Current Heart Failure Reports最新文献

{"title":"Urinary Biomarkers for the Risk Assessment and Management of Heart Failure: Pearls and Pitfalls.","authors":"Bethany Roehm, Yash Vaggar, Justin L Grodin, Robert D Toto","doi":"10.1007/s11897-026-00774-9","DOIUrl":"10.1007/s11897-026-00774-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>We review potential applications and pitfalls of urinary biomarkers in people with heart failure (HF).</p><p><strong>Recent findings: </strong>Albuminuria may indicate kidney damage and guide prioritization of medications in HF. Urine sodium is useful in guiding diuretic management. Several experimental urine biomarkers have been evaluated, with the most robust data available for neutrophil gelatinase-associated lipocalin, kidney injury marker 1, insulin-like growth factor-binding protein 7 in conjunction with tissue inhibitor of metalloproteinases-2, angiotensinogen, and N-acetyl-β-D-glucosaminidase. None provide diagnostic superiority over serum creatinine in evaluating risk of kidney injury. Some may have utility in identifying those at risk for adverse clinical outcomes. While urine albumin and sodium have prognostic and diagnostic utility in HF, the current role for other urine biomarkers is less clear, particularly in predicting worsening kidney function. Some of these biomarkers may provide mechanistic insights into kidney damage in HF.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Imaging in Heart Failure: Toward Precision Phenotyping, Integration, and Intelligence.","authors":"Moritz J Hundertmark","doi":"10.1007/s11897-026-00769-6","DOIUrl":"10.1007/s11897-026-00769-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Heart failure (HF) is increasingly understood not as a single, uniformly treated diagnosis but as a heterogeneous syndrome requiring aetiological clarification, in which cardiac imaging is central. As the opening article of this journal's 'Imaging in Heart Failure' section, this review surveys the technologies currently reshaping HF imaging and sets out the section's scope and priorities, framing the shift from a descriptive, modality-siloed practice toward an integrated, predictive, patient-specific discipline.</p><p><strong>Recent findings: </strong>Artificial intelligence (AI) now delivers expert-level echocardiography automation, guides image acquisition by novices in resource-limited settings, detects aetiologies such as transthyretin amyloid cardiomyopathy from a single acquisition and enables deep phenotyping through radiomics and vendor-agnostic strain analysis. Handheld, AI-enabled point-of-care ultrasound extends imaging-guided triage beyond the echocardiography laboratory. Cardiovascular magnetic resonance (CMR) advances - parametric mapping, four-dimensional flow, diffusion tensor imaging, spectroscopy, and accelerated reconstruction - broaden tissue and metabolic characterisation, including patients with implanted devices. Molecular imaging with novel positron emission tomography tracers and hyperpolarised magnetic resonance is moving from depicting the structural consequences of disease to imaging active pathobiology, while photon-counting computed tomography and image-derived digital twins support one-stop structural assessment and in-silico prediction of therapy response. The convergence of AI, molecular imaging and advanced precision is transforming HF imaging from better pictures into smarter, integrated, personalised data that directly inform care. Realising this promise will require rigorous validation, attention to algorithmic bias and generalisability, demonstrated cost-effectiveness, curricular reform, and equitable access. This section aims to critically appraise these innovations and their translation into practice.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Personalize Surveillance for Cancer Therapy-Related Cardiac Dysfunction in HER2-Targeted Therapy: One Size Does Not Fit All.","authors":"Sara Ebrahimi, Lalith Vardhan Namburu, Anita Deswal","doi":"10.1007/s11897-026-00770-z","DOIUrl":"10.1007/s11897-026-00770-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cancer therapy-related cardiac dysfunction (CTRCD) remains a significant risk of contemporary cancer treatment. Despite advances in oncologic therapies, cardiac surveillance strategies have largely relied on uniform, intensive monitoring, often without consideration of individual cardiotoxicity risk. This review evaluates the rationale for transitioning from blanket surveillance to risk-based, personalized cardiac monitoring strategies, especially for HER2-targeted therapy.</p><p><strong>Recent findings: </strong>Evolving definitions of CTRCD and improved risk stratification tools, have highlighted substantial heterogeneity in cardiotoxicity risk. Prospective studies in low-risk patients receiving non-anthracycline HER2-targeted therapies demonstrate that reduced-frequency echocardiographic surveillance appears safe and does not compromise cardiovascular or oncologic outcomes. Similar paradigms need to be studied for other cardiotoxic therapies, including BRAF/MEK inhibitors and VEGF inhibitors, with a need for prospective validation before clinical application. Risk-adapted cardiac surveillance offers a pragmatic, evidence-based approach to optimize resource utilization while maintaining patient safety. Future research should focus on prospective validation and guideline harmonization to enable personalized cardio-oncology care.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Cardioprotection to Trial Design: Rethinking Cardiac Safety in Oncology.","authors":"Antonio Iaconelli, Roberto Scacciavillani, Lorenzo Cacioli, Giovanni Pecorini, Lucie Kretzler, Markus S Anker","doi":"10.1007/s11897-026-00765-w","DOIUrl":"10.1007/s11897-026-00765-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardio-oncology has emerged as a pivotal discipline aimed at preserving cardiovascular health in patients undergoing contemporary cancer therapies. Despite growing awareness of treatment-related cardiac injury, the evidence base supporting preventive strategies and standardized safety assessment remains fragmented. This review critically appraises randomized controlled trials evaluating pharmacological and non-pharmacological interventions for the prevention of cancer therapy-related cardiac dysfunction. In parallel, we examine how cardiovascular events are monitored, defined, and reported in major oncology trials, with particular emphasis on patient selection criteria and the use of structured surveillance protocols.</p><p><strong>Recent findings: </strong>Across drug classes repurposed from heart failure (HF) prevention and treatment, including neurohormonal antagonists, angiotensin receptor-neprilysin inhibition, lipid-lowering therapies, as well as exercise-based interventions, randomized evidence has demonstrated modest and inconsistent benefits. Reported effects are largely confined to subclinical alterations, such as changes in left ventricular systolic function, myocardial deformation parameters, or circulating cardiac biomarkers. By contrast, convincing reductions in clinically meaningful outcomes, including overt HF, treatment interruption, or cardiovascular mortality, remain limited. Concurrently, oncology trials frequently exhibit heterogeneous cardiovascular event definitions, incomplete safety reporting, and systematic exclusion of patients with pre-existing cardiac disease, thereby constraining external validity and obscuring the true burden of cardiotoxicity and competing cardiovascular risks. Advancing the field will require a paradigm shift toward individualized, risk-enriched prevention strategies anchored in clinically relevant endpoints. Broader inclusion of patients with stable cardiovascular comorbidities, managed under structured specialist supervision, alongside standardized frameworks for cardiovascular safety monitoring and reporting, is essential. Emerging artificial intelligence, as enabled tools applied to cardiac imaging, electrocardiography, and remote monitoring offer a promising opportunity to harmonize early detection of cardiotoxicity across trial sites and refine phenotyping of treatment-related cardiac injury. Integrating these elements into future trial design will be critical to ensure that therapeutic progress in oncology is not undermined by preventable cardiovascular harm.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute and Chronic Myocarditis in Men and Women.","authors":"Enrico Ammirati, Adelina Selimi, Matteo Palazzini, Nicolina Conti, Maria Di Cicco, Marisa Varrenti, Daniel Ignacio Conforme Torres, Iside Cartella, Paola Sormani, Caterina Santolamazza, Andrea Farina, Andrea Garascia, Piero Gentile, Sara Mori","doi":"10.1007/s11897-026-00768-7","DOIUrl":"10.1007/s11897-026-00768-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Acute myocarditis (AM) shows sex-specific differences in prevalence, clinical phenotype, and outcomes. This review summarizes evidence from studies published between 2000 and 2026 reporting sex-stratified data on AM epidemiology, presentation, and prognosis to guide future research and a more personalized management.</p><p><strong>Recent findings: </strong>AM is more frequent in males (54-84%), who present at a younger median age than females (31-35 vs. 38-54 years). This disparity emerges from school age, peaks between 15 and 50 years, and attenuates after menopause, when female incidence increases. Men more often present with chest pain (78-91% vs. 58-78%), ST-segment elevation (35-75% vs. 8-44%), and higher troponin levels. Women more frequently present with dyspnea (29-71% vs. 9-26%), heart failure (11-55% vs. 4-47%), and a prior autoimmune disease (4-25% vs 1-10%). Contemporary registries suggest a worse early course in women, with fulminant presentation in 10-71% vs. 15-17% in men, and in-hospital mortality of 4-8% vs. 2-5%. Conversely, men appear more prone to recurrent myocarditis (3-6% vs. 2-3%). Women are overrepresented in AM associated with desmosomal gene variants (33-69%) and systemic lupus erythematosus (83-91%), whereas men predominate in eosinophilic myocarditis (67-82%) and cardiac sarcoidosis (57-70%). Current evidence supports meaningful sex-related differences in AM prevalence and prognosis, with women appearing to experience a worse early clinical course despite the overall male predominance. Larger dedicated studies are needed to improve sex-tailored risk stratification and management.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smart Technology, Fragile Hearts: Navigating AI's Challenges and Limitations in Heart Failure Management.","authors":"Paul Nona, Juma Bin Firos, Carrie Zografos, Mark J Schuuring, Ami Bhatt, Efstathia Andrikopoulou","doi":"10.1007/s11897-026-00766-9","DOIUrl":"10.1007/s11897-026-00766-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review synthesizes recent progress in applications of artificial intelligence to heart failure care, including phenotyping, risk stratification, imaging interpretation, and point-of-care decision support, and delineates barriers that currently limit safe and equitable clinical translation.</p><p><strong>Recent findings: </strong>Clinical datasets remain heterogeneous and incomplete; fragmentation across electronic records, telemetry, and imaging repositories constrains generalizability and external validity. Underrepresentation of key subgroups and outcome misclassification introduce systematic error that can widen disparities. Performance drifts as therapies and workflows evolve, yet monitoring after deployment is uncommon. Model opacity hinders error analysis and clinician trust. Regulatory and data-sharing frameworks are evolving and inconsistent, complicating multisite validation and ongoing surveillance. Mitigation strategies with the strongest support include rigorous cohort curation; transparent reporting; geographic and temporal external validation; prospective pilots with prespecified safety checks; bias auditing with equity metrics; concise documentation such as model cards and factsheets; continuous monitoring with clear contingency and rollback plans; and human oversight embedded throughout governance. Embedding safeguards into development and implementation can enable AI to deliver measurable value in heart failure care while protecting patient safety and equity. Immediate priorities are robust evaluation, routine surveillance for drift and harm, and alignment with outcomes that matter to patients.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative Care in Advanced Heart Failure.","authors":"Giada Colombo, Luca Fazzini, Enrico Perna, Robert Mentz, Loreena Hill, Emilia D'Elia, Michela Barisone","doi":"10.1007/s11897-026-00767-8","DOIUrl":"10.1007/s11897-026-00767-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Advanced heart failure (HF) is characterized by high symptom burden, poor quality of life (QoL), and recurrent hospitalizations. As survival improves, an increasing proportion of patients progresses to advanced stages, leading to a growing population of individuals with end-stage HF, many of whom are ineligible for heart transplantation or mechanical circulatory support due to age, comorbidities, frailty, or limited social support. This review aims to synthesize current evidence on palliative care (PC) integration in advanced HF, focusing on indications, timing of referral, and the role of multidisciplinary care in optimizing patient management.</p><p><strong>Recent findings: </strong>Recent evidence supports early integration of PC across the HF trajectory, demonstrating reductions in hospital readmissions and improvements in QoL. Screening tools, patient reported outcome measures, and frailty assessments have emerged as key instruments to identify unmet needs and appropriate referral. Multidisciplinary models involving cardiology, palliative specialists, nurses, and community care providers have shown benefits in symptom control, care coordination, and advance care planning. PC represents a fundamental component of advanced HF management and should be integrated early in the disease trajectory. A structured, multidisciplinary approach that supports holistic care, improves patient outcomes, and aligns treatment strategies with patient preferences should be routinely adopted by HF clinicians.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolving Utility of Artificial Intelligence-Based Tools for the Detection of Heart Failure and Cardiomyopathies: From Potential to Implementation.","authors":"Philip M Croon, Lovedeep S Dhingra, Aline F Pedroso, Rohan Khera","doi":"10.1007/s11897-026-00764-x","DOIUrl":"10.1007/s11897-026-00764-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Artificial intelligence (AI) is poised to transform heart failure (HF) care across the clinical continuum, yet a substantial gap remains between model development and implementation. This review aims to summarize key AI-enabled innovations across HF care and provide a practical framework for clinical implementation.</p><p><strong>Recent findings: </strong>AI applications based on electrocardiography, echocardiography, electronic health records, wearable devices, and large language models have demonstrated promise for early detection, diagnosis, risk stratification, and treatment optimization in HF. The field is shifting from retrospective model development toward prospective evaluation, workflow integration, and health-system deployment, though challenges related to bias, generalizability, interoperability, and clinician adoption persist. Here, we propose a practical stepwise framework to support the safe, scalable, and sustainable implementation of AI in real-world heart failure care.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Continuous-Flow: The Next Wave of Fully Implantable LVADs and Total Artificial Hearts.","authors":"Tasuku Hada, Julia Baranowska, Koji Takeda, Gabriel T Sayer, Nir Uriel","doi":"10.1007/s11897-026-00763-y","DOIUrl":"10.1007/s11897-026-00763-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Ventricular assist devices (VADs) have evolved from a bridge-to-transplantation strategy into a cornerstone of long-term advanced heart failure management. While continuous-flow technology has dramatically improved survival and device reliability, the paradigm shift toward extended mechanical circulatory support has exposed critical unresolved challenges. This review examines current limitations and four transformative technological directions shaping the next generation of VAD therapy.</p><p><strong>Recent findings: </strong>Four key areas are driving innovation in the field. First, growing evidence linking prolonged non-pulsatile hemodynamics to vascular dysfunction and hemorrhagic complications has renewed interest in miniaturized pulsatile devices, with multiple engineering approaches under active investigation. Second, the development of physiologically responsive \"smart pump\" technology represents a major advance, enabling dynamic modulation of pump output in response to patient hemodynamic demands. Third, transcutaneous energy transfer (TET) systems combined with advanced battery technologies are progressing toward fully implantable designs that would eliminate driveline-related infections, a persistent and clinically significant complication of current-generation devices. Fourth, total artificial heart (TAH) development continues to advance, with both pulsatile and continuous-flow platforms incorporating TET technology to address biventricular failure. Despite ongoing challenges in balancing miniaturization, durability, and biocompatibility, these four innovations collectively hold promise for transforming mechanical circulatory support into a viable long-term therapeutic option, improving both survival and quality of life for a broader population of patients with advanced heart failure.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Artificial Intelligence Tools for the Screening of Structural and Valvular Heart Disease.","authors":"Yasmine Abbaoui, Alexis Nolin-Lapalme, Julianne Morisset, Ines El Adib, Philippe Genereux, Timothy J Poterucha, Pierre Elias, Xioaxi Yao, Robert Avram","doi":"10.1007/s11897-026-00757-w","DOIUrl":"10.1007/s11897-026-00757-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Structural heart disease (SHD) encompasses diseases involving the heart valves, chambers, walls, and muscles. Current diagnostic methods have limited accessibility and predictive value. This review aims to present recent advances in artificial intelligence (AI)-guided tools in the screening of SHD and valvular heart disease (VHD), and to present challenges and opportunities for their use in clinical practice.</p><p><strong>Recent findings: </strong>AI-guided models trained on ECGs, chest X-rays, and coronary artery calcium scans have a high accuracy in the diagnosis of SHD, heart failure, low left ventricular ejection fraction, and VHD. Some of these models can highlight the signals that influence their predictions, improving explainability. The use of AI in screening for SHD and VHD could lead to earlier diagnosis, enhanced accuracy, and better accessibility. However, outcome data on earlier diagnosis using these tools is required before broad deployment.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"23 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}