ESC Heart Failure最新文献

{"title":"Celebrating a decade of the HFA young community: Achievements and future directions by the HFA Young Committee.","authors":"Mateusz Sokolski, Emanuele Bobbio, Alberto Esteban-Fernandez, Sotiria Liori, Cornelia Margineaunu, Francesca Musella, Chris J Kapelios, Henrike Arfsten, Shirley Sze, Daniela Tomasoni, Han Naung Tun, Markus Wallner, Brenda Moura, Ewa A Jankowska, Alexandre Mebazaa, Marco Metra, Wilfried Mullens, Jozine M Ter Maaten, Antonio Cannata","doi":"10.1002/ehf2.15323","DOIUrl":"https://doi.org/10.1002/ehf2.15323","url":null,"abstract":"<p><p>The Heart Failure Association (HFA) Young initiative, established in 2014, welcomes all HFA members under 40 years of age, including physicians, scientists, nurses and allied health professionals. Its primary aim is to foster the growth of the next generation of heart failure (HF) specialists through a variety of educational and career-building programmes such as the monthly HFA Cardiotalk Podcast, the quarterly HFA Journal Club and the Career Café. The members also have the possibility to participate in the construction of the annual HFA congress programme and benefit from travel grants for the HFA Congress, and networking events at scientific meetings. In 2022-2023, the HFA Young conducted a survey that garnered 305 members, giving an important snapshot of their needs, expectations and aspirations, which served as a roadmap for the priorities of the group. Finally, in order to build and maintain networks of young professionals at the national level, the HFA Young Ambassadors initiative was established, connecting the HFA Young Committee with young HF professionals in their respective countries. This initiative has proven to be crucial for building a global community of emerging HF specialists and enhancing the awareness of the HFA's activities. The article presents the evolution of HFA Young over the past 10 years, summarizes key activities and survey results and seeks to outline future development directions.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A two-phase approach to identifying HFpEF in heart failure patients: Risk score evaluation and decision tree development.","authors":"Izabella Uchmanowicz, Magdalena Lisiak, Piotr Ponikowski, Ewa A Jankowska, Andrzej Mysiak, Marta Wleklik","doi":"10.1002/ehf2.15333","DOIUrl":"https://doi.org/10.1002/ehf2.15333","url":null,"abstract":"<p><strong>Aims: </strong>Heart failure (HF) with preserved ejection fraction (HFpEF) poses significant diagnostic challenges due to its complex aetiology and overlapping symptoms with other HF types. The heterogeneity of HFpEF, compounded by frequent comorbidities, complicates diagnosis. This study aimed to enhance HFpEF prediction through a two-phase approach: a simplified risk score and a decision tree model.</p><p><strong>Methods and results: </strong>In Phase 1, an 8-point risk score based on accessible clinical parameters was developed. In Phase 2, we conducted comprehensive predictive modelling using decision tree analysis. Data from 560 HF patients were analysed. It achieved an accuracy of 63.13% (sensitivity: 62.87%, specificity: 54.24%). In Phase 2, a decision tree model using broader clinical variables improved accuracy to 73.04% (sensitivity: 53.89%, specificity: 81.17%).</p><p><strong>Conclusions: </strong>This dual framework provides tools for both quick screening and detailed risk stratification in various clinical settings.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple jugular venous assessment: a new approach to heart failure.","authors":"Tatsuya Kawasaki","doi":"10.1002/ehf2.15339","DOIUrl":"https://doi.org/10.1002/ehf2.15339","url":null,"abstract":"","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations of myocardial ketone metabolism in heart failure with preserved ejection fraction (HFpEF).","authors":"Qiuyu Sun, Cory S Wagg, Nathan Wong, Kaleigh Wei, Ezra B Ketema, Liyan Zhang, Liye Fang, John M Seubert, Gary D Lopaschuk","doi":"10.1002/ehf2.15319","DOIUrl":"https://doi.org/10.1002/ehf2.15319","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac energy metabolism is disrupted in heart failure with preserved ejection fraction (HFpEF), as characterized by a switch from glucose oxidation towards fatty acid oxidation. However, although oxidation of ketones is an important source of ATP it remains unclear how the heart oxidizes ketones in HFpEF. It is also unclear whether elevating ketone supply to the heart can improve cardiac energetics and/or provide functional benefit for the hearts in HFpEF.</p><p><strong>Aims: </strong>The present study investigated the effects of increasing ketone supply to the heart via ketone supplementation or SGLT2 inhibitor treatment in a mouse model of HFpEF.</p><p><strong>Methods: </strong>HFpEF was induced in 13-month-old C57BL/6N female mice with 60% high-fat diet and L-NAME (0.5 g/L/day in the drinking water) for 6 weeks. In parallel, two other groups of mice were maintained on the HFpEF protocol while also receiving either a ketone ester supplement (1-3 butanediol 1 g/kg/day) or SGLT2 inhibitor (empagliflozin 10 mg/kg/day) for 6 weeks. Control mice were fed with regular low-fat diet and regular drinking water. Hearts of the mice were excised and perfused in the isolated working mode aerobically with 5-mM glucose, 0.8-mM palmitate, 100-μU/mL insulin, with either low (0.6 mM) or high (1 mM) levels of β-hydroxybutyrate. Metabolic rates of the hearts were measured with radiolabelled [U-¹⁴C] glucose, [9,10-³H] palmitate and [3-¹⁴C] β-hydroxybutyrate.</p><p><strong>Results: </strong>In HFpEF mouse hearts, glucose oxidation was significantly decreased with a parallel increase in fatty acid oxidation. Increasing β-hydroxybutyrate levels from 0.6 to 1 mM in the perfusate resulted in a rise in ketone oxidation rates in control hearts (from 861 ± 63 to 1377 ± 94 nmol g dry wt^-1 min^-1), which was muted in HFpEF hearts (from 737 ± 68 to 897 ± 134 nmol g dry wt^-1 min^-1). Following ketone ester supplement or SGLT2 inhibitor treatment, HFpEF mice presented with restored ketone oxidation rates (from 674 ± 36 to 1181 ± 115 nmol g dry wt^-1 min^-1 with ketone ester supplement and from 797 ± 121 to 1240 ± 120 nmol g dry wt^-1 min^-1 with SGLT2i). Yet, this was not associated with improvement in cardiac function.</p><p><strong>Conclusions: </strong>In HFpEF mice, the heart switches from glucose oxidation to fatty acid oxidation, with ketone oxidation being impaired. Increasing ketone supply to the heart via ketone ester supplementation or SGLT2 inhibitor treatment increases myocardial ketone oxidation rates but was not associated with functional improvements. Unlike HFrEF, ketone supplementation strategies may be less effective in HFpEF due to an impairment of myocardial ketone oxidation in HFpEF.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular decompression in paediatric veno-arterial extracorporeal life support: Reviewing the evidence.","authors":"Giacomo Veronese, Paolo Meani, Domenico Sirico, Giovanni Di Salvo, Enrico Ammirati, Alessandro Varrica, Umberto Di Dedda, Paolo Bianchi, Giuseppe Isgrò, Alessandro Giamberti, Tommaso Aloisio, Marc Dickstein, Ezio Bonanomi, Bahaaldin Alsoufi, Ravi R Thiagarajan, Peta M A Alexander, D Michael McMullan, Ryan P Barbaro, Graeme MacLaren, Marco Ranucci, Navin K Kapur, Roberto Lorusso","doi":"10.1002/ehf2.15325","DOIUrl":"https://doi.org/10.1002/ehf2.15325","url":null,"abstract":"<p><p>Veno-arterial extracorporeal life support (VA ECLS) is crucial for neonatal and paediatric patients with severe circulatory collapse but may cause left ventricular (LV) overload, affecting myocardial recovery and causing complications. Evidence on optimal LV decompression strategies in paediatric patients remains limited. We conducted a systematic review following PRISMA guidelines, including articles published between 1993 and 2024 focused on VA ECLS and LV decompression in patients under 18 years of age. The review included 11 retrospective cohorts and registry-based studies (2012-2024), totalling 1222 paediatric patients undergoing decompression. Patient demographics, initial diagnoses and VA ECLS settings were heterogeneous. The prevalence of LV decompression ranged from 46.6% in post-cardiotomy to 10.5% in non-post-cardiotomy peripheral VA ECLS cases. Most patients (57.1%) were supported with peripheral VA ECLS, and the majority (57.4%) underwent percutaneous decompression, whereas surgical approaches predominated in post-cardiotomy central VA ECLS. Balloon atrial septostomy (BAS) was the most frequent technique (50%), followed by surgically placed left atrial cannula (37.4%). Thirteen case series (70 patients) and 28 case reports (28 patients) were also reviewed. Substantial variability in LV decompression strategies exists based on age and clinical scenario. PAS-based techniques were more common in younger patients on peripheral VA ECLS while older children often underwent different strategies. Surgical approaches were preferred in central VA ECLS, particularly in the post-cardiotomy setting. Procedural safety varied by technique. While PAS-based strategies such as BAS generally showed low complication rates, adverse events like arrhythmia, bleeding and cardiac perforation were reported in 7%-9% of cases. Surgical LA cannulation was associated with higher bleeding risk. Impella use was linked to haemolysis (50%) and major bleeding (20%). Comparative data highlight that each technique carries distinct procedural risks and complication profiles. In conclusion, LV decompression during paediatric VA ECLS remains technically challenging and variably adopted. Its benefit appears more consistent in the post-cardiotomy setting, where improved survival and reduced adverse outcomes were observed. Given the lack of standardization, further prospective studies and collaborative registries are essential to guide strategy selection, timing and risk-benefit balance, particularly in such a vulnerable population.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ending nuclear weapons, before they end us.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Marion Birch, Inga Blum, Peter Doherty, Andy Haines, Ira Helfand, Richard Horton, Kati Juva, Jose F Lapena, Robert Mash, Olga Mironova, Arun Mitra, Carlos Monteiro, Elena N Naumova, David Onazi, Tilman Ruff, Peush Sahni, James Tumwine, Carlos Umaña, Paul Yonga, Chris Zielinski","doi":"10.1002/ehf2.15334","DOIUrl":"https://doi.org/10.1002/ehf2.15334","url":null,"abstract":"","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of lipid parameters among patients with heart failure: A systematic review and meta-analysis.","authors":"Ahmed Sayed, Hesham Afify, Malak Munir, Ibrahim ElGarhy, Omar Shazly, Mohamed ElRefaei, Saeed Ahmed, Ahmed M Amin, Omar Chikh Amine, Islam Y Elgendy","doi":"10.1002/ehf2.15315","DOIUrl":"https://doi.org/10.1002/ehf2.15315","url":null,"abstract":"<p><strong>Aims: </strong>We sought to evaluate the prognostic value of different lipid parameters in patients with heart failure (HF).</p><p><strong>Methods and results: </strong>Electronic databases including MEDLINE, Embase, CENTRAL, and Web of Science were searched to identify studies that reported the association of any of the four lipid parameters [total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides] with mortality among patients with HF. A random-effects model was used to estimate the association per 10 mg/dL increment. The QUIPS tool was used to assess the risk of bias. Fifty-two studies enrolling 93 286 patients were included. On univariable analysis, higher levels of the four lipid parameters were associated with lower mortality: TC [hazard ratio/odds ratio (HR/OR): 0.94; 95% confidence interval (CI): 0.93 to 0.96], HDL-C (HR/OR: 0.89; 95% CI: 0.80 to 0.99), LDL-C (HR/OR: 0.93; 95% CI: 0.90 to 0.97) and triglycerides (HR/OR: 0.95; 95% CI: 0.92 to 0.99). On multivariable analysis, lower levels of TC (HR/OR: 0.95; 95% CI: 0.93 to 0.97) and LDL-C (HR/OR: 0.94; 95% CI: 0.89 to 0.99) were associated with lower mortality.</p><p><strong>Conclusions: </strong>Higher levels of lipids parameters were associated with lower mortality in patients with HF. Lipid parameters may improve prognostication in predictive models for patients with HF. Because of the observational nature of included studies, no claims about the causal effect of changing lipid parameters can be made.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute myocarditis according to age: Presentation, management and early outcomes.","authors":"Clément Karsenty, Paul Vignaud, Clara Brusq, Pamela Moceri, Pascal Lim, Edouard Gerbaud, Olivier Lairez, Coline Lelarge, Caroline Ovaert, Claire Bouleti, Oscar Werner, Vanina Bongard, Thibaud Genet, Laurent Bonnemains, Christophe Tron, Elise Barre, Margaux Boddaert, Jacques Mansourati, Chérine Benzouid, François Roubille, Hadi Khachab, Sabrina Uhry, Ariel Cohen, Benoit Lattuca, Sylvie Di Filippo, Clément Delmas","doi":"10.1002/ehf2.15304","DOIUrl":"https://doi.org/10.1002/ehf2.15304","url":null,"abstract":"<p><strong>Aims: </strong>Acute myocarditis (AM) is a rare but severe disease affecting patients of all ages. Large multicentric studies comparing children and adults are currently lacking. We aimed to elucidate differences in presentation, management, and outcomes of AM across age groups.</p><p><strong>Methods: </strong>We analysed a comprehensive French national cohort study, encompassing 53 paediatric and adult units from March 2020 to November 2021, collecting data on baseline characteristics, evolution, management and in-hospital complications. Myocarditis-related events (MRE) within 30 days included all-cause death, cardiogenic shock, cardiac arrest, ventricular arrhythmias or complete AV block.</p><p><strong>Results: </strong>We included 745 AM patients (328 children and 417 adults), mainly male (73.4%) with a median age of 10.9 years [Q1-Q3 (7.3-14.6)] for children and 28.7 years [22.6-41.2] for adults. Multisystem inflammatory syndrome (MIS) was more prevalent among children (69.8%), and infectious aetiologies dominated in adults (13.4 vs. 52.4%). Children exhibited more severe clinical presentation (15.9 vs. 7.2%, P < 0.001, with heart failure and 14.4 vs. 6.9%, P < 0.001, with cardiogenic shock), requiring higher use of inotropes (25.0 vs. 9.4%, P < 0.001), vasopressors (12.0 vs. 6.2%, P < 0.001), and ventilatory support (13.7% vs. 7.9%, P = 0.01). Cardiac treatments were used less frequently in children, and corticosteroids (68.3 vs, 14.3, P < 0.001) and immunomodulators (65.1 vs. 4.5%, P < 0.001) were more common. MRE occurrence was substantial but not significantly different between children and adults (18.1 vs. 13.4%, P = 0.09). Extra-cardiac manifestations at admission were significant predictors of MRE [adjusted odds ratio 2.40 (1.43-4.38)], regardless of MIS status.</p><p><strong>Conclusions: </strong>AM exhibits variations in presentation, aetiologies and management but has a comparable 30 day prognosis in children and adults. These findings underscore the importance of tailored management strategies in AM across different age groups.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 the association between nutritional status and in-hospital mortality in HFpEF patients.","authors":"Michał Czapla, Adrian Kwaśny, Izabella Uchmanowicz, Łukasz Pietrzykowski, Christopher S Lee, Wojciech Kosowski, Stanisław Surma, Halina Grajeta, Łukasz Lewandowski","doi":"10.1002/ehf2.15332","DOIUrl":"https://doi.org/10.1002/ehf2.15332","url":null,"abstract":"<p><strong>Aims: </strong>The study aimed to assess whether the effect of nutritional risk score (NRS-2002) on the odds of in-hospital mortality would be modulated by sex and body mass index (BMI) in patients with heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Methods and results: </strong>A retrospective analysis was conducted on 234 patients admitted with acute heart failure, in whom HFpEF was identified as the underlying diagnosis, during the period 08.2018-08.2020. Nutritional status was assessed using BMI and NRS2002. NRS-2002 is a validated screening tool recommended by ESPEN that evaluates nutritional risk based on recent weight loss, reduced dietary intake, severity of illness and age. Logistic regression models were used to evaluate the associations between these nutritional indices and in-hospital mortality. The models were adjusted for sex, age and comorbidities. Interactions between NRS2002, BMI and sex were also explored to assess whether the effect of nutritional status on mortality was modulated by these factors. The analysis revealed that male patients with elevated NRS2002 scores had significantly higher odds of in-hospital mortality (odds = 47.512 at NRS2002 = 4 compared to odds = 0.031 at NRS2002 = 1; BMI = 28 in both cases). BMI negatively modulated the odds of death (OR = 0.843, P = 0.012) in the population sample. This effect was consistent across the sample regardless of NRS2002 score, as NRS2002 did not significantly influence the BMI-mortality relationship (P = 0.289). Importantly, this relationship was observed only in male patients, as no such association between NRS2002 and mortality was found in women.</p><p><strong>Conclusions: </strong>In male patients with HFpEF, elevated NRS2002 scores showed significantly higher odds of in-hospital mortality. Higher BMI was generally associated with lower odds of mortality, with this protective effect remaining consistent in the population sample, regardless of the NRS2002 score.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of early exercise on cardiovascular biomarkers in patients with congestive heart failure.","authors":"Yanxiang Sun, Xuansheng Huang, Bing Hu, Zidi Wu, Yanchun Zhang, Yong Yuan, Li Feng","doi":"10.1002/ehf2.15317","DOIUrl":"https://doi.org/10.1002/ehf2.15317","url":null,"abstract":"<p><strong>Background: </strong>Exercise training improves functional outcomes in chronic heart failure (HF), but the effects of early in-hospital physical activity on cardiovascular biomarkers and prognosis in acute congestive heart failure (AHF) patients remain unclear. This study investigated the short-term impact of early rehabilitation on prognostic biomarkers-high-sensitivity troponin T (hs-TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), soluble suppression of tumourigenesis-2 (sST2), galectin-3 (Gal-3) and endothelin-1 (ET-1)-and evaluated associations with clinical outcomes.</p><p><strong>Methods and results: </strong>A total of 118 hospitalized AHF patients (35 controls and 83 exercise group) underwent biomarker measurement before and after supervised rehabilitation using non-invasive cardiac output monitoring. Serum levels of NT-proBNP, hs-TnT, sST2, Gal-3, and ET-1 were analysed. Prognosis was assessed via 12-month follow-up for all-cause mortality. Statistical analysis included ANOVA for biomarker changes and Kaplan-Meier survival analysis. Post-intervention, NT-proBNP levels increased significantly in the exercise group (2900 ± 700 pg/mL to 3500 ± 760 pg/mL, P = 0.012), as did ET-1 (1.9 ± 0.4 pg/mL to 2.4 ± 0.5 pg/mL, P = 0.018). Hs-TnT, sST2 and Gal-3 showed no significant changes (all P > 0.05). Survival analysis demonstrated higher baseline hs-TnT [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.3-3.4] and greater NT-proBNP elevation post-exercise (ΔNT-proBNP HR 1.8, 95% CI 1.1-2.9) were independent predictors of mortality.</p><p><strong>Conclusions: </strong>Early in-hospital exercise in AHF patients transiently elevates NT-proBNP and ET-1, indicative of acute haemodynamic stress, without altering myocardial injury or fibrosis markers (hs-TnT, sST2 and Gal-3). Elevated baseline hs-TnT and post-exercise NT-proBNP increases correlate with poorer survival, highlighting their prognostic value in risk assessment.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}