Circulation: Heart Failure最新文献

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Mavacamten: Real-World Experience From 22 Months of the Risk Evaluation and Mitigation Strategy (REMS) Program. Mavacamten:风险评估和缓解策略 (REMS) 计划实施 22 个月的实际经验。
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1161/CIRCHEARTFAILURE.124.012441
Milind Y Desai, Dewey Seto, Michael Cheung, Sonia Afsari, Niki Patel, Arnaud Bastien, Jeffrey Lockman, Michele Coiro, Matthew W Martinez
{"title":"Mavacamten: Real-World Experience From 22 Months of the Risk Evaluation and Mitigation Strategy (REMS) Program.","authors":"Milind Y Desai, Dewey Seto, Michael Cheung, Sonia Afsari, Niki Patel, Arnaud Bastien, Jeffrey Lockman, Michele Coiro, Matthew W Martinez","doi":"10.1161/CIRCHEARTFAILURE.124.012441","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012441","url":null,"abstract":"<p><strong>Background: </strong>Mavacamten is the only cardiac myosin inhibitor approved by the U.S. Food and Drug Administration for the treatment of patients with symptomatic New York Heart Association class II-III obstructive hypertrophic cardiomyopathy. Under the Risk Evaluation and Mitigation Strategy program for mavacamten, patients are required to be monitored for the development of systolic heart failure and reduction of left ventricular ejection fraction (LVEF) to <50%. We report results from the mavacamten Risk Evaluation and Mitigation Strategy database (April 28, 2022 to February 27, 2024).</p><p><strong>Methods: </strong>Data on health care providers and pharmacy certification, patient monitoring (from Patient Status Forms, based partly on echocardiograms), and screening for drug interactions before each dispense were collected.</p><p><strong>Results: </strong>Of the 6299 patients who received ≥1 dose of mavacamten, 60.0% were women; 64.6% were aged >60 years. Of the 5573 patients with submitted Patient Status Forms, 256 (4.6%) developed LVEF <50%, and 71 (1.3%) experienced heart failure requiring hospitalization. On the 29 111 status forms in these patients, each representing an assessment of an echocardiogram, LVEF <50% was reported on 276 (0.9%), and heart failure requiring hospitalization was reported on 86 (0.3%). Of the 1929 patients with ≥1 year of treatment, 78 (4.0%) had an LVEF reduction to <50%, and 4 (0.2%) experienced LVEF <50% and heart failure requiring hospitalization but later resumed treatment. Of the 3228 patients initiated on 5 mg/d mavacamten and were treated for at least 6 months, 2391 (74.1%) remained at 5 or 10 mg/d. At 3 and 6 months following mavacamten treatment initiation, 57.2% and 70.3%, respectively, demonstrated post-Valsalva left ventricular outflow tract gradient <30 mm Hg.</p><p><strong>Conclusions: </strong>We describe the feasibility and experience of the first 22 months of the Risk Evaluation and Mitigation Strategy program for prescribing mavacamten in >6000 patients with symptomatic obstructive hypertrophic cardiomyopathy. The need for temporary interruption for LVEF <50% was low, including for patients on therapy ≥1 year, with even fewer LVEF reductions associated with heart failure requiring hospitalization.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012441"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615683","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}
引用次数: 0
Social Determinants of Health and Disparities in Guideline-Directed Medical Therapy Optimization for Heart Failure. 健康的社会决定因素与心力衰竭指南指导下医疗疗法优化中的差异。
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1161/CIRCHEARTFAILURE.124.012357
Joshua A Jacobs, Iyanuoluwa Ayodele, Adam P Bress, Madeline R Sterling, Ambarish Pandey, Catherine G Derington, Alexander R Zheutlin, Kevin S Shah, Stephen J Greene, Brooke Alhanti, Rosalia Blanco, Gregg C Fonarow
{"title":"Social Determinants of Health and Disparities in Guideline-Directed Medical Therapy Optimization for Heart Failure.","authors":"Joshua A Jacobs, Iyanuoluwa Ayodele, Adam P Bress, Madeline R Sterling, Ambarish Pandey, Catherine G Derington, Alexander R Zheutlin, Kevin S Shah, Stephen J Greene, Brooke Alhanti, Rosalia Blanco, Gregg C Fonarow","doi":"10.1161/CIRCHEARTFAILURE.124.012357","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012357","url":null,"abstract":"<p><strong>Background: </strong>Fewer than 20% of eligible patients with heart failure with reduced ejection fraction receive all 4 pillars of guideline-directed medical therapy. Understanding disparities by race, ethnicity, sex, and adverse social determinants of health is necessary to equitably optimize quadruple therapy.</p><p><strong>Methods: </strong>Utilizing the American Heart Association's Get With The Guidelines-Heart Failure registry, we examined associations between race and ethnicity, sex, and adverse social determinants of health (insurance type and documented social need [any barrier to accessing health care]) with quadruple therapy optimization (QTO) in patients with heart failure with reduced ejection fraction hospitalized between July 1, 2021, and September 30, 2023, with complete medication data at discharge. We calculated adjusted mean differences (AMDs) in the discharge QTO score (range, 0%-100%) reflecting the proportion of eligible use of renin-angiotensin system inhibitors, β-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors and compared across demographic and adverse social determinants of health groups.</p><p><strong>Results: </strong>Among 82 637 patients (median age, 66 years; 32.5% female; 57.0% non-Hispanic White; 76.4% prior heart failure with reduced ejection fraction), the overall mean QTO score was 56.2% (SD, 25.5). After adjustment, compared with non-Hispanic White individuals, Black (AMD, 2.56 percentage points [95% CI, 2.16-2.96]) and Hispanic individuals (AMD, 0.71 percentage points [95% CI, 0.11-1.31]) had higher QTO scores. Females had higher QTO scores than males (AMD, 1.94 percentage points [95% CI, 1.58-2.31]). Patients with no insurance (AMD, -4.90 percentage points [-5.62 to -4.17]), Medicaid (AMD, -0.45 percentage points [-0.89 to -0.01]), and Medicare (AMD, -1.64 percentage points [-2.10 to -1.18]) had lower QTO scores versus private insurance. Those with an identified social need (n=24 651) had lower QTO scores than those without (AMD, -3.40 percentage points [95% CI, -4.10 to -2.71]).</p><p><strong>Conclusions: </strong>Disparities in QTO were most evident for patients with no insurance, Medicaid, Medicare, or potentially an identified social need. Future efforts should focus on reducing gaps to improve equitable guideline-directed medical therapy use.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012357"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615705","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}
引用次数: 0
Elevated Donor-Derived Cell-Free DNA Levels Are Associated With Reduced Myocardial Blood Flow but Not Angiographic Cardiac Allograft Vasculopathy: The EVIDENT Study. 供体来源的无细胞DNA水平升高与心肌血流量减少有关,但与血管造影心脏移植血管病变无关。
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-12-10 DOI: 10.1161/CIRCHEARTFAILURE.124.011756
Cathrine M Moeller, Daniel Oren, Andrea Fernandez Valledor, Gal Rubinstein, Ersilia M DeFilippis, Salwa Rahman, Yonatan Mehlman, Elena M Donald, Dor Lotan, Edward Lin, Kyung T Oh, Sun H Lee, Jayant K Raikhelkar, Justin A Fried, David Majure, Farhana Latif, Gabriel T Sayer, Nir Uriel, Kevin J Clerkin
{"title":"Elevated Donor-Derived Cell-Free DNA Levels Are Associated With Reduced Myocardial Blood Flow but Not Angiographic Cardiac Allograft Vasculopathy: The EVIDENT Study.","authors":"Cathrine M Moeller, Daniel Oren, Andrea Fernandez Valledor, Gal Rubinstein, Ersilia M DeFilippis, Salwa Rahman, Yonatan Mehlman, Elena M Donald, Dor Lotan, Edward Lin, Kyung T Oh, Sun H Lee, Jayant K Raikhelkar, Justin A Fried, David Majure, Farhana Latif, Gabriel T Sayer, Nir Uriel, Kevin J Clerkin","doi":"10.1161/CIRCHEARTFAILURE.124.011756","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.011756","url":null,"abstract":"<p><strong>Background: </strong>Cardiac allograft vasculopathy (CAV) leads to impaired myocardial blood flow (MBF), increasing the risk of cardiovascular death or retransplant among heart transplantation (HT) recipients. Data on elevation in donor-derived cell-free DNA (dd-cfDNA) and CAV in the absence of rejection are mixed. We sought to test the hypothesis that CAV with reduced MBF (RMBF) is associated with elevated dd-cfDNA.</p><p><strong>Methods: </strong>A retrospective review was conducted on HT recipients at a high-volume center who underwent dd-cfDNA testing between September 2019 and November 2022. Inclusion criteria included undergoing CAV screening with cardiac positron emission tomography scans and coronary angiograms. Patients were grouped by the presence of angiographic CAV diagnosis and MBF reserve evaluated through cardiac positron emission tomography. The latter was subdivided into normal MBF or RMBF, with RMBF defined as an MBF reserve ≤2. Elevated dd-cfDNA was defined as ≥0.12%.</p><p><strong>Results: </strong>Two hundred fifty-six HT recipients were included (median age, 55 years; 27.6% female; median, 8 years [interquartile range (IQR), 5-14] post-HT). Ischemic etiology of heart failure was more prevalent in the RMBF group (36%) compared with the normal MBF group (20%; <i>P</i>=0.02). The prevalence and magnitude of a positive dd-cfDNA test with angiographic CAV (29%; median, 0.26% [IQR, 0.15%-0.62%]) were not significantly different from those without CAV (30%; <i>P</i>=0.94; median, 0.31% [IQR, 0.17%-0.71%]; <i>P</i>=0.38). However, RMBF patients exhibited significantly higher dd-cfDNA prevalence and levels (51%; median, 0.81% [IQR, 0.48%-1.11%]) compared with normal MBF patients (27%; <i>P</i><0.001; median, 0.25% [IQR, 0.15%-0.52%]; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>HT recipients with angiographic CAV had similar dd-cfDNA levels and rates as those without. Notably, dd-cfDNA levels and rates were significantly elevated in patients with RMBF assessed by positron emission tomography compared with those with normal MBF.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011756"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799647","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}
引用次数: 0
Comprehensive Proteomics Profiling Identifies Circulating Biomarkers to Distinguish Hypertrophic Cardiomyopathy From Other Cardiomyopathies With Left Ventricular Hypertrophy. 综合蛋白质组学分析发现循环生物标记物,可将肥厚型心肌病与其他左心室肥厚型心肌病区分开来
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1161/CIRCHEARTFAILURE.124.012434
Keitaro Akita, Mathew S Maurer, Albree Tower-Rader, Michael A Fifer, Yuichi J Shimada
{"title":"Comprehensive Proteomics Profiling Identifies Circulating Biomarkers to Distinguish Hypertrophic Cardiomyopathy From Other Cardiomyopathies With Left Ventricular Hypertrophy.","authors":"Keitaro Akita, Mathew S Maurer, Albree Tower-Rader, Michael A Fifer, Yuichi J Shimada","doi":"10.1161/CIRCHEARTFAILURE.124.012434","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012434","url":null,"abstract":"<p><strong>Background: </strong>Distinguishing hypertrophic cardiomyopathy (HCM) from other cardiomyopathies with left ventricular hypertrophy (LVH), such as hypertensive LVH, transthyretin amyloid cardiomyopathy, and aortic stenosis, is sometimes challenging. Using plasma proteomics profiling, we aimed to identify circulating biomarkers and dysregulated signaling pathways specific to HCM.</p><p><strong>Methods: </strong>In this multicenter case-control study, plasma proteomics profiling was performed in cases with HCM and controls with hypertensive LVH, transthyretin amyloid cardiomyopathy, and aortic stenosis. Two-thirds of patients enrolled earlier in each disease group were defined as the training set and the remaining one-third as the test set. Protein concentrations in HCM were compared with those in hypertensive LVH (comparison 1), transthyretin amyloid cardiomyopathy (comparison 2), and aortic stenosis (comparison 3). Candidate proteins that meet the following 2 criteria were selected: (1) higher abundance in HCM throughout all 3 comparisons or lower abundance in HCM throughout all 3 comparisons with univariable <i>P</i><0.05 and |log<sub>2</sub>(fold change)| >0.5 in both the training and test sets and (2) independently associated with HCM with multivariable <i>P</i><0.05 after adjusting for clinical parameters significantly different between HCM and controls. Using the selected candidate proteins, a logistic regression model to distinguish HCM from controls was developed in the training set and applied to the test set. Finally, pathway analysis was performed in each comparison using proteins with different abundance.</p><p><strong>Results: </strong>Overall, 4979 proteins in 1415 patients (HCM, n=879; hypertensive LVH, n=331; transthyretin amyloid cardiomyopathy, n=169; aortic stenosis, n=36) were analyzed. Of those, 5 proteins were selected as candidate proteins. The logistic regression model with these 5 proteins had an area under the receiver operating characteristic curve of 0.86 (95% CI, 0.82-0.89) in the test set. The MAPK (mitogen-activated protein kinase) and HIF-1 (hypoxia-inducible factor 1) pathways were dysregulated in HCM throughout the 3 comparisons.</p><p><strong>Conclusions: </strong>This study identified circulating biomarkers that distinguish HCM from other cardiomyopathies with LVH independently from confounders and revealed signaling pathways associated with HCM.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012434"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615678","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}
引用次数: 0
Editors and Editorial Board. 编辑和编辑委员会。
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2025-01-21 DOI: 10.1161/HHF.0000000000000087
{"title":"Editors and Editorial Board.","authors":"","doi":"10.1161/HHF.0000000000000087","DOIUrl":"https://doi.org/10.1161/HHF.0000000000000087","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":"18 1","pages":"e000087"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001172","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}
引用次数: 0
Clinical Management and Transplant Considerations in Pediatric Pulmonary Hypertension Due to Left Heart Disease: A Scientific Statement From the American Heart Association. 美国心脏协会的科学声明:左心疾病引起的儿童肺动脉高压的临床管理和移植考虑
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-12-09 DOI: 10.1161/HHF.0000000000000086
Rachel K Hopper, Georg Hansmann, Seth A Hollander, Anne I Dipchand, Oscar van der Have, Colleen Iler, Cynthia Herrington, Erika B Rosenzweig, Juan C Alejos, Karin Tran-Lundmark
{"title":"Clinical Management and Transplant Considerations in Pediatric Pulmonary Hypertension Due to Left Heart Disease: A Scientific Statement From the American Heart Association.","authors":"Rachel K Hopper, Georg Hansmann, Seth A Hollander, Anne I Dipchand, Oscar van der Have, Colleen Iler, Cynthia Herrington, Erika B Rosenzweig, Juan C Alejos, Karin Tran-Lundmark","doi":"10.1161/HHF.0000000000000086","DOIUrl":"10.1161/HHF.0000000000000086","url":null,"abstract":"<p><p>Children with left heart disease are at risk for developing pulmonary hypertension, initially secondary to pulmonary venous hypertension that can progress to include elevated pulmonary vascular resistance, known as combined pre- and postcapillary pulmonary hypertension. Elevated pulmonary vascular resistance may pose a risk to the right ventricle of a newly transplanted heart because of increased afterload and is an important consideration for heart transplant eligibility. However, the epidemiology, pathophysiology, optimal diagnostic and treatment approaches, and thresholds for pulmonary vascular resistance in pulmonary hypertension associated with left heart disease remain unclear because of lack of evidence, particularly in pediatrics. The result is heterogeneity with respect to hemodynamic assessment, use of pulmonary vasodilator therapies, and heart transplant listing. This scientific statement aims to synthesize the available data and highlight areas of general consensus as well as important knowledge gaps.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e000086"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794253","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}
引用次数: 0
Natural Language Processing to Adjudicate Heart Failure Hospitalizations in Global Clinical Trials. 在全球临床试验中通过自然语言处理来判断心力衰竭的住院情况。
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-11-16 DOI: 10.1161/CIRCHEARTFAILURE.124.012514
Pablo M Marti-Castellote, Christopher Reeder, Brian Claggett, Pulkit Singh, Emily S Lau, Shaan Khurshid, Puneet Batra, Steven A Lubitz, Mahnaz Maddah, Orly Vardeny, Eldrin F Lewis, Marc Pfeffer, Pardeep Jhund, Akshay S Desai, John J V McMurray, Patrick T Ellinor, Jennifer E Ho, Scott D Solomon, Jonathan W Cunningham
{"title":"Natural Language Processing to Adjudicate Heart Failure Hospitalizations in Global Clinical Trials.","authors":"Pablo M Marti-Castellote, Christopher Reeder, Brian Claggett, Pulkit Singh, Emily S Lau, Shaan Khurshid, Puneet Batra, Steven A Lubitz, Mahnaz Maddah, Orly Vardeny, Eldrin F Lewis, Marc Pfeffer, Pardeep Jhund, Akshay S Desai, John J V McMurray, Patrick T Ellinor, Jennifer E Ho, Scott D Solomon, Jonathan W Cunningham","doi":"10.1161/CIRCHEARTFAILURE.124.012514","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012514","url":null,"abstract":"<p><strong>Background: </strong>Medical record review by a physician clinical events committee is the gold standard for identifying cardiovascular outcomes in clinical trials, but is labor-intensive and poorly reproducible. Automated outcome adjudication by artificial intelligence (AI) could enable larger and less expensive clinical trials but has not been validated in global studies.</p><p><strong>Methods: </strong>We developed a novel model for automated AI-based heart failure adjudication (Heart Failure Natural Language Processing) using hospitalizations from 3 international clinical outcomes trials. This model was tested on potential heart failure hospitalizations from the DELIVER trial (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure), a cardiovascular outcomes trial comparing dapagliflozin with placebo in 6063 patients with heart failure with mildly reduced or preserved ejection fraction. AI-based adjudications were compared with adjudications from a clinical events committee that followed Food and Drug Administration-based criteria.</p><p><strong>Results: </strong>AI-based adjudication agreed with the clinical events committee in 83% of events. A strategy of human review for events that the AI model deemed uncertain (16%) would have achieved 91% agreement with the clinical events committee while reducing the adjudication workload by 84%. The estimated effect of dapagliflozin on heart failure hospitalization was nearly identical with AI-based adjudication (hazard ratio, 0.76 [95% CI, 0.66-0.88]) compared with clinical events committee adjudication (hazard ratio, 0.77 [95% CI, 0.67-0.89]). The AI model extracted symptoms, signs, and treatments of heart failure from each medical record in tabular format and quoted sentences documenting them.</p><p><strong>Conclusions: </strong>AI-based adjudication of clinical outcomes has the potential to improve the efficiency of global clinical trials while preserving accuracy and interpretability.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012514"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643876","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}
引用次数: 0
Unraveling Comorbidities Contribution to Cardiac Diastolic Dysfunction and Heart Failure. 揭示心脏舒张功能障碍和心力衰竭的合并症。
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-11-29 DOI: 10.1161/CIRCHEARTFAILURE.124.011724
María Villalba-Orero, Marina López-Olañeta, Belén Campos-Olmo, Daniel Jimenez-Carretero, Lucía Sánchez, Fátima Sánchez-Cabo, Antonella Ausiello, Rodrigo Cañas-Álvaro, Emilio Camafeita, Jesús Vázquez, Pablo García-Pavía, Domingo Pascual-Figal, Enrique Lara-Pezzi
{"title":"Unraveling Comorbidities Contribution to Cardiac Diastolic Dysfunction and Heart Failure.","authors":"María Villalba-Orero, Marina López-Olañeta, Belén Campos-Olmo, Daniel Jimenez-Carretero, Lucía Sánchez, Fátima Sánchez-Cabo, Antonella Ausiello, Rodrigo Cañas-Álvaro, Emilio Camafeita, Jesús Vázquez, Pablo García-Pavía, Domingo Pascual-Figal, Enrique Lara-Pezzi","doi":"10.1161/CIRCHEARTFAILURE.124.011724","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.011724","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is a major public health problem characterized by multiple simultaneous comorbidities whose specific contribution is challenging to disentangle in humans, leading to a generalized therapeutic approach that may not account for the underlying pathology.</p><p><strong>Methods: </strong>We followed distinct mouse models of major HFpEF comorbidities for 2.5 years to unveil their specific contribution to the syndrome.</p><p><strong>Results: </strong>All comorbidities contributed to HFpEF through partially distinct routes. Aging alone resulted in HFpEF in old age, with delayed left ventricular relaxation and kidney fibrosis. Obesity induced a faster deterioration of relaxation associated with enlarged left ventricle and liver fibrosis. Hypertension caused delayed ventricular relaxation independent from structural changes that preceded left atrial dilatation linked to aortic stiffness and increased fibrosis in myocardium and kidney. Chronic intermittent hypoxia led to HFpEF and relaxation impairment associated with pulmonary hypertension. Hyperglycemia accelerated diastolic dysfunction and HFpEF onset associated with reduced arterial flow and left ventricular remodeling. Therefore, the pathological substrates contributing to HFpEF included cardiac and noncardiac alterations with differential features for each comorbidity. Critically, the characteristics linked to diastolic dysfunction and HFpEF across the various comorbidities agreed with phenogroups observed in human patients.</p><p><strong>Conclusions: </strong>The identification of time-dependent pathological features provides a comprehensive picture of HFpEF progression associated with each comorbidity.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011724"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750117","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}
引用次数: 0
Stop Dreaming: Mavacamten REMS Data Are Here. 别做梦了Mavacamten REMS 数据来了。
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1161/CIRCHEARTFAILURE.124.012545
Ahmad Masri, Neal K Lakdawala
{"title":"Stop Dreaming: Mavacamten REMS Data Are Here.","authors":"Ahmad Masri, Neal K Lakdawala","doi":"10.1161/CIRCHEARTFAILURE.124.012545","DOIUrl":"10.1161/CIRCHEARTFAILURE.124.012545","url":null,"abstract":"","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012545"},"PeriodicalIF":7.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615726","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}
引用次数: 0
Is It Primetime for Finerenone in Heart Failure? 芬内酮是治疗心力衰竭的黄金时机吗?
IF 7.8 1区 医学
Circulation: Heart Failure Pub Date : 2025-01-01 Epub Date: 2024-11-29 DOI: 10.1161/CIRCHEARTFAILURE.124.012530
Neal M Dixit, Saul Schaefer
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