystatin C-based equations were more accurate than eGFRcr, particularly within HFEF<50% (1-P30 of 28% and 34% for CKD-EPI eGFRcys and eGFRcrcys, respectively, versus 60% for eGFRcr), whereas eGFRcrcys was more accurate in controls. The CKD-EPI and EKFC equations were overall convergent, showing similar results.</p><p><strong>Conclusions: </strong>Among patients with HF, eGFRcr demonstrates inferior performance (more bias and less accuracy) compared with cystatin C-based eGFRs, with this effect being more pronounced in those with HFEF<50%.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013014"},"PeriodicalIF":8.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854747","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":"Between the Sheets: A Rare Case of HeartMate 3 Pump Failure Due to Electrostatic Interference.","authors":"Boaz Elad, Ersilia M DeFilippis, Edward Lin, Jennifer Haythe, Vivian Feldman, Ilan Richter, Melana Yuzefpolskaya, Paolo C Colombo, Koji Takeda, Yuji Kaku, Gabriel Sayer, Nir Uriel, Dor Lotan","doi":"10.1161/CIRCHEARTFAILURE.124.012750","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012750","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012750"},"PeriodicalIF":8.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109708","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 Hu Regarding Article, \"Plasma Proteomics of the Fontan Circulation Reveal Signatures of Oxidative Stress and Cell Death\".","authors":"Shuaishuai Hu","doi":"10.1161/CIRCHEARTFAILURE.125.013214","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.013214","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013214"},"PeriodicalIF":8.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301214","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":"Sex Differences in Utilization of Donation After Circulatory Death Donors for Heart Transplantation and Associated Outcomes.","authors":"Ersilia M DeFilippis, Maria Masotti, Elena M Donald, Joanna Eichler, Bhavadharini Ramu, Tessa Watt, Michael S Mulvihill, Koji Takeda, Nir Uriel, Rebecca Cogswell","doi":"10.1161/CIRCHEARTFAILURE.125.012835","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.012835","url":null,"abstract":"<p><strong>Background: </strong>The use of donation after circulatory death (DCD) donors for heart transplantation (HT) is increasing in the United States. Whether sex differences exist in DCD HT utilization and outcomes is unknown.</p><p><strong>Methods: </strong>Adults listed for HT at DCD centers between January 1, 2019 (first US DCD HT) and September 15, 2023, in the Organ Procurement and Transplantation Network Registry were included. Differences in listing for DCD HT by sex were investigated using multivariable logistic regression. The impact of listing for DCD HT (modeled as a time-varying covariate) on waitlist outcomes including the rate of HT waitlist removal for death or clinical deterioration was assessed using multivariable competing risk analyses. Annual trends in DCD HT and 2-year survival after DCD HT by sex were also investigated.</p><p><strong>Results: </strong>A total of 9807 individuals were listed at DCD centers during the study period. Listing for DCD HT was less common among women after multivariable adjustment (odds ratio, 0.84 [95% CI, 0.76-0.92]; <i>P</i><0.001). Listing for DCD HT was associated with an adjusted increased rate of HT (hazard ratio, 1.85 [95% CI, 1.75-1.95]; <i>P</i><0.001) and a lower risk of waitlist removal for death or clinical deterioration (hazard ratio, 0.57 [95% CI, 0.45-0.73]; <i>P</i><0.001) for both men and women; these protective effects were not different between sexes (interaction terms: transplant, <i>P</i>=0.55; delisting, <i>P</i>=0.91). During the study period, women made up 26% to 29% of donation after brain death transplants, but only 18% to 20% of DCD transplants. Survival at 2 years after DCD HT was similar between sexes (87% for women and 88% for men; log-rank <i>P</i>=0.37).</p><p><strong>Conclusions: </strong>Women were less likely to be listed for DCD HT and makeup proportionally less DCD transplants compared with men. Being listed for DCD HT improved waitlist outcomes in both sexes. One-year survival after DCD HT was similar by sex. As DCD HT expands, additional measures to ensure equitable access are imperative.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012835"},"PeriodicalIF":8.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494976","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 Reddy to Letter Regarding Article, \"Plasma Proteomics of the Fontan Circulation Reveal Signatures of Oxidative Stress and Cell Death\".","authors":"Sushma Reddy","doi":"10.1161/CIRCHEARTFAILURE.125.013241","DOIUrl":"10.1161/CIRCHEARTFAILURE.125.013241","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e013241"},"PeriodicalIF":8.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309566","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":"Sex-Related Prognosis of VA-ECMO-Treated Cardiogenic Shock: A Post Hoc Analysis of the HYPO-ECMO Trial.","authors":"Guillaume Baudry, Nicolas Girerd, Kevin Duarte, Luca Monzo, Clément Delmas, Harriette G C Van Spall, Antoine Kimmoun, Bruno Levy","doi":"10.1161/CIRCHEARTFAILURE.124.012702","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012702","url":null,"abstract":"<p><strong>Background: </strong>The sex-related prognosis of patients with cardiogenic shock undergoing venoarterial extracorporeal membrane oxygenation remains unclear. Our analyses aim to assess sex-specific outcomes in patients with cardiogenic shock receiving venoarterial extracorporeal membrane oxygenation and explore whether the effect of moderate hypothermia on clinical outcomes was modified by sex.</p><p><strong>Methods: </strong>In this post hoc analysis of the HYPO-ECMO trial (Hypothermia During ECMO), clinical outcomes were compared by sex. The primary outcome was 30-day all-cause mortality. Key secondary outcomes included all-cause mortality and a composite outcome of all-cause mortality, heart transplant, escalation to left ventricular assist device implantation, or stroke at 30, 60, and 180 days.</p><p><strong>Results: </strong>Among the 334 patients enrolled in the trial, 81 (24%) were female. At 30 days, 45.7% of female and 46.6% of male patients experienced the primary outcome, with no sex differences (adjusted odds ratio, 1.01 [0.57-1.78]; <i>P</i>=0.98 and log-rank test; <i>P</i>=0.93). No significant sex differences were observed in all-cause mortality at 60 and 180 days (adjusted odds ratio, 0.87 [0.49-1.52]; <i>P</i>=0.61 and 0.83 [0.47-1.46]; <i>P</i>=0.51, respectively) or in the composite outcome up to 180 days (<i>P</i>>0.2 for all). The effect of moderate hypothermia on the primary outcome (adjusted odds ratio, 0.73 [0.43-1.25]; <i>P</i>=0.25 and 0.67 [0.26-1.76]; <i>P</i>=0.41, in male and female, respectively, interaction <i>P</i>=0.88) and secondary outcomes (interaction <i>P</i>>0.3 for all) was not modified by sex.</p><p><strong>Conclusions: </strong>In this post hoc analysis of the HYPO-ECMO trial, male and female patients experienced similar outcomes in cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation. Sex did not significantly modify the effect of moderate hypothermia on outcomes.</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov/study/NCT02754193; Unique identifier: NCT02754193.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012702"},"PeriodicalIF":8.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101435","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}