{"title":"Response by Bhimaraj et al to Letter Regarding Article, \"Pitfalls in the World of Evidence-Based Medicine: Should IABP Be en-DANGER-ed by the DanGer Shock Trial?\"","authors":"Arvind Bhimaraj, Arthur R Garan, Manreet K Kanwar","doi":"10.1161/CIRCHEARTFAILURE.124.012655","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012655","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012655"},"PeriodicalIF":7.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467191","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 Dalzell and Cannon Regarding Article, \"Pitfalls in the World of Evidence-Based Medicine: Should IABP Be en-DANGER-ed by the DanGer Shock Trial?\"","authors":"Jonathan R Dalzell, Jane A Cannon","doi":"10.1161/CIRCHEARTFAILURE.124.012607","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012607","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012607"},"PeriodicalIF":7.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467188","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}
Lara S Schlender, Marco Ochs, Reza Wakili, Robert Stöhr, Fabian Emrich, Thomas Walther, Jan Gummert, Michiel Morshuis, David M Leistner, Maria Papathanasiou
{"title":"Disseminated Intracardiac Thrombosis Due to Long-Standing, Asymptomatic Ventricular Fibrillation Under Left Ventricular Assist Device Support.","authors":"Lara S Schlender, Marco Ochs, Reza Wakili, Robert Stöhr, Fabian Emrich, Thomas Walther, Jan Gummert, Michiel Morshuis, David M Leistner, Maria Papathanasiou","doi":"10.1161/CIRCHEARTFAILURE.124.011639","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.011639","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011639"},"PeriodicalIF":7.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467184","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}
Stéphanie Kristina Schwarting, Thomas Bieber, Daniel R Davies, Fabian Aus dem Siepen, Julian Schwarting, Ulrich Grabmaier, Steffen Massberg, Mathew S Maurer, Stefan Kääb
{"title":"Guideline-Directed Medical Therapy for Heart Failure in Transthyretin Amyloid Cardiomyopathy.","authors":"Stéphanie Kristina Schwarting, Thomas Bieber, Daniel R Davies, Fabian Aus dem Siepen, Julian Schwarting, Ulrich Grabmaier, Steffen Massberg, Mathew S Maurer, Stefan Kääb","doi":"10.1161/CIRCHEARTFAILURE.124.011796","DOIUrl":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.011796","url":null,"abstract":"<p><p>Cardiac amyloidosis is an underdiagnosed cause of infiltrative cardiomyopathy, leading to heart failure across the spectrum of ejection fractions. Although there are approved disease-modulating therapies for the transthyretin subtype (transthyretin amyloid cardiomyopathy [ATTR-CM]), the role of heart failure medications remains uncertain and challenging in clinical practice. Their effects on clinical outcomes, such as mortality and hospitalization, are unknown for ATTR-CM. This review aims to explore the use of these medications in ATTR-CM, considering the disease's stage and patient-specific issues, such as fluid homeostasis, autonomic dysfunction, conduction disorders, low and fixed stroke volumes, and decreased functional capacity. As our understanding of this condition deepens, it is important to reassess the impact of contemporary heart failure medication in ATTR-CM. Finally, the relevance of guideline recommendations for heart failure drugs based on left ventricular ejection fraction should be reconsidered in the context of ATTR-CM.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011796"},"PeriodicalIF":7.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439993","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":"Unraveling the Role of Myocardial Inflammation in ATTR-CM: A Targetable Mechanism?","authors":"Aldostefano Porcari, Marianna Fontana, Mattia Riefolo","doi":"10.1161/CIRCHEARTFAILURE.124.012652","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012652","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012652"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045415","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}
Circulation: Heart FailurePub Date : 2025-02-01Epub Date: 2024-12-09DOI: 10.1161/CIRCHEARTFAILURE.124.011981
Alexander C Egbe, Ahmed E Ali, William R Miranda, Heidi M Connolly, Barry A Borlaug
{"title":"Aerobic Capacity of Adults With Fontan Palliation: Disease-Specific Reference Values and Relationship to Outcomes.","authors":"Alexander C Egbe, Ahmed E Ali, William R Miranda, Heidi M Connolly, Barry A Borlaug","doi":"10.1161/CIRCHEARTFAILURE.124.011981","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.011981","url":null,"abstract":"<p><strong>Background: </strong>Patients with Fontan palliation have reduced aerobic capacity because of impaired cardiac, pulmonary, and skeletal muscle function. However, the assessment of aerobic capacity in this population still relies on comparisons with people without cardiovascular disease rather than comparison with the expected aerobic capacity of other Fontan patients. The purpose of this study was to determine the expected aerobic capacity of adults with Fontan palliation.</p><p><strong>Methods: </strong>Adults with Fontan palliation who underwent a cardiopulmonary exercise test at Mayo Clinic (2003-2023) were stratified into quartiles based on the predicted peak oxygen consumption (VO<sub>2</sub>). We assessed the correlates of predicted peak VO<sub>2</sub> and the relationship between predicted peak VO<sub>2</sub> quartiles and cardiovascular outcomes (death/transplant).</p><p><strong>Results: </strong>Of 323 patients (age, 29±9 years; 177 [55%] men), the median peak VO<sub>2</sub> was 19.1 (15.2-23.9) mL/kg per minute, and this corresponds to a predicted peak VO<sub>2</sub> of 51% (range, 19-88; interquartile range, 41-62). After multivariable adjustments, the correlates of predicted peak VO<sub>2</sub> were body mass index (β±SE, -2.61±0.95; 2.61% decrease in predicted peak VO<sub>2</sub> per 5 kg/m<sup>2</sup> increase in body mass index; <i>P</i>=0.009), systemic saturation (β±SE, 3.65±0.85; 3.65% increase in predicted peak VO<sub>2</sub> per 5% increase in oxygen saturation; <i>P</i><0.001), and Fontan pressure (β±SE, -1.24±0.22; 1.24% decrease in predicted peak VO<sub>2</sub> per 1 mm Hg increase in Fontan pressures; <i>P</i><0.001). There was a 47% increase in the risk for death/transplant from a higher predicted peak VO<sub>2</sub> quartile to the next lower quartile (adjusted hazard ratio, 1.47 [95% CI, 1.09-2.05]; <i>P</i>=0.01).</p><p><strong>Conclusions: </strong>The results of the current study would help calibrate the interpretation of exercise test data in adults with Fontan palliation and improve risk stratification in this population. It also underscores the need to maintain normal Fontan hemodynamics and body weight, which are important determinants of aerobic capacity.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011981"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794252","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}
Circulation: Heart FailurePub Date : 2025-02-01Epub Date: 2025-01-20DOI: 10.1161/CIRCHEARTFAILURE.124.012154
Reza Poyanmehr, Jasmin S Hanke, Dietmar Boethig, Ali Saad Merzah, Jan Karsten, Paul Frank, Martin Hinteregger, Alina Zubarevich, Günes Dogan, Jan D Schmitto, Andreas Schäfer, L Christian Napp, Aron Frederik Popov, Alexander Weymann, Johann Bauersachs, Arjang Ruhparwar, Bastian Schmack
{"title":"Validity and Accuracy of the Derived Left Ventricular End-Diastolic Pressure in Impella 5.5.","authors":"Reza Poyanmehr, Jasmin S Hanke, Dietmar Boethig, Ali Saad Merzah, Jan Karsten, Paul Frank, Martin Hinteregger, Alina Zubarevich, Günes Dogan, Jan D Schmitto, Andreas Schäfer, L Christian Napp, Aron Frederik Popov, Alexander Weymann, Johann Bauersachs, Arjang Ruhparwar, Bastian Schmack","doi":"10.1161/CIRCHEARTFAILURE.124.012154","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012154","url":null,"abstract":"<p><strong>Background: </strong>Consensus regarding on-support evaluation and weaning concepts from Impella 5.5 support is scarce. The derived left ventricular end-diastolic pressure (dLVEDP), estimated by device algorithms, is a rarely reported tool for monitoring the weaning process. Its validation and clinical accuracy have not been studied in patients. We assess dLVEDP's accuracy in predicting pulmonary capillary wedge pressure (PCWP) and propose a corrective equation.</p><p><strong>Methods: </strong>We included 29 consecutive patients treated with Impella 5.5: 12 in a generation cohort and 17 in a validation cohort. dLVEDP and PCWP were measured 5-fold every 8 hours during support, totaling 698 series with 3490 measurements. Variables such as Impella 5.5 performance level, heart rhythm, pacemaker settings, sex, mechanical ventilation, and body mass index were recorded. Linear regression was used to correct dLVEDP-PCWP discrepancies. Analysis included Bland-Altman plots, linear regression, histograms, and violin plots.</p><p><strong>Results: </strong>The raw dLVEDP and PCWP data did not coincide satisfactorily. The Impella 5.5 dLVEDP overestimation was 3.5±1.5 mm Hg (mean±SD), increasing with higher pressures and unaffected by cardiac rhythm, mechanical ventilation, and performance levels. Statistical correction using the formula modified dLVEDP=-0.457+(1-sex[1=male, 0=female])×0.719-0.0496× body mass index+1.015×body surface area+0.811×dLVEDP significantly reduced the overestimation (<i>P</i><0.01) to 0.0±1.2 mm Hg.</p><p><strong>Conclusions: </strong>dLVEDP, calculated by the Impella 5.5 Smart Algorithm, is a feasible and effective tool for continuously monitoring PCWP at performance levels 3 to 9. Correction of dLVEDP by using the described equation further enhances its accuracy. Hence, hemodynamic surveillance via dLVEDP may aid in managing and weaning temporary microaxial support, potentially reducing the need for continuous monitoring with a Swan-Ganz catheter.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012154"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001157","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}
Circulation: Heart FailurePub Date : 2025-02-01Epub Date: 2024-12-09DOI: 10.1161/CIRCHEARTFAILURE.124.011641
Willard N Applefeld, Jacob C Jentzer, Saraschandra Vallabhajosyula
{"title":"Cognitive and Procedural Competencies in the Cardiac Intensive Care Unit.","authors":"Willard N Applefeld, Jacob C Jentzer, Saraschandra Vallabhajosyula","doi":"10.1161/CIRCHEARTFAILURE.124.011641","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.011641","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011641"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794257","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}
Circulation: Heart FailurePub Date : 2025-02-01Epub Date: 2025-01-08DOI: 10.1161/CIRCHEARTFAILURE.124.012109
Stephanie Skove, David D Berg, Erin A Bohula, Jianping Guo, Carlos E Alfonso, Gregory W Barsness, James A Burke, Meshe D Chonde, Jacob C Jentzer, Jason N Katz, Michael C Kontos, Younghoon Kwon, Patrick R Lawler, Shuangbo Liu, P Elliott Miller, Connor G O'Brien, Alexander I Papolos, Alastair G Proudfoot, Kiran Sidhu, Shashank S Sinha, Lakshmi Sridharan, Jeffrey J Teuteberg, Sean van Diepen, Sammy Zakaria, David A Morrow, Kevin S Shah
{"title":"Early Evolution of SCAI Shock Stage and In-Hospital Mortality in the Cardiovascular Intensive Care Unit Population: From the Critical Care Cardiology Trials Network (CCCTN).","authors":"Stephanie Skove, David D Berg, Erin A Bohula, Jianping Guo, Carlos E Alfonso, Gregory W Barsness, James A Burke, Meshe D Chonde, Jacob C Jentzer, Jason N Katz, Michael C Kontos, Younghoon Kwon, Patrick R Lawler, Shuangbo Liu, P Elliott Miller, Connor G O'Brien, Alexander I Papolos, Alastair G Proudfoot, Kiran Sidhu, Shashank S Sinha, Lakshmi Sridharan, Jeffrey J Teuteberg, Sean van Diepen, Sammy Zakaria, David A Morrow, Kevin S Shah","doi":"10.1161/CIRCHEARTFAILURE.124.012109","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012109","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012109"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945670","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}