ESC Heart Failure最新文献

{"title":"Identification of serum C4BPA as a potential diagnostic marker of right ventricular remodelling via proteomic analysis","authors":"Xuenan Wang,&nbsp;Cheng Yu,&nbsp;Meiling Li,&nbsp;Huiling Cai,&nbsp;Yongjian Yang,&nbsp;Cong Lan","doi":"10.1002/ehf2.15292","DOIUrl":"10.1002/ehf2.15292","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Right ventricular (RV) remodelling, a progressive condition characterized by maladaptive cardiac structural and functional changes, primarily results from prolonged pressure overload in patients with pulmonary hypertension (PH). Accurate, universal and easy-to-use biomarkers for assessing the severity of RV remodelling are lacking. This study aimed to identify serum proteins as potential biomarkers of RV remodelling using high-throughput proteomic analysis-based screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sprague–Dawley rats were subjected to sham surgery (control group) or pulmonary artery banding for 4 weeks with 2.3-mm diameter and 1.8-mm diameter rubber rings to induce mild and severe RV modelling, respectively. Serum proteomic profiling revealed 170 differentially expressed serum proteins (DEPs) among the three groups, and three DEPs gradually increased with worsening RV remodelling. Among the three DEPs, C4b-binding protein alpha chain (C4BPA) exhibited the highest upregulation in the severe group (6.93 vs. 16.5 ng/mL, <i>P</i> &lt; 0.001), and linear regression analysis revealed a negative correlation between serum C4BPA levels and tricuspid annular plane systolic excursion (TAPSE) in rats [beta = −0.78, 95% confidence interval (CI) −14.5 to −7.11, <i>P</i> &lt; 0.001]. The diagnostic power of C4BPA was further validated in 127 patients (34 with adaptive RV pressure overload, 36 with maladaptive RV pressure overload, 32 with left ventricular hypertrophy and 25 controls). Control and left ventricular hypertrophy patients exhibited lower serum C4BPA levels than the two RV groups, and serum C4BPA levels were higher in patients with maladaptive RV than in those with adaptive RV (754 vs. 524 pg/mL, <i>P</i> &lt; 0.001). Linear regression analysis revealed a negative correlation between serum C4BPA levels and TAPSE in PH patients. The predictive power of C4BPA for maladaptive RV function in PH patients, indicated by receiver operating characteristic analysis (cut-off value 573 pg/mL, area under the curve 0.792), was as good as that of B-type natriuretic peptide (BNP). High serum C4BPA levels (≥573 pg/mL) were associated with lower TAPSE/pulmonary arterial systolic pressure ratios (<i>P</i> &lt; 0.001) and higher BNP levels (<i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum C4BPA may represent a novel diagnostic biomarker for RV pathological remodelling associated with RV maladaptation in PH patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2843-2854"},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signs of congestion, quality of life and short-term rehospitalization in patients with heart failure","authors":"Geert H.D. Voordes,&nbsp;Adriaan A. Voors,&nbsp;Hailun Qin,&nbsp;Jozine M. ter Maaten,&nbsp;Kevin Damman","doi":"10.1002/ehf2.15277","DOIUrl":"10.1002/ehf2.15277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Signs of congestion are a treatment target in patients with heart failure (HF), as they affect patients' well-being, and congestion scores are associated with the risk of early readmission. However, which individual sign of congestion has the strongest association with quality of life (QoL) and HF rehospitalization remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We included 1551 HF patients hospitalized for worsening HF. QoL was assessed using the Kansas City Cardiomyopathy Questionnaire-23 (KCCQ-23) on the same day as physical examination. We performed linear and Cox regression to find associations of signs of HF to QoL and 60 day HF rehospitalization. All analyses were externally validated in a similar independent cohort. Patients with worse QoL were older and more often female and had more comorbidities and signs of HF. In multivariable regression analyses, peripheral oedema and orthopnoea (standardized beta −0.210, <i>P</i> &lt; 0.001 and standardized beta −0.206, <i>P</i> &lt; 0.001, respectively) had the strongest association with worse QoL. Elevated jugular venous pressure (JVP) was the only multivariable adjusted congestive sign associated with a higher risk of 60 day HF rehospitalization [hazard ratio (HR) 1.64 (1.03–2.60), <i>P</i> = 0.038]. QoL was significantly associated with 60 day HF rehospitalization [HR 1.09 (1.04–1.14), per 5-unit Kansas City Cardiomyopathy Questionnaire (KCCQ) decrease; <i>P</i> &lt; 0.001]. The presence or absence of signs of congestion did not modify the association between QoL and 60 day HF rehospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Peripheral oedema and orthopnoea showed the strongest association with QoL in patients admitted for HF. JVP had the strongest association with the risk of 60 day rehospitalization. Clinically, it is important to distinguish between individual signs due to the discrepancy of their impact on outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2477-2486"},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricular strain predicts outcome in patients receiving sacubitril/valsartan: A sub-analysis of DISCOVER-ARNI","authors":"Maria Concetta Pastore,&nbsp;Giulia Elena Mandoli,&nbsp;Alberto Giannoni,&nbsp;Francesca Rubina Ginetti,&nbsp;Michele Correale,&nbsp;Natale Daniele Brunetti,&nbsp;Andrea Igoren Guaricci,&nbsp;Laura Piscitelli,&nbsp;Anna Degiovanni,&nbsp;Giuseppe Patti,&nbsp;Alessandro Malagoli,&nbsp;Luca Moderato,&nbsp;Erberto Carluccio,&nbsp;Paolo N. Marino,&nbsp;Michele Emdin,&nbsp;Matteo Cameli","doi":"10.1002/ehf2.15297","DOIUrl":"10.1002/ehf2.15297","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Angiotensin receptor/neprilysin inhibitors (ARNI) have emerged as a pivotal medical treatment considerably improving the clinical outcome of patients with heart failure and reduced ejection fraction (HFrEF). Identifying individuals who stand to benefit the most from ARNI could markedly enhance patient management strategies. The aim of this sub-analysis of DISCOVER-ARNI register was to evaluate the prospective prognostic significance of speckle tracking echocardiography (STE) parameters in patients undergoing ARNI therapy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods and results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;DISCOVER-ARNI multicentre Italian register retrospectively enrolled 341 patients with HFrEF referred for treatment with ARNI. These patients underwent clinical, biohumuoral, and echocardiographic assessment at baseline. Subsequently, among those with available right ventricular STE data, a prospective long-term follow-up was conducted by telephone interview or on-site visits. The primary endpoint encompassed a composite of outcomes, including all-cause or cardiovascular mortality, heart failure hospitalization, heart transplantation, and left ventricular assist device (LVAD) implantation. Overall, 136 HFrEF patients were included in this sub-analysis (mean age 65 ± 10 years, 82% male). The mean follow-up was 40 ± 18 months, during which 32 patients reached the primary endpoint (14 deaths of which 10 due to cardiovascular reasons, 22 hospitalization, 3 heart transplantation, 1 LVAD implantation). Baseline assessment revealed that patients with events had higher LV volumes and EF (LV end-diastolic volume 212 ± 65 vs.174 ± 57 mL, &lt;i&gt;P = 0.002&lt;/i&gt;; LV end-systolic volume 156 ± 52 vs. 122 ± 49 mL, &lt;i&gt;P = 0.001&lt;/i&gt;; LV EF = 26 ± 5 vs. 29 ± 5 mL, &lt;i&gt;P = 0.006&lt;/i&gt;, respectively), lower but preserved tricuspid annular plane systolic excursion (TAPSE, 17 ± 3 vs.19 ± 3, &lt;i&gt;P = 0.008&lt;/i&gt;), and higher systolic pulmonary artery pressures (38 ± 11 vs. 31 ± 8 mmHg, &lt;i&gt;P = 0.001&lt;/i&gt;) compared to those who did not experience events. LV, left atrial (LA), and free wall right ventricular longitudinal strain (fwRVLS) were reduced in patients with events (−7 ± 2 vs. −8 ± 2%, &lt;i&gt;P = 0.002&lt;/i&gt;; 11 ± 3 vs. 15 ± 7%, &lt;i&gt;P = 0.001&lt;/i&gt; and −15 ± 5 vs. −22 ± 5%, &lt;i&gt;P = 0.007&lt;/i&gt;, respectively). Employing Cox proportional hazard model including LVEF, TAPSE, RVFAC, LV strain, LA strain, and fwRVLS, the latest emerged as the sole independent predictor of the combined endpoint (hazard ratio = 1.15 [1.05;1.26], &lt;i&gt;P&lt;/i&gt; = 0.002). Receiver operating characteristic (ROC) curves determined that fwRVLS = −20% was the optimal cut-off for predicting the combined endpoint (area under curve [AUC] = 0.70). This threshold was used for constructing Kaplan–Meier survival curves, demonst","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2878-2886"},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right atrial remodelling and prognosis in patients with severe atrial functional tricuspid regurgitation","authors":"Soongu Kwak,&nbsp;Dong-Jae Han,&nbsp;Seung-Pyo Lee,&nbsp;Ho Young Hwang,&nbsp;Hyung-Kwan Kim,&nbsp;Yong-Jin Kim,&nbsp;Kyung Hwan Kim,&nbsp;Jae Woong Choi,&nbsp;Jun-Bean Park","doi":"10.1002/ehf2.15301","DOIUrl":"10.1002/ehf2.15301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Atrial functional tricuspid regurgitation (AFTR) is increasingly recognized as a distinct cause of tricuspid regurgitation, yet data on outcomes and their determinants are limited. This study examines the prognostic role of right atrial (RA) remodelling in patients with severe AFTR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>This retrospective study included consecutive patients with severe AFTR. The primary outcome was all-cause mortality. Cutoff values for RA and right ventricular (RV) sizes related to mortality were identified using receiver operating characteristic curves and maximally selected rank statistics. The cohort included 155 patients with severe AFTR, 96.1% of whom had atrial fibrillation. Of these, 121 received medical treatment, and 34 underwent surgery during follow-up. In the medical management group, 42 deaths (34.7%) occurred over a median of 3.3 years. Patients with high RV end-diastolic area and RA area indices (&gt;14.5 cm²/m² and &gt;22 cm²/m²) had significantly lower survival compared to their counterparts (<i>P</i> = 0.012 and P = 0.001, respectively). Cox analyses demonstrated that increased RV end-diastolic area and RA area indices were associated with higher mortality (RV end-diastolic area index, per 1 cm²/m² increase: adjusted hazard ratio 1.11, 95% confidence interval 1.02–1.22, <i>P</i> = 0.019; RA area index, per 1 cm²/m² increase: adjusted hazard ratio 1.06, 95% confidence interval 1.02–1.10, <i>P</i> = 0.006). Mortality was highest in patients with both high RV end-diastolic area index (&gt;14.5 cm²/m²) and RA area index (&gt;22 cm²/m²) and lowest in those with low values for both indices (<i>P</i> = 0.001). In the surgical intervention group, four post-surgical deaths (11.8%) occurred exclusively in patients with both high RA area and RV end-diastolic area indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RA and RV enlargement are poor prognostic factors in patients with severe AFTR. These findings underscore the importance of assessing RA and RV remodelling to optimize the timing of intervention in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2909-2920"},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma metabolomics identifies signatures that distinguish heart failure with reduced and preserved ejection fraction","authors":"Fawaz Naeem,&nbsp;Teresa C. Leone,&nbsp;Christopher Petucci,&nbsp;Clarissa Shoffler,&nbsp;Ravindra C. Kodihalli,&nbsp;Tiffany Hidalgo,&nbsp;Cheryl Tow-Keogh,&nbsp;Jessica Mancuso,&nbsp;Iphigenia Tzameli,&nbsp;Donald Bennett,&nbsp;John D. Groarke,&nbsp;Rachel J. Roth Flach,&nbsp;Daniel J. Rader,&nbsp;Daniel P. Kelly","doi":"10.1002/ehf2.15285","DOIUrl":"10.1002/ehf2.15285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Two general phenotypes of heart failure (HF) are recognized: HF with reduced ejection fraction (HFrEF) and with preserved EF (HFpEF). To develop phenotype-specific approaches to treatment, distinguishing biomarkers are needed. The goal of this study was to utilize quantitative metabolomics on a large, diverse population to replicate and extend existing knowledge of the plasma metabolic signatures in human HF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma metabolomics and proteomics was conducted on 787 samples collected by the Penn Medicine BioBank from subjects with HFrEF (<i>n</i> = 219), HFpEF (<i>n</i> = 357) and matched controls (<i>n</i> = 211). A total of 90 metabolites were analysed, comprising 28 amino acids, 8 organic acids and 54 acylcarnitines. Seven hundred thirty-three of these samples also underwent proteomic profiling via the O-Link proteomics panel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Unsaturated forms of medium-/long-chain acylcarnitines were elevated in the HFrEF group. Amino acid derivatives, including 1- and 3-methylhistidine, homocitrulline and symmetric and asymmetric (ADMA) dimethylarginine were elevated in HF, with ADMA elevated uniquely in HFpEF. While the branched-chain amino acids (BCAAs) were minimally changed, short-chain acylcarnitine species indicative of BCAA catabolism were elevated in both HF groups. 3-hydroxybutyrate (3-HBA) and its metabolite, C4-OH carnitine, were uniquely elevated in the HFrEF group. Linear regression models demonstrated a significant correlation between plasma 3-HBA and N-terminal pro-brain natriuretic peptide in both forms of HF, stronger in HFrEF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results identify plasma signatures that are shared as well as potentially distinguish HFrEF and HFpEF. Metabolite markers for ketogenic metabolic re-programming were identified as unique signatures in the HFrEF group, possibly related to increased levels of BNP. Our results set the stage for future studies aimed at assessing selected metabolites as relevant biomarkers to guide HF phenotype-specific therapeutics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2803-2813"},"PeriodicalIF":3.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prescription of quadruple therapy in acute decompensated heart failure with reduced ejection fraction: A propensity score-matched analysis","authors":"Luis E. Echeverría,&nbsp;Lyda Z. Rojas,&nbsp;Angie Yarlady Serrano-García,&nbsp;Daniel Botero,&nbsp;Karen Andrea García-Rueda,&nbsp;Ángela Torres-Bustamante,&nbsp;Diana Ivonne Cañón-Gómez,&nbsp;Juan Sebastián Salcedo,&nbsp;Alexandra Hurtado-Ortiz,&nbsp;Jaime A. Rodríguez,&nbsp;Sergio A. Gómez-Ochoa","doi":"10.1002/ehf2.15286","DOIUrl":"10.1002/ehf2.15286","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The optimal timing for prescribing guideline-directed medical therapy (GDMT) in patients with heart failure with reduced ejection fraction (HFrEF) during acute decompensated heart failure (ADHF) remains uncertain. This study evaluated the real-world impact of early in-hospital quadruple GDMT prescription in ADHF patients with HFrEF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>In this retrospective cohort study using the Institutional aCute descompensAted heaRt failUre regiStry (ICARUS), we analysed 2051 HFrEF patients (71% male, median age 68 years) hospitalized for ADHF between June 2022 and March 2024. Early quadruple therapy was defined as the prescription of beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs)/angiotensin receptor–neprilysin inhibitors (ARNIs), mineralocorticoid receptor antagonists (MRAs) and sodium–glucose cotransporter-2 inhibitors (SGLT2is) within 48 h of admission. Among included patients, 898 (43.8%) received early quadruple therapy. Using optimal full matching propensity score methodology, early quadruple therapy was associated with lower 30 day mortality/rehospitalization [relative risk (RR) 0.73; 95% confidence interval (CI) 0.55–0.97, <i>P</i> = 0.028], reduced in-hospital mortality (RR 0.29; 95% CI 0.15–0.56, <i>P</i> &lt; 0.001) and shorter hospital stay (<i>β</i> = −2.65 days; 95% CI −3.67 to −1.63, <i>P</i> &lt; 0.001). Patients receiving early quadruple therapy showed higher rates of GDMT continuation at discharge (RR 3.82; 95% CI 3.01–4.86, <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this HFrEF cohort, early initiation of comprehensive GDMT during ADHF hospitalization was associated with improved clinical outcomes. Future randomized trials including patients across the full spectrum of ejection fraction are needed to validate these findings and determine their applicability to other heart failure phenotypes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2814-2826"},"PeriodicalIF":3.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of mitral valve transcatheter edge-to-edge repair on haemodynamic parameters in cardiogenic shock","authors":"Michal Droppa,&nbsp;Dominik Rath,&nbsp;Philippa Jaeger,&nbsp;Ioannis Toskas,&nbsp;Monika Zdanyte,&nbsp;Andreas Goldschmied,&nbsp;Jürgen Schreieck,&nbsp;Meinrad Gawaz,&nbsp;Tobias Geisler","doi":"10.1002/ehf2.15306","DOIUrl":"10.1002/ehf2.15306","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter edge-to-edge repair (TEER) has been shown to be an effective treatment option for patients experiencing cardiogenic shock (CS) with concomitant high-grade mitral valve regurgitation. However, haemodynamic changes following M-TEER have not been thoroughly investigated. Afterload mismatch, leading to the deterioration of haemodynamics subsequent to mitral regurgitation correction, could potentially occur and adversely impact prognosis. Our objective was to analyse the effect of TEER on haemodynamic and echocardiographic parameters in patients with CS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>We conducted a retrospective study of patients undergoing TEER for mitral valve regurgitation in the setting of CS. Haemodynamic and echocardiographic parameters before and after TEER were systematically analysed. A total of 25 patients underwent TEER in the context of CS. All patients were successfully treated with at least of one grade reduction in mitral regurgitation. The median left atrial mean pressure decreased from 23 mmHg (IQR 17–30) to 16 mmHg (IQR 11–20, <i>P</i> &lt; 0.01), and the V-wave decreased from 36 mmHg (IQR 27–44) to 21 mmHg (IQR 14–25, <i>P</i> &lt; 0.01) following the procedure. The stroke volume index and cardiac index increased from 25 mL/m² (IQR 18–29) to 34 mL/m² (IQR 25–44, <i>P</i> &lt; 0.01) and from 1.90 L/min/m² (IQR 1.41–2.30) to 2.50 L/min/m² (IQR 1.99–2.86, <i>P</i> &lt; 0.01), respectively. We did not observe any worsening of the ejection fraction after the procedure. Ten patients (40%) died during their hospital stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study demonstrates that TEER leads to favourable haemodynamic changes in patients with CS. We observed a significant reduction in left atrial pressure, V-wave, and an elevation in cardiac index. Importantly, we did not observe any deterioration in left ventricular function following the procedure. This supports the concept of haemodynamic stabilization with TEER in patients with CS and high-grade mitral regurgitation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"3173-3178"},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and long-term outcomes in patients with apical hypertrophic cardiomyopathy","authors":"Meng Guo,&nbsp;Chuanfen Liu,&nbsp;Jingjing Ye,&nbsp;Jian Liu","doi":"10.1002/ehf2.15298","DOIUrl":"10.1002/ehf2.15298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>As a special type of hypertrophic cardiomyopathy (HCM), apical HCM (ApHCM) has different clinical characteristics while its nature history and prognosis are not well recognized. We aimed to describe the characteristics and outcomes of ApHCM and identify predictors of adverse outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-centre retrospective study, we included 479 patients with HCM and divided them into ApHCM and non-ApHCM groups. Clinical, electrocardiographic, echocardiographic and survival data were compared between the groups. The primary outcome was major adverse cardiac events in hospital and during follow-up. A two-sided <i>P</i>-value &lt; 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 109 ApHCM patients and 370 non-ApHCM patients were analysed and 379 patients completed the follow-up among them. The age of enrolled patients was 61.0 (50.0–69.0) years, and 289 (60.3%) were male. Compared with non-ApHCM patients, ApHCM patients were older at diagnosis [55.0 (45.0–64.0) vs. 50.0 (40.0–61.0) years, <i>P</i> = 0.006] and had less positive family history for HCM [3 (2.8%) vs. 34 (9.2%), <i>P</i> = 0.027], more electrocardiographic abnormalities [101 (92.7%) vs. 287 (77.6%), <i>P</i> &lt; 0.001], lower brain natriuretic peptide level [135.5 (60.8–272.8) vs. 422.5 (182.8–888.2) pg/mL, <i>P</i> &lt; 0.001] and better left ventricular ejection fraction (LVEF) [69.00 (64.00–73.87) vs. 67.00 (60.24–73.45) %, <i>P</i> = 0.048] at baseline. During a median follow-up of 5.59 (2.33–10.30) years, the primary outcome occurred less frequently in ApHCM patients [11.4% vs 27.2%; hazard ratio (HR)_adj 0.360 (95% confidence interval, CI: 0.187–0.696), <i>P</i> = 0.002; log rank <i>P</i> = 0.001]. Specifically, ApHCM was characterized by fewer all-cause death (HR_adj 0.545, 95% CI: 0.305–0.975; <i>P</i> = 0.041) and fatal ventricular arrhythmia or appropriate implantable cardioverter defibrillator intervention (HR_adj 0.099, 95% CI: 0.013–0.724; <i>P</i> = 0.023). LVEF (HR_adj 0.861, 95% CI: 0.763–0.971; <i>P</i> = 0.015) and age (HR_adj 1.247, 95% CI: 1.095–1.419; <i>P</i> = 0.001) were identified as independent predictors of the composite outcome in ApHCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with ApHCM may have better prognosis. LVEF and age were independent predictors of long-term outcomes in ApHCM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2887-2897"},"PeriodicalIF":3.2,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicentre registry of hospitalized patients with acute and chronic heart failure: Study design of the H2-registry","authors":"Johannes Leiner,&nbsp;Sebastian König,&nbsp;Anne Nitsche,&nbsp;Sven Hohenstein,&nbsp;Jana Nagel,&nbsp;Melchior Seyfarth,&nbsp;Henning Baberg,&nbsp;Alexander Lauten,&nbsp;Hans Neuser,&nbsp;Alexander Staudt,&nbsp;Jürgen Tebbenjohanns,&nbsp;René Andrié,&nbsp;Michael Niehaus,&nbsp;Markus W. Ferrari,&nbsp;Ralf Kuhlen,&nbsp;Andreas Bollmann","doi":"10.1002/ehf2.15266","DOIUrl":"10.1002/ehf2.15266","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Heart failure (HF) is a highly prevalent condition affecting 1–3% of the adult population in Europe. Despite landmark improvements in HF care over the last two decades, hospitalization and mortality rates remain relatively high. Gathering real-world data on HF populations is crucial, especially in the light of newly emerging therapeutic approaches. The Helios Heart (H²)-registry was established to provide up-to-date, real-world data on a contemporary cohort of hospitalized HF patients in Germany using a standardized set of outcome measures with a focus on patient-reported outcomes (PROs). This manuscript describes the registry's design and presents an interim analysis of baseline characteristics and 1-year outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>The H²-registry is a prospective, investigator-initiated, multicentre observational registry in Germany that started in 2021 and is actively enrolling patients. Inpatients ≥18 years of age with a present diagnosis of chronic or acute HF are recruited in secondary and tertiary hospitals throughout Germany. Routine follow-up (FU) is conducted every 6 months. Data collection is based on a set of variables following recommendations of the International Consortium of Health Outcome Measurements (ICHOM) covering data on demographics, medical history, HF characteristics, medication, procedures, and patients' perceived health status via the collection of standardized PROs. Until 31 December 2023, a total of 2361 patients were enrolled in 10 study centres. Mean age in this cohort is 72 years, 36.9% are female, and median left ventricular ejection fraction is 45%. An analysis of 6-month and 12-month outcomes in a cohort of 1593 patients with complete FU data revealed all-cause mortality rates of 9.0% and 16.2% at 6 and 12 months, while HF-related rehospitalizations occurred in 24.4% and 43.5% at 6 and 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The H²-registry is currently the largest ongoing prospective registry of HF patients in Germany. It is foreseeable that the H²-registry will significantly contribute to the collection of real-world data and provide a comprehensive and unique perspective on the current characteristics, treatment strategies, and resulting outcomes of HF patients in Germany.</p>\u0000 \u0000 <p>Trial registration number: NCT04844944.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"3114-3133"},"PeriodicalIF":3.2,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Length of stay and prior heart failure admission in frailty and heart failure: A systematic review and meta-analysis","authors":"Konstantinos Prokopidis,&nbsp;Amy Nortcliffe,&nbsp;Chukwuma Okoye,&nbsp;Massimo Venturelli,&nbsp;Gregory Y. H. Lip,&nbsp;Masoud Isanejad","doi":"10.1002/ehf2.15300","DOIUrl":"10.1002/ehf2.15300","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study was to compare the differences in length of stay (LoS) and prior hospitalization due to heart failure (HHF) in patients with HF and frailty versus without frailty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>From inception until August 2024, PubMed, Scopus, Web of Science and Cochrane Library were searched. To examine the association related to LoS and HHF in patients with HF, a meta-analysis using a random-effects model was conducted (CRD42024570604). Our main analysis demonstrated a significantly increased LoS in patients with frailty versus those without frailty [<i>n</i> = 10; mean difference (MD): 3.67; 95% CI: 2.26–5.08, <i>I</i>² = 93%, <i>P</i> &lt; 0.01]. Likewise, patients with frailty had significantly increased odds of HHF [<i>n</i> = 17; odds ratio (OR): 1.76; 95% CI: 1.50–2.07, <i>I</i>² = 81%, <i>P</i> &lt; 0.01]. Risk of bias assessment of the included studies was overall fair, while Egger's test showed publication bias regarding studies that examined LoS (<i>P</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with frailty have longer LoS and more frequent HHF, underscoring the need for early, targeted interventions to manage frailty that may be attributed primarily to ageing and comorbidity-related status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2417-2426"},"PeriodicalIF":3.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}