Heart Failure Reviews最新文献

{"title":"Aerobic, resistance, and specialized exercise training in heart failure with preserved ejection fraction: A state-of-the-art review.","authors":"Saeid Mirzai, Uttsav Sandesara, Mark J Haykowsky, Peter H Brubaker, Dalane W Kitzman, Anthony E Peters","doi":"10.1007/s10741-025-10526-x","DOIUrl":"https://doi.org/10.1007/s10741-025-10526-x","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is a growing public health burden, contributing to significant morbidity, mortality, and healthcare costs. Exercise intolerance, a hallmark of HFpEF, stems from central (cardiac and pulmonary) and peripheral (vascular and skeletal muscle) factors that result in reduced oxygen delivery and utilization by active muscles. With relatively few effective therapies, exercise training has emerged as a reliable and proven therapeutic intervention to improve exercise capacity and physical function in HFpEF. This review synthesizes evidence from the existing literature to describe and evaluate various exercise modalities in HFpEF. Moderate-intensity continuous training significantly improves peak oxygen consumption and symptom burden and is supported by a large evidence base in patients with HFpEF. High-intensity interval training has shown potential as an alternative regimen with particular benefit in highly selected populations. Multi-modality regimens and low-intensity training approaches are potentially suitable for patients with limited exercise tolerance or those who are more vulnerable or frail. The addition of resistance training may further improve muscle strength and functional capacity. Integrating exercise interventions with complementary dietary approaches has also shown potential for enhancing exercise capacity response. Lastly, emerging modalities, such as inspiratory muscle training and functional electrical stimulation, offer additional unique options. Despite robust evidence, challenges in the long-term durability of benefits, poor responder rates (~ 1/3 of participants), and implementation persist. Ongoing and future efforts can focus on evaluating long-term clinical outcomes (i.e., mortality and hospitalizations), developing more personalized exercise protocols, and applying sustainable implementation strategies in clinical practice.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077590","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 Comprehensive Review: Unraveling the Role of Inflammation in the Etiology of Heart Failure.","authors":"Diana Roman-Pepine, Adela Mihaela Serban, Roxana-Denisa Capras, Cristina Mihaela Cismaru, Adriana Gabriela Filip","doi":"10.1007/s10741-025-10519-w","DOIUrl":"https://doi.org/10.1007/s10741-025-10519-w","url":null,"abstract":"<p><p>Heart failure (HF) remains a leading cause of morbidity and mortality worldwide, with inflammation playing a pivotal role in its pathogenesis. This comprehensive review aims to elucidate the intricate mechanisms by which inflammation contributes to the development and progression of HF. The review synthesizes current research on the involvement of both innate and adaptive immune responses in HF, highlighting the roles of cytokines, chemokines, and other inflammatory mediators. Recent studies have demonstrated that chronic inflammation, driven by factors such as oxidative stress, neurohormonal activation, and metabolic disturbances, leads to adverse cardiac remodeling and impaired myocardial function. The review explores how systemic inflammation, characterized by elevated levels of inflammatory biomarkers like C-reactive protein (CRP) and interleukin-6 (IL-6), correlates with HF severity and outcomes. Additionally, it discusses the impact of comorbid conditions such as diabetes, obesity, and hypertension on inflammatory pathways and HF risk. The review also delves into the therapeutic implications of targeting inflammation in HF. Despite mixed results from early clinical trials, emerging evidence suggests that anti-inflammatory therapies offer benefits in specific HF phenotypes. The potential of novel therapeutic strategies, including the use of biologics and small molecule inhibitors, is examined in the context of their ability to modulate inflammatory responses and improve clinical outcomes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015978","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":"Bumetanide nasal spray: a novel approach to enhancing diuretic response and advancing ambulatory heart failure care?","authors":"Jan Biegus, Beata Ponikowska, Mario Enrico Canonico, Kevin Damman, Alberto Palazzuoli, Andrew P Ambrosy","doi":"10.1007/s10741-025-10517-y","DOIUrl":"https://doi.org/10.1007/s10741-025-10517-y","url":null,"abstract":"<p><p>Loop diuretics are the cornerstone of managing congestion in heart failure (HF). It is hypothesized that in heavily congested patients, gut edema may lead to lower bioavailability of oral drugs, including diuretics, which, in turn, may lead to insufficient diuresis. Intravenous (IV) loop diuretics are often required to achieve rapid diuresis due to their high plasma concentrations. However, reliance on IV administration limits options in ambulatory settings, where effective rescue therapies are needed. Bumetanide Nasal Spray (BNS) is a novel formulation designed to overcome absorption challenges and provide rapid, high bioavailability through intranasal administration. This mini-review summarizes the results of the recently presented bioavailability study of BNS conducted in healthy individuals, showing its bioequivalence to oral formulations. Lastly, the paper discusses the potential caveats and limitations of the trial and further perspectives.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of echocardiography in the diagnosis of heart failure with preserved ejection fraction.","authors":"Bharathi Upadhya, Geoffrey A Rose, R Brandon Stacey, Richard A Palma, Thomas Ryan, Akshay Pendyal, Anita M Kelsey","doi":"10.1007/s10741-025-10516-z","DOIUrl":"https://doi.org/10.1007/s10741-025-10516-z","url":null,"abstract":"<p><p>Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF in older adults. While manifest as distinct clinical phenotypes, almost all patients with HFpEF will present with exercise intolerance or exertional dyspnea. Distinguishing HFpEF from other clinical conditions remains challenging, as the accurate diagnosis of HFpEF involves integrating a diverse array of cardiovascular (CV) structural and physiologic inputs. Owing to its intrinsic ability to characterize the structure and function of the myocardium, cardiac valves, pericardium, and vasculature, echocardiography (TTE) has emerged as an essential modality for diagnosing HFpEF. In contrast to HF with reduced EF, however, no single TTE variable defines HFpEF. Abnormal diastolic function is typically associated with HFpEF, but \"diastolic dysfunction\" per se is not synonymous with \"HFpEF\": the pathophysiology of HFpEF is more complex than diastolic dysfunction alone. HFpEF may involve abnormalities at multiple loci within the CV system, including (1) dysfunction of the left ventricle, left atrium, or right ventricle; (2) pulmonary hypertension or pulmonary vascular disease; (3) pericardial restraint; (4) abnormal systemic vascular impedance; (5) coronary or peripheral microcirculatory dysfunction; and (6) defects of tissue oxygen uptake within the periphery. Thus, the accurate diagnosis of HFpEF - and its specific clinical phenotypes - requires diagnostic algorithms that comprise multiple clinical variables, many of which may be derived from TTE data. Refining such algorithms to better discriminate among specific HFpEF phenotypes is the subject of continued investigation.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007948","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":"Emerging use of pulmonary artery and cardiac pressure sensing technology in the management of worsening heart failure events.","authors":"Matthew I Mace, Anuradha Lala-Trindade, Timothy J Fendler, Andrew J Sauer","doi":"10.1007/s10741-025-10513-2","DOIUrl":"https://doi.org/10.1007/s10741-025-10513-2","url":null,"abstract":"<p><p>Unplanned admissions for worsening heart failure (WHF) are the largest resource cost in heart failure (HF) management. Despite advances in pharmacological agents and interventional therapy, HF remains a global epidemic. One crucial-and costly-gap in HF management is the inability to obtain objective information to identify and quantify congestion and personalize treatment plans to effectively manage WHF events without resorting to expensive, invasive methods. Although the causes of WHF are varied and complex, the universal effect of HF decompensation is the significant decline in quality of life due to symptoms of hypervolemic congestion and the resultant reduction in cardiac output, which can be quantified via increased pulmonary venous congestion due to high intracardiac filling pressures. Accessible and reliable markers of congestion could more precisely quantify the severity of WHF events and stabilize patients earlier by interrupting and reversing this process with timely introduction or modification of evidence-based treatments. Pulmonary artery and cardiac pressure sensing tools have gained evidential credence and increased clinical uptake in recent years for the prevention and treatment of WHF, as studies of implantable hemodynamic devices have iteratively and reliably demonstrated substantial reductions in WHF events. Recent advances in sensing technologies have ranged from single-parameter invasive pulmonary artery monitors to completely non-invasive multi-parameter devices incorporating multi-sensor concept technologies aided by machine learning or artificial intelligence, although many remain investigational. This review aims to evaluate the potential for novel pulmonary artery and cardiac pressure sensing technology to reshape the management of WHF from within the hospitalized and ambulatory care environments.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994589","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":"Exercise prescriptions for ischemic cardiomyopathy: a scoping review.","authors":"Lida Koskina, Nicholas H Huerta, Shiavax J Rao, Ahmad Amin","doi":"10.1007/s10741-025-10521-2","DOIUrl":"https://doi.org/10.1007/s10741-025-10521-2","url":null,"abstract":"<p><p>This review explores the critical role of exercise as a non-pharmacological intervention in managing ischemic cardiomyopathy (ICM), a leading cause of heart failure. It highlights the profound cardiovascular benefits of exercise, such as improved cardiopulmonary parameters, decreased morbidity and mortality, and enhanced functional capacity. It also critically evaluates existing literature on the efficacy of various exercise types and intensities, including aerobic, resistance, and high-intensity interval training. There is a significant gap in current clinical guidelines, which lack specific exercise prescriptions tailored to the unique pathophysiology of ICM. By synthesizing data from both older and contemporary studies, this review highlights specific, evidence-based exercise regimens and promotes supervised cardiac rehabilitation programs. This review also addresses potential barriers to cardiac rehabilitation participation and proposes future directions, which include the use of technology to improve adherence and outcomes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962136","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":"Obesity and inflammation in chronic and acute heart failure.","authors":"Gad Cotter, Mark C Petrie, Javed Butler, Beth Davison, Ovidiu Chioncel, Jan Biegus, Matteo Pagnesi, Adriaan A Voors, Marco Metra, Piotr Ponikowski, Douglas Mann, Deepak L Bhatt","doi":"10.1007/s10741-025-10518-x","DOIUrl":"https://doi.org/10.1007/s10741-025-10518-x","url":null,"abstract":"<p><p>Obesity and inflammation have been associated with an increased incidence of heart failure (HF) and death. However, until recent years, no therapy directed towards reducing inflammation and reducing obesity has been shown to reduce those adverse outcomes. Over the past few years, a few small studies have suggested that improving obesity-and in even smaller studies, reducing inflammation-may help improve HF severity, congestion, quality of life, and possibly outcomes. Larger studies that are being planned and executed, which will report their results within the next 2-3 years, should help further clarify the effects of weight and inflammation reduction in patients with HF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The application of neighborhood area deprivation index to improve health equity across the spectrum of heart failure: a review.","authors":"Tracy T Makuvire, Jose L Lopez, Zara Latif, Damla Mergen, Christy N Taylor, Ersilia M DeFilippis, Nasrien E Ibrahim","doi":"10.1007/s10741-025-10492-4","DOIUrl":"10.1007/s10741-025-10492-4","url":null,"abstract":"<p><p>Neighborhood environments play a key role in the development of individual risk factors for heart failure (HF) and impact health outcomes across the spectrum of HF. The area deprivation index (ADI) is an important composite measure of neighborhood depravity that has been associated with poor cardiovascular outcomes. The objective of our review is to discuss how neighborhood deprivation, with an emphasis on ADI, influences the spectrum of HF among patients and to propose solutions for ADI applications to improve the implementation of equitable care across the HF spectrum. MEDLINE/Pubmed was systematically searched to identify observational studies published between 2016 and 2024, examining the impact of ADI on HF risk, management, and outcomes. The search involved crossing two sets of terms included in article titles and abstracts: (1) social deprivation, area deprivation index, and neighborhood deprivation; (2) cardiovascular disease risk, heart failure, heart failure medications, and heart failure outcomes. Additional references were identified through searching relevant author reference lists and review articles. Key findings suggest that (1) the prevalence of HF risk is increased in individuals residing in neighborhoods with higher ADI; (2) HF patients living in more deprived neighborhoods have increased odds of being hospitalized for HF; (3) after HF admission, the relationship between ADI and risk for readmissions varies by race; and (4) there is an excess 30-day mortality of HF associated with race and neighborhood deprivation. The ADI is an important value to consider in patients with HF, given its association with clinical outcomes. Therefore, we suggest practical ways to incorporate ADI into the management of patients with HF to improve equitable outcomes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"589-604"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742750","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":"Epicardial adipose tissue: a new link between type 2 diabetes and heart failure-a comprehensive review.","authors":"Si-Jia Zhang, Si-Wei Wang, Shi-Yu Liu, Ping Li, De-Lian Huang, Xi-Xi Zeng, Tian Lan, Ye-Ping Ruan, Hai-Jiao Shi, Xin Zhang","doi":"10.1007/s10741-024-10478-8","DOIUrl":"10.1007/s10741-024-10478-8","url":null,"abstract":"<p><p>Diabetic cardiomyopathy is a unique cardiomyopathy that is common in diabetic patients, and it is also a diabetic complication for which no effective treatment is currently available. Moreover, relevant studies have revealed that a link exists between type 2 diabetes and heart failure and that abnormal thickening of EAT is inextricably linked to the development of diabetic heart failure. Numerous clinical studies have demonstrated that EAT is implicated in the pathophysiologic process of diabetic myocardial disease. In this overview, we will introduce the physiology, pathophysiology of the disease and potential therapeutic strategies, knowledge gaps, and future directions of the role of epicardial adipose tissue in type 2 diabetes mellitus and heart failure to promote the development of novel therapeutic approaches to improve the prognosis of patients with diabetic cardiomyopathy.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"477-491"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894095","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":"Initiation and sequencing of guideline-directed medical therapy for heart failure across the ejection fraction spectrum.","authors":"Izza Shahid, Muhammad Shahzeb Khan, Javed Butler, Gregg C Fonarow, Stephen J Greene","doi":"10.1007/s10741-025-10481-7","DOIUrl":"10.1007/s10741-025-10481-7","url":null,"abstract":"<p><p>Strong evidence supports the importance of rapid sequence or simultaneous initiation of quadruple guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) for substantially reducing risk of mortality and hospitalization. Barring absolute contraindications for each individual medication, employing the strategy of rapid sequence, simultaneous, and/or in-hospital initiation at the time of HF diagnosis best ensures patients with HFrEF have the opportunity to benefit from proven medications and achieve large absolute risk reductions for adverse clinical outcomes. However, despite guideline recommendations supporting this approach, implementation in clinical practice remains persistently low, with less than one-fifth of eligible patients being prescribed the quadruple GDMT regimen. Additionally, for heart failure with mildly reduced or preserved ejection fraction (HFpEF), sodium-glucose co-transporter 2 inhibitors (SGLT2i) and non-steroidal mineralocorticoid receptor antagonists (MRA) constitute foundational therapy for all eligible patients with significant clinical benefits within just weeks of medication initiation. Nonetheless, the burden of symptoms, functional limitations, and hospitalizations remains substantial for many of these patients, even with SGLT2i and non-steroidal MRA therapy. Additional evidence supports consideration of adjunctive therapies for HF with EF > 40% that can be tailored to the patient phenotype, including glucagon-like peptide-1 receptor agonists (GLP-1 RA) for patients with obesity, as well as angiotensin receptor-neprilysin inhibitors (ARNI) for patients with EF below normal. This article reviews the evidence-based sequencing of GDMT for HF across the spectrum of EF, emphasizing the rationale and benefits of early up-front initiation of quadruple medical therapy for HFrEF, rapid initiation of SGLT2i for HF regardless of EF, and prompt phenotype-specific tailored approach to adjunctive therapies for HF with EF > 40%.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"515-523"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004223","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}