ESC Heart Failure最新文献

{"title":"Exploring heart failure prevalence and dimensions: A comprehensive NT-proBNP study in high-risk primary care patients.","authors":"Ahmet Celik, Emrah Yesil, Unal Kılıç, Gizem Akcay Ozyurt, Selman Aytimur, Mustafa Demir, Huseyin Naci Eker, Ayse Siddika Col, Cemil Ilker Altiparmak, Mustafa Ergen, Selen Bozkaya, Ismail Sefa Okyay, Ibrahim Ethem Kerem, Kiristin Marina Arap, Melike Yirtar, Deniz Korkmaz, Ali Kırdağ, Ismail Turkay Ozcan","doi":"10.1002/ehf2.15290","DOIUrl":"https://doi.org/10.1002/ehf2.15290","url":null,"abstract":"<p><strong>Introduction: </strong>Early detection of heart failure (HF), particularly in asymptomatic individuals, is essential for timely intervention. This study aimed to determine the prevalence of HF among high-risk individuals in primary care using N-terminal probrain natriuretic peptide (NT-proBNP) screening.</p><p><strong>Methods: </strong>A prospective cohort of 874 participants aged ≥40 years with at least one HF risk factor but no prior HF diagnosis was analysed. NT-proBNP levels were measured, and all participants underwent comprehensive cardiac evaluations, including laboratory tests, electrocardiography and echocardiography.</p><p><strong>Results: </strong>The mean age of the cohort was 62.5 ± 9.1 years, and 51.9% were female. Based on ACC/AHA HF staging, 69.1% of participants were classified as Stage A, 21.9% as Stage B and 9.0% as Stage C. Elevated NT-proBNP levels were detected in 84.8% of Stage B and 100% of Stage C patients. Among Stage C patients, 92.4% had HF with preserved ejection fraction (HFpEF). NT-proBNP levels correlated positively with left atrial volume index (r = 0.273, P < 0.001), left ventricular mass index (r = 0.207, P < 0.001), E/e' ratio (r = 0.182, P < 0.001) and estimated systolic pulmonary artery pressure (r = 0.124, P < 0.001), while showing a negative correlation with estimated glomerular filtration rate (r = -0.222, P < 0.001).</p><p><strong>Conclusions: </strong>A significant proportion of high-risk individuals in primary care had undiagnosed HF, particularly Stage B (pre-HF) and early symptomatic Stage C HF. The predominance of HFpEF highlights the need for targeted management. NT-proBNP screening is a valuable tool for early identification and risk stratification, especially for detecting Stage B HF, where it serves as an effective standalone method in the absence of imaging.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198582","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":"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 Mazen Amin, Omar Chikh Amine, Islam Y Elgendy","doi":"10.1002/ehf2.15315","DOIUrl":"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":"Predicting 1-year heart failure hospitalization and mortality post-discharge from the intensive cardiac care unit.","authors":"Andreas Bugge Tinggaard, Solenn Toupin, Jean Guillaume Dillinger, Clément Delmas, Antonin Trimaille, Claire Bouleti, Guillaume Schurtz, Charles Fauvel, Jean Claude Dib, Stéphane Andrieu, François Roubille, Thomas Levasseur, Guillaume Bonnet, Marouane Boukhris, Thomas Bochaton, Vincent Roule, Laura Delsarte, Albert Boccara, Franck Albert, Franck Boccara, Etienne Puymirat, Henrik Wiggers, Alexandre Mebazaa, Alain Cohen-Solal, Benjamin G Chousterman, Patrick Henry, Théo Pezel","doi":"10.1002/ehf2.15140","DOIUrl":"https://doi.org/10.1002/ehf2.15140","url":null,"abstract":"<p><strong>Aims: </strong>Despite the high risk of rehospitalization for heart failure (HF) and death among patients admitted to the intensive cardiac care unit (ICCU), no accurate prediction score for these outcomes exists. We aimed to develop a risk score to predict unplanned HF hospitalization and death 1-year post-discharge in an unselected cohort of patients admitted to the ICCU.</p><p><strong>Methods: </strong>Based on a national, multicentre study, we included all consecutive patients admitted to the ICCUs in 39 French centres from 7 to 22 April 2021. We randomly selected a training cohort of 21 centres (n = 1008) to develop the ICCU-HF score and a validation cohort of eight other centres (n = 463). The primary composite outcome was unplanned hospitalization for HF and cardiovascular death at 1-year follow-up after discharge. Using the score, patients were stratified into three risk groups to evaluate the prognostic value.</p><p><strong>Results: </strong>Using a least absolute shrinkage and selection operator (LASSO) regression approach, we identified seven predictors: left ventricular ejection fraction, significant valvular disease grade 2+, Killip score >1, NT-proBNP, creatinine level, previous ventricular arrhythmia and use of inotropes during hospitalization. In 1471 patients (63 ± 15 years, 70% men), 99 (6.7%) experienced the primary outcome. The ICCU-HF score outperformed NT-proBNP, the strongest individual predictor (area under the curve [AUC] 0.77, 95% CI [0.71-0.83] vs. AUC 0.72, 95% CI [0.66-0.79], P = 0.008), demonstrating excellent performance with an AUC of 0.83 (95% CI: 0.77-0.89) to predict outcomes in the validation cohort. Compared with the low-risk group, the intermediate-risk and high-risk groups had significantly higher risks of the composite outcome (HR 4.09, 95% CI [2.23-7.50], P < 0.001 and 12.69, 95% CI [7.02-22.95], P < 0.001), proving strong risk stratification capability of the ICCU-HF score.</p><p><strong>Conclusions: </strong>The ICCU-HF score showed good performance in predicting the 1-year risk of unplanned HF hospitalization and death in a large cohort of unselected patients admitted to the ICCU, with excellent results in the validation cohort. This score effectively stratifies patients into risk groups, enhancing its utility in clinical decision-making.</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":"144208047","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}