Circulation: Heart Failure最新文献

{"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}

{"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}

{"title":"Neurohormonal and Renal Effects of 14-Day Oral Ketone Ester Treatment in Patients With Heart Failure With Reduced Ejection Fraction.","authors":"Kristoffer Berg-Hansen, Nigopan Gopalasingam, Kristian Hylleberg Christensen, Mads Svart, Nikolaj Rittig, Roni Nielsen, Kent Lodberg, Niels Møller, Henrik Wiggers","doi":"10.1161/CIRCHEARTFAILURE.124.012167","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012167","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012167"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881376","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":"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}

{"title":"Letter by Bonaventura and Tangianu Regarding Article, \"Pleural Effusion and Invasive Hemodynamic Measurements in Advanced Heart Failure\".","authors":"Aldo Bonaventura, Flavio Tangianu","doi":"10.1161/CIRCHEARTFAILURE.124.012603","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012603","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012603"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001122","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":"Ironing Out the Controversies Surrounding the Iron Deficiency Definition in Heart Failure.","authors":"Micha T Maeder, Frederik H Verbrugge","doi":"10.1161/CIRCHEARTFAILURE.124.012675","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012675","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012675"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001119","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":"Real-Time Pressure-Volume Loop Assessment of Left Ventricular Performance to Evaluate Suitability for Repair in Congenitally Corrected Transposition of the Great Arteries.","authors":"Kyong-Jin Lee, Kaitlin Flannery, Michael Ma, Deborah Ho","doi":"10.1161/CIRCHEARTFAILURE.124.012609","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012609","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012609"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892540","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 Glargaard et al to Letter Regarding Article, \"Pleural Effusion and Invasive Hemodynamic Measurements in Advanced Heart Failure\".","authors":"Signe Glargaard, Jakob Hartvig Thomsen, Jens Jakob Thune","doi":"10.1161/CIRCHEARTFAILURE.124.012654","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012654","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012654"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001089","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 Jha Regarding Article, \"Pathophysiologic Vasodilation in Cardiogenic Shock and Its Impact on Mortality\".","authors":"Ajay Kumar Jha","doi":"10.1161/CIRCHEARTFAILURE.124.012511","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012511","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012511"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001135","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":"Structural and Functional Characterization of the Aorta in Hypertrophic Obstructive Cardiomyopathy.","authors":"Ayman M Ibrahim, Mohamed Roshdy, Najma Latif, Amr Elsawy, Padmini Sarathchandra, Mohammed Hosny, Soha Hekal, Ahmed Attia, Wesam Elmozy, Amany Elaithy, Ahmed Elguindy, Ahmed Afifi, Yasmine Aguib, Magdi Yacoub","doi":"10.1161/CIRCHEARTFAILURE.124.012384","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012384","url":null,"abstract":"<p><strong>Background: </strong>Changes in the phenotype and genotype in hypertrophic cardiomyopathy (HCM) are thought to involve the myocardium as well as extracardiac tissues. Here, we describe the structural and functional changes in the ascending aorta of obstructive patients with HCM.</p><p><strong>Methods: </strong>Changes in the aortic wall were studied in a cohort of 101 consecutive patients with HCM undergoing myectomy and 9 normal controls. Biopsies were examined histologically, immunohistochemically, and by electron microscopy. Changes in protein expression were quantified using morphometry and Western blotting. Pulse wave velocity was measured using cardiac magnetic resonance in 85 patients with HCM and compared with 117 age-matched normal controls.</p><p><strong>Results: </strong>In HCM, the number of medial lamellar units was significantly decreased, associated with an increase in interlamellar distance and aortic wall thickness, as compared with controls. Electron microscopy showed an altered lamellar structure with disorientation of elastin fibers from the circumferential direction. There was a significant decrease in collagen content, α-smooth muscle actin, smooth muscle myosin, smooth muscle 22 and integrin β1, as well as a significant increase in calponin and caspase-3. Fibulins 1, 2, and 5 showed reduced expression in HCM-aortic biopsies. Functionally, pulse wave velocity was significantly higher in patients with HCM compared with healthy controls, with an association between higher pulse wave velocity and more severe molecular and clinical parameters.</p><p><strong>Conclusions: </strong>The increased wall stiffness observed in the aortas of obstructive patients with HCM is associated with structural alterations in the medial lamellar unit, including changes in smooth muscle cells and the extracellular matrix, indicating potential arterial dysfunction.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012384"},"PeriodicalIF":7.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022305","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}