ESC Heart Failure最新文献

{"title":"Pulmonary artery pressure trajectories in heart failure patients treated with GLP-1 receptor agonists","authors":"Haoran Jiang,&nbsp;Phuuwadith Wattanachayakul,&nbsp;Veraprapas Kittipibul,&nbsp;Erika Nicolsen,&nbsp;Todd McVeigh,&nbsp;Oksana Kamneva,&nbsp;Marat Fudim","doi":"10.1002/ehf2.15308","DOIUrl":"10.1002/ehf2.15308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Data support favourable haemodynamic benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on improving cardiac structural abnormalities and function in patients with heart failure (HF). However, the direct haemodynamic effects of GLP-1 RAs remain inadequately characterized. We aim to investigate temporal trends of pulmonary artery pressure (PAP) in HF patients receiving GLP-1 RAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>In this single-centre retrospective cohort study, we identified HF patients with a CardioMEMS device who received semaglutide or tirzepatide for at least 6 months during the monitoring period. Patients who were already on GLP-1 RAs prior to device implantation were excluded. The relationship between weight change and PAPs was assessed using Pearson correlation. A total of nine patients were included (54 years, BMI 41.4 kg/m², 67% men, 44% with EF &lt; 40%, 89% diabetes, 89% semaglutide). Median dose of semaglutide (or equivalent) at 6 months was 0.9 (range 0.25–1) mg/week. Body weight significantly decreased from 123.6 to 117.2 kg (<i>P</i> = 0.047), while guideline-directed medical therapy (GDMT) and loop diuretic uses and dosages remained unchanged. Significant reductions were observed in systolic PAP (38.9 to 34.0 mmHg, <i>P</i> = 0.045), diastolic PAP (20.0 to 17.8 mmHg, <i>P</i> = 0.019) and mean PAP (27.3 to 24.3 mmHg, <i>P</i> = 0.018). There was a significant correlation between weight loss and reductions in systolic PAP (<i>r</i> = 0.69, <i>P</i> = 0.04) and mean PAP (<i>r</i> = 0.72, <i>P</i> = 0.029).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GLP1-RA use in HF patients was significantly associated with reductions in body weight and PAPs at 6 months, despite no changes in GDMT and loop diuretic doses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2578-2582"},"PeriodicalIF":3.2,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959334","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":"T1 mapping and major cardiovascular events in non-ischaemic dilated cardiomyopathy: a systematic review and meta-analysis","authors":"Federico Marchini,&nbsp;Beatrice Dal Passo,&nbsp;Gianluca Campo,&nbsp;Elisabetta Tonet,&nbsp;Matteo Serenelli,&nbsp;Alberto Cossu,&nbsp;Serena Chiarello,&nbsp;Maria Lo Monaco,&nbsp;Erika Bertella,&nbsp;Rita Pavasini","doi":"10.1002/ehf2.15279","DOIUrl":"10.1002/ehf2.15279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study is to investigate the prognostic role of T1 mapping techniques in predicting major adverse cardiovascular events (MACE) in patients affected by non-ischaemic dilated cardiomyopathy (NIDCM) by performing a meta-analysis of available studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>Data from 12 observational studies exploring the prognostic role of native T1 mapping and extracellular volume (ECV) were analysed with random effect generic inverse variance. The primary endpoint was MACE defined as a composite of heart failure or arrhythmic-related events, expressed as hazard ratio (HR) with 95% confidence interval (CI). Secondary main outcomes were heart failure-related events, arrhythmic-related events, and weighted mean difference of native T1 mapping values or ECVs between patients with or without MACE. Overall, 4025 patients with NIDCM were included. The median follow-up length was 22 (IQR 14–22) months. The primary outcome of MACE occurred in 610 patients with a pooled HR for native T1 mapping values of 1.07 (95% CI 1.04–1.09, <i>I</i>² 31.5%) and a pooled HR for ECV of 1.37 (95% CI 1.29–1.44, <i>I</i>² 0%). HF-related events occurred in 492 patients, with a pooled HR for T1 mapping of 1.05 (95% CI 1.03–1.07, <i>I</i>² 1%) and a pooled HR for ECVs of 1.43 (95% CI 1.25–1.61, <i>I</i>² 63%). Arrhythmic-related events occurred in 118 patients, with a pooled HR for T1 mapping values of 1.09 (95% CI 1.07–1.12, <i>I</i>² 0%). The weighted mean difference of native T1 mapping between patients with and without MACE was 30.91 (95% CI 18.45–43.16, <i>I</i>² 16.72%), while the mean difference of ECV was 4.52 (95% CI 2.78–6.26, <i>I</i>² 86%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In NIDCM patients, native T1 mapping and ECV were associated with increased risk of the composite primary endpoint of MACE and the secondary endpoint of heart failure and arrhythmic-related events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2621-2630"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990744","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":"Microaxial pump-supported coronary surgery without CPB to optimize outcome in severely impaired left ventricles","authors":"Anna Kathrin Assmann,&nbsp;Merve Arik-Doganay,&nbsp;Sebastian Waßenberg,&nbsp;Payam Akhyari,&nbsp;Artur Lichtenberg,&nbsp;Alexander Assmann","doi":"10.1002/ehf2.15261","DOIUrl":"10.1002/ehf2.15261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Cardiopulmonary bypass (CPB) is the standard approach for coronary artery bypass grafting (CABG) in advanced ischaemic cardiomyopathy. Microaxial pump support has been envisioned to allow for beating-heart CABG without CPB (MPCAB), thereby avoiding CPB-inherent complications. This study aims to compare the in-hospital and follow-up outcome of MPCAB versus CPB-CABG in patients with severely impaired left ventricular function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>Eleven patients suffering from three-vessel coronary artery disease with median ejection fraction of 27% and deemed appropriate for CABG according to a heart team decision underwent MPCAB (support up to 5.5 L/min). Propensity score matching generated a CPB-CABG control group (<i>n</i> = 33). The primary endpoint was defined as death from any cause by the end of the follow-up (up to 4 years). MPCAB enabled continuous intraoperative and postoperative haemodynamic stabilization and complete myocardial revascularization. After CPB-CABG, additional mechanical circulatory support was required in 45.5% (vs. 9.1% in MPCAB; <i>P</i> = 0.0363). The follow-up all-cause mortality after MPCAB amounted to 0% (vs. 33.3% after CPB-CABG; <i>P</i> = 0.0414; NNT = 3). MPCAB patients showed a significantly decreased occurrence of major adverse cardiovascular events (MACE: 0% vs. 39.4%; <i>P</i> = 0.0189).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MPCAB allows for complete surgical revascularization without the necessity of extracorporeal circulation in spite of severely impaired left ventricular function. This first comparative study on the outcome after MPCAB versus CPB-CABG demonstrates a significantly decreased risk of death as well as MACE in MPCAB patients. The MPCAB concept expands the spectrum of patients eligible for CABG without CPB towards patients with severely impaired left ventricular function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2749-2758"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984049","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":"Dilated cardiomyopathy evaluation with Imagenomics: combining multimodal cardiovascular imaging and genetics","authors":"Kristian Galanti,&nbsp;Ghaith Sharaf Dabbagh,&nbsp;Fabrizio Ricci,&nbsp;Sabina Gallina,&nbsp;Roberta Giansante,&nbsp;Ron Jacob,&nbsp;Edmond Obeng-Gyimah,&nbsp;Leslie T. Cooper Jr,&nbsp;Sanjay K. Prasad,&nbsp;David H. Birnie,&nbsp;Andrew P. Landstrom,&nbsp;Selma F. Mohammed,&nbsp;Saidi Mohiddin,&nbsp;Mohammed Y. Khanji,&nbsp;Anwar A. Chahal","doi":"10.1002/ehf2.15307","DOIUrl":"10.1002/ehf2.15307","url":null,"abstract":"<p>Dilated cardiomyopathy (DCM) is a clinical diagnosis characterized by the presence of left ventricular dilatation and systolic dysfunction unexplained by abnormal loading conditions or coronary artery disease. However, a broad range of phenotypic manifestations, encompassing isolated scar, DCM with preserved ejection fraction, and overt DCM, should be regarded as a diagnostic classification representing a broad spectrum of underlying aetiologies, including both inherited and acquired heart muscle disorders. A multimodal non-invasive imaging approach is essential for accurate morpho-functional assessment of cardiac chambers and is key to establish the cardiac phenotype and to rule out an underlying ischaemic aetiology. Furthermore, advanced imaging techniques enable deep cardiovascular phenotyping and non-invasive tissue characterization. The aim of this review is to propose a systematic approach to the diagnosis of DCM, emphasizing the importance of genetics and clinical findings for a precise and practical clinical approach. Also, we strive to qualify the role of cardiac imaging in the diagnosis of DCM, particularly on the relevance of novel techniques and clinical utility of actionable parameters to improve current diagnostic schemes and risk stratification algorithms. We further elaborate on the role of cardiac imaging to deliver optimal guidance to aetiology-based therapeutic approaches, verification of treatment response and disease progression monitoring.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2669-2690"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984795","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":"Prognostic value of left atrial strain in acute and chronic heart failure: A meta-analysis","authors":"Maria Concetta Pastore,&nbsp;Mariangela Vigna,&nbsp;Andrea Saglietto,&nbsp;Maria Alma Iuliano,&nbsp;Giulia Elena Mandoli,&nbsp;Andrea Stefanini,&nbsp;Chiara Carrucola,&nbsp;Laura Fusini,&nbsp;Luna Cavigli,&nbsp;Flavio D'ascenzi,&nbsp;Marta Focardi,&nbsp;Serafina Valente,&nbsp;Matteo Cameli","doi":"10.1002/ehf2.15302","DOIUrl":"10.1002/ehf2.15302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Heart failure (HF) is a global health burden which prognostic assessment is currently challenging. Speckle tracking left atrial strain is widely recognized as a predictor of HF outcome. Our aim was to systematically investigate the prognostic value of peak atrial longitudinal strain (PALS) in acute and chronic HF and according to left ventricular (LV) function, age and gender.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>A systematic literature search of medical databases was performed using PRISMA principles. All relevant studies reporting the prognostic value of LA strain in HF with reduced, mildly reduced and preserved ejection fraction (EF) with ≥6 months follow-up were included. All-cause mortality and HF hospitalization were considered as primary endpoint. Random-effect meta-analysis was performed to evaluate the pooled hazard ratios (HR) of the primary outcome. Eight studies (<i>n</i> = 5767 patients, median [interquartile range] age = 66.3 [65; 68.6]) satisfied the inclusion criteria (five chronic HF, two acute HF and one both). Median global PALS was 17.6 [14.9; 26.8]%, median LVEF was 36 [30; 56]%, median left ventricular global longitudinal strain (GLS) was −9% [−7; −16.9]. Over a median follow-up of 903 [321; 1062] days, 2688 patients reached the primary endpoint (944 all-cause mortality and 1963 hospitalizations). Each unit decrease in global PALS was independently associated with 5% increase for the primary endpoint (meta-analytic HR = 1.05; 95% CI [1.02–1.07]; <i>P</i> &lt; 0.01). Subgroup analysis showed no differences in acute and chronic HF (<i>P</i> = 0.18). Meta-regression analysis showed a higher prognostic value of global PALS for lower values of LVEF (beta = −0.0023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Global PALS may be used as prognostic tool in acute and chronic HF and especially in patients with reduced EF, providing an additional independent value for risk stratification in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2921-2931"},"PeriodicalIF":3.2,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990741","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":"Percutaneous mechanical circulatory support for acute right heart failure: A practical approach","authors":"Mario Gramegna,&nbsp;Christophe Vandenbriele,&nbsp;Guido Tavazzi,&nbsp;Mir B. Basir,&nbsp;Caroline Bleakley,&nbsp;Mario Iannaccone,&nbsp;Daniel Kretzschmar,&nbsp;Francesco Maisano,&nbsp;Anna Mara Scandroglio,&nbsp;Benedikt Schrage,&nbsp;P. Christian Schultze,&nbsp;Gregory Serrao,&nbsp;Matthew Tomey,&nbsp;Richard Trimlett,&nbsp;Dirk Westermann,&nbsp;Matteo Montorfano,&nbsp;George Dangas,&nbsp;Susanna Price,&nbsp;Alaide Chieffo","doi":"10.1002/ehf2.15305","DOIUrl":"10.1002/ehf2.15305","url":null,"abstract":"<p>Acute right heart failure (RHF) represents a critical entity with significant morbidity and mortality. This review examines the role of percutaneous right ventricular assist devices (pRVADs) as a cornerstone of therapy in cases refractory to conventional management. Devices such as the Impella RP and dual-lumen cannulas provide targeted haemodynamic support, with indications in various clinical scenarios, including acute myocardial infarction, post-cardiac surgery, myocarditis, and after left ventricular assist device (LVAD) implantation. Successful implementation requires meticulous haemodynamic assessment, including parameters derived from pulmonary artery catheterization and echocardiography, to guide patient selection, optimize device placement, and monitor therapeutic response. The manuscript highlights contemporary weaning strategies, emphasizing recovery of right ventricular function, stabilization of systemic haemodynamics, and restoration of end-organ perfusion. While no universal protocols exist, this review presents a pragmatic framework informed by available evidence and expert consensus. Furthermore, the potential complications of pRVAD use—ranging from thromboembolism and haemolysis to device-specific issues such as migration and tricuspid valve damage—are discussed alongside preventive and management strategies. Key challenges in RHF management, including the interplay between right and left ventricular function, the impact of pulmonary vascular resistance, and the use of adjunctive pulmonary vasodilators, are addressed. The review underscores the absence of durable right ventricular assist devices and the need for innovation to close this therapeutic gap. Multidisciplinary collaboration among intensivists, cardiologists, and cardiac surgeons is critical to optimizing outcomes. This review provides actionable insights to assist clinicians in navigating the complexities of acute RHF, fostering a tailored and evidence-based approach to this high-risk population.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2652-2668"},"PeriodicalIF":3.2,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973026","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 volume status predicting clinical outcomes in patients undergoing transcatheter edge-to-edge mitral valve repair","authors":"Ai Kagase,&nbsp;Masanori Yamamoto,&nbsp;Takahiro Tokuda,&nbsp;Ryotaku Kawahata,&nbsp;Hiroto Nishio,&nbsp;Tetsuro Shimura,&nbsp;Ryo Yamaguchi,&nbsp;Mitsuru Sago,&nbsp;Yuki Izumi,&nbsp;Mike Saji,&nbsp;Masahiko Asami,&nbsp;Yusuke Enta,&nbsp;Masaki Nakashima,&nbsp;Shinichi Shirai,&nbsp;Masaki Izumo,&nbsp;Shingo Mizuno,&nbsp;Yusuke Watanabe,&nbsp;Makoto Amaki,&nbsp;Kazuhisa Kodama,&nbsp;Junichi Yamaguchi,&nbsp;Toru Naganuma,&nbsp;Hiroki Bouta,&nbsp;Yohei Ohno,&nbsp;Masahiro Yamawaki,&nbsp;Hiroshi Ueno,&nbsp;Kazuki Mizutani,&nbsp;Daisuke Hachinohe,&nbsp;Toshiaki Otsuka,&nbsp;Shunsuke Kubo,&nbsp;Kentaro Hayashida,&nbsp;OCEAN-Mitral Investigators","doi":"10.1002/ehf2.15295","DOIUrl":"10.1002/ehf2.15295","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Plasma volume status (PVS) is recognized as a marker of systemic congestion, but its clinical utility in patients with mitral regurgitation (MR) undergoing transcatheter edge-to-edge mitral valve repair (M-TEER) has not been well established. This study aimed to evaluate the prognostic significance of PVS in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>Data from 3763 patients who underwent M-TEER were analysed from a Japanese multicentre registry. Patients were classified into functional MR (FMR) and degenerative MR (DMR) according to MR aetiology, and the median PVS values for each were calculated (FMR 12.7, DMR 14.4). The median value was used as the cut-off, stratifying the cohort into a high PVS group (<i>n</i> = 1882) and a low PVS group (<i>n</i> = 1881). All-cause mortality, cardiovascular death, and heart failure (HF) hospitalization between these two groups were compared up to 3 years in the overall, FMR, and DMR populations. The cumulative incidence rates of all-cause mortality, cardiovascular death, and HF hospitalization were higher in the high PVS group than in the low PVS group (47.0% vs. 22.2%, <i>P</i> &lt; 0.001, 31.6% vs. 13.6%, <i>P</i> &lt; 0.001, and 35.9% vs. 24.7%, <i>P</i> &lt; 0.001, respectively). Similar trends in terms of all-cause mortality, cardiovascular death, and HF hospitalization were observed in the FMR and DMR cohorts (all <i>P</i> &lt; 0.05). In the multivariate Cox regression analysis, the high PVS compared with the low PVS group was independently associated with the increased risk of all-cause death (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.01–1.03; <i>P</i> &lt; 0.001), cardiovascular death (HR, 1.02; 95% CI, 1.01–1.03, <i>P</i> &lt; 0.001) and HF hospitalization (HR, 1.02; 95% CI, 1.01–1.02, <i>P</i> &lt; 0.001). An independent association between a high PVS and all-cause death, cardiovascular death, and HF hospitalization was also found in FMR and DMR sub-groups (all <i>P</i> &lt; 0.05) while reducing MR severity to moderate or less after M-TEER was associated with improved outcomes in both the high and low PVS groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preoperative PVS is a strong independent prognostic marker in patients undergoing M-TEER, correlating with increased risk of mortality and HF hospitalization. PVS may provide valuable clinical insights for patient stratification and management strategies in M-TEER patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2855-2865"},"PeriodicalIF":3.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957400","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 administration of SGLT2 inhibitors in hospitalized patients: A practical guidance from the current evidence","authors":"Ruggero Mazzotta,&nbsp;Manuel Garofalo,&nbsp;Samuele Salvi,&nbsp;Matteo Orlandi,&nbsp;Gianluca Marcaccini,&nbsp;Pietro Susini,&nbsp;Luca Checchi,&nbsp;Alberto Palazzuoli,&nbsp;Carlo Di Mario,&nbsp;Maurizio Pieroni,&nbsp;Matteo Beltrami","doi":"10.1002/ehf2.15293","DOIUrl":"10.1002/ehf2.15293","url":null,"abstract":"<p>Sodium-glucose cotransporter-2 (SGLT2) inhibitors represent one of the main cornerstones of heart failure treatment. Nevertheless, while the cardiovascular beneficial effects of these drugs have been clearly demonstrated by several clinical trials, in clinical practice, it remains challenging to identify the appropriate timing to start SGLT2 inhibitors. The potential risk of side effects, like genito-urinary infections and interaction with other drugs, may often lead to delay the prescription of these drugs in the acute setting. However, several studies have demonstrated the safety and the prognostic impact of SGLT2 inhibitors in the hospitalized patient, suggesting that treatment initiation during hospitalization or early post-discharge may represent an ideal therapeutic option. In this review, we discuss the main trials on early administration of SGLT2 inhibitors in acute heart failure supporting early introduction of SGLT2 inhibitors to optimize heart failure treatment. The efficacy and safety of these drugs in patients with acute myocardial infarction are also discussed. Based on the review of existing evidences, a practical flowchart on early administration of SGLT2 inhibitors in the acute setting is proposed.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2631-2642"},"PeriodicalIF":3.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985151","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":"Association between tricuspid regurgitation and heart failure outcomes: A meta-analysis","authors":"Zongle Sun,&nbsp;Yan Luo,&nbsp;Xiaoli Wang,&nbsp;Tianying Chang,&nbsp;Mengmeng Chang,&nbsp;Yingzi Cui,&nbsp;Jiajuan Guo","doi":"10.1002/ehf2.15303","DOIUrl":"10.1002/ehf2.15303","url":null,"abstract":"<p>This study aimed to perform a systematic meta-analysis to investigate how varying severities of tricuspid regurgitation (TR) affect mortality in patients with heart failure (HF). PubMed, Web of Science, Embase and the Cochrane Library were searched up to March 2024. Heterogeneity and sensitivity analyses as well as subgroup analyses were carried out using Stata (15.1). In total, 12 cohort studies involving 45 829 HF patients were included. The meta-analysis demonstrated that the TR group exhibited notably higher all-cause mortality [risk ratio (RR) = 1.15, 95% confidence interval (CI): 1.02–1.29, <i>P</i> &lt; 0.05] and HF rehospitalization rate (RR = 1.24, 95% CI: 1.13–1.36, <i>P</i> &lt; 0.001) than the non-TR group. Subgroup analysis by the severity of TR indicated that all-cause mortality (RR = 1.34, 95% CI: 1.10–1.63, <i>P</i> &lt; 0.05), HF rehospitalization rate (RR = 1.30, 95% CI: 1.16–1.45, <i>P</i> &lt; 0.001) and cardiovascular mortality (RR = 1.49, 95% CI: 1.04–2.15, <i>P</i> &lt; 0.05) were notably higher in the moderate/severe TR group than in the non-TR/mild TR group. Subgroup analysis showed that ejection fraction, region, regression methods and publication year affected the results of both groups. Moderate and severe TR can increase the risk of all-cause mortality and HF rehospitalization rate. However, these results may be influenced by other factors. More studies on the prognosis of HF patients with different ejection fractions and regions are desired to further validate and improve our findings.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2643-2651"},"PeriodicalIF":3.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970195","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":"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}