Heart Failure Reviews最新文献

{"title":"Cancer therapy-induced cardiotoxicity: mechanisms and mitigations.","authors":"Solanki Shil, Prabodh Kumar, Kamalesh Dattaram Mumbrekar","doi":"10.1007/s10741-025-10531-0","DOIUrl":"10.1007/s10741-025-10531-0","url":null,"abstract":"<p><p>Cancer treatments like chemotherapy, radiotherapy, and combined immunotherapies have significantly increased patient survival. However, these treatments are frequently linked to cardiovascular toxicity, which has a significant impact on clinical outcomes and patient well-being. Chemotherapy, targeted therapy, and radiotherapy induce significant cellular stress in cardiomyocytes and endothelial cells, causing DNA damage, activating pro-inflammatory and pro-apoptotic signalling pathways. Cumulative damage causes cardiomyocyte loss, followed by fibrosis, resulting in pathological structural and functional remodelling of the myocardium. Endothelial cell damage disrupts vascular integrity, increasing the risk of atherosclerosis, coronary artery disease, and ischaemia. Over time, these changes can lead to clinical conditions like dilated and restrictive cardiomyopathy, which are frequently accompanied by arrhythmias and can result in heart failure and sudden cardiac death. To overcome this problem, the novel field of cardio-oncology aims to provide effective cancer treatments with a multifaceted cardioprotection approach involving pharmacological, diagnostic, natural compounds, and lifestyle interventions during and after cancer therapy. In this review, we cover the important cancer therapies, and their cardiotoxic mechanisms and detail different cardioprotective strategies aimed at mitigating these adverse effects and improve patient outcomes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"1075-1092"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247561","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":"Beyond GDMT: bridging the therapeutic gap in heart failure.","authors":"Laurie A Letarte, Vikram Raje, Jason P Feliberti, Steve M Antoine, Amarinder S Bindra, Dmitry M Yaranov, Amin Yehya, Rachel A Garcia, Pujan Patel, Marat Fudim, Brian Howard, Vishal N Rao, Albert Hicks, Kiran Mahmood, Richa Gupta, Allman Rollins, Amit Alam, Patrick McCann, Nirav Y Raval","doi":"10.1007/s10741-025-10512-3","DOIUrl":"10.1007/s10741-025-10512-3","url":null,"abstract":"<p><p>Guideline-directed medical therapy is the backbone of heart failure treatment. However, patients continue to experience heart failure symptoms, impaired quality of life, and reduced functional status despite guideline-directed medical and device treatment. There is a void in treatment alternatives between guideline-directed therapy and the advanced heart failure surgical options of heart transplant (HT) and left ventricular assist device (LVAD). Cardiac contractility modulation and baroreceptor activation therapies are shown to improve heart failure symptoms, quality of life, and exertional capacity in select patients and complement our current treatment paradigm. The purpose of this paper is to review these novel Food and Drug Administration (FDA)-approved heart failure therapies and facilitate the identification of appropriate candidates.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"855-868"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017157","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":"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":"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":"1015-1034"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296771/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronized diaphragmatic stimulation for the treatment of HFrEF-a review.","authors":"L R Goldberg, M Mirro, G Becker, T Shaburishvili, M Fudim","doi":"10.1007/s10741-025-10525-y","DOIUrl":"10.1007/s10741-025-10525-y","url":null,"abstract":"<p><p>The gap between maximally tolerated medical therapy and consideration for permanent mechanical circulatory support and/or cardiac transplant or palliative treatment of moderate to severe heart failure represents an underserved patient population. New therapies are evolving which may not only improve quality of life for these patients but also improve hemodynamics and potentially reverse the progression of the disease. This review is focused on one such therapy, synchronized diaphragmatic stimulation. Current clinical results suggest that patients experience improved exercise tolerance, quality of life, and hemodynamic function over 6-12 months of therapy which can be safely implemented through a minimally invasive laparoscopic procedure, often as an outpatient. This technology has been granted breakthrough device designation and is being evaluated for a double-blinded, randomized controlled trial by the US FDA.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"1035-1043"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158233","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":"Remote monitoring in heart failure: artificial intelligence and the use of remote speech analysis to detect worsening heart failure events.","authors":"Jospeh D Abraham, William T Abraham","doi":"10.1007/s10741-025-10522-1","DOIUrl":"10.1007/s10741-025-10522-1","url":null,"abstract":"<p><p>Globally, heart failure (HF) is a leading cause of hospitalization and mortality, primarily among the elderly, and is estimated to affect more than 64 million individuals. Hospitalization for HF represents the largest part of overall medical care expenditures for HF, and hospitalization for HF is associated with high rates of in-hospital and post-discharge morbidity and mortality. Patients discharged from the hospital with a diagnosis of acute decompensated HF have an increased risk for clinical worsening, rehospitalization, and mortality. A major goal for patients with HF is to detect and prevent both first and recurrent hospitalizations. However, detecting and preventing worsening HF events requiring hospitalization and/or pharmacotherapy remains an unmet medical need. Artificial intelligence (AI) is helping us meet this clinical challenge. An example leverages speech processing for the assessment of HF clinical status. In the acute setting, changes in speech measures (SM) can identify the decompensated from the compensated state. A remote monitoring system (HearO™), which includes a mobile speech application (App) to detect worsening HF prior to decompensation events is undergoing evaluation in ambulatory HF patients for reducing the rate of hospitalization. This App is readily downloadable on a smartphone and is user-friendly, and presents an example of how AI-assisted speech signal processing system development may enhance diagnostic accuracy. Preliminary results from clinical trials indicate high rates of sensitivity for detecting HF events along with high rates of adherence. Further elucidation of the effectiveness of this system will be provided by ongoing and planned studies in patients with chronic HF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"985-989"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158232","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":"The role of transcatheter edge-to-edge repair in functional mitral regurgitation: key takeaways from the MATTERHORN and RESHAPE-HF2 trials.","authors":"Vasiliki-Maria Dragona, Konstantinos Sideris, Sotiria Liori","doi":"10.1007/s10741-025-10533-y","DOIUrl":"10.1007/s10741-025-10533-y","url":null,"abstract":"<p><p>Functional mitral regurgitation (MR) is a common complication in heart failure (HF) and remains a major contributor to adverse outcomes despite advances in pharmacologic therapy. Guideline-directed medical therapy (GDMT) can lead to reverse remodeling and reduce MR severity in some patients, but many continue to experience symptomatic, moderate-to-severe MR. Transcatheter edge-to-edge repair (TEER) with the MitraClip® device has emerged as an important therapeutic option, particularly in patients who remain symptomatic despite optimized GDMT. Recent randomized trials-most notably RESHAPE-HF2 and MATTERHORN-have expanded the evidence base supporting TEER. RESHAPE-HF2 demonstrated that TEER significantly reduces heart failure hospitalizations and cardiovascular death in well-selected patients with moderate-to-severe functional MR, especially those with recent decompensation and favorable anatomy. MATTERHORN confirmed the noninferiority of TEER compared to surgery in high-risk patients, with a markedly better safety profile. These findings, alongside robust data on post-procedural GDMT intensification and functional improvement, support earlier integration of TEER into clinical practice. Collectively, the evidence suggests a paradigm shift: from reserving TEER as a last-resort therapy to incorporating it as an early intervention for appropriately selected patients with functional MR and persistent symptoms or incomplete reverse remodeling on optimal medical therapy.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"1133-1138"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191720","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 effect of GLP-1 receptor agonists on cardiac remodeling in heart failure patients with preserved and reduced ejection fraction: a systematic review and meta-analysis.","authors":"Hasan Fareed Siddiqui, Saad Ahmed Waqas, Ruqiat Masooma Batool, Hussain Salim, Abdul Mannan Khan Minhas, Syed Farhan Hasni, Amro Alsaid, Anna Sannino, Aasim M Afzal, Muhammad Shahzeb Khan","doi":"10.1007/s10741-025-10523-0","DOIUrl":"10.1007/s10741-025-10523-0","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown promising effects on heart failure (HF) outcomes, particularly in phenotype-specific populations. However, their impact on cardiac structure and function in HF with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) remains unclear.</p><p><strong>Methods: </strong>Medline, Cochrane Library, and Scopus were queried through December 2024 for primary and secondary analyses of randomized controlled trials comparing GLP-1RA with placebo in HF patients. Outcomes included changes in left ventricular ejection fraction (LVEF), end-diastolic volume (LVEDV), end-systolic volume (LVESV), global longitudinal strain (GLS), left ventricular mass, left atrial volume (LAV), and NT-proBNP levels. Random-effects models were used to calculate weighted mean differences (WMDs) or hazard ratios (HRs).</p><p><strong>Results: </strong>Six trials (n = 1,195) were included, with three each evaluating HFpEF and HFrEF populations. In patients with HFpEF, GLP-1RA significantly reduced the LV mass (WMD: -8.6 g; 95% CI: -14.6, -2.6; p = 0.005) and LAV (WMD: -5.4 ml; 95% CI: -8.8, -2.0; p = 0.002) and lowered NT-proBNP concentration throughout (HR: 0.85; 95% CI: 0.8, 0.9; p < 0.001). A decrease in LAV was observed in the HFrEF population (WMD: -5.4 ml [95% CI: -8.8, -2.0]; p = 0.002). However, no significant improvements were observed in LVEF, LVEDV, LVESV, or GLS. There were significant differences between HFpEF and HFrEF for LVEDV (p = 0.01) and LVESV (p = 0.04).</p><p><strong>Conclusions: </strong>GLP-1RA demonstrated phenotype-specific benefits, improving structural remodeling in HFpEF but showing limited effects in HFrEF. These findings highlight the importance of targeted therapeutic strategies based on HF phenotypes. Further research is warranted to elucidate underlying mechanisms and optimize patient selection.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"991-1004"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119393","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":"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":"1123-1126"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296838/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A spotlight on congestion in acute heart failure: a joint session with the Romanian Society of Cardiology (part I).","authors":"Linda Ye, Alex J Chang, Ovidiu Chioncel, Elena-Laura Antohi, Oliviana Geavlete, Magdy Abdelhamid, Mariana Adamo, Jan Biegus, Vijay Chopra, Gad Cotter, Avishay Grupper, Mitja Lainscak, Alexandre Mebazaa, Alberto Palazzuoli, Giuseppe Rosano, Gianluigi Savarese, Sean P Collins, Steven A Hamilton, Andrew P Ambrosy","doi":"10.1007/s10741-025-10515-0","DOIUrl":"10.1007/s10741-025-10515-0","url":null,"abstract":"<p><p>Heart failure (HF) is a leading cause of hospitalizations, with over 1 million admissions annually in the USA and Europe due to signs and symptoms of congestion. Congestion in HF is now understood to result from both an absolute increase in total body fluid volume and a relative redistribution of fluid from capacitance vessels to the effective circulation. While guideline-directed medical therapy (GDMT) has greatly improved the outlook for stable HF patients, there has been little progress in managing acute HF (AHF) over the past 50 years. To address this unmet need, a group of expert clinicians met at the 63rd Annual Romanian Society of Cardiology Meeting on September 20th, 2024. They critically evaluated current evidence and identified knowledge gaps in three key areas of AHF management: (1) enhancing diuresis beyond standard therapy; (2) targeting fluid redistribution with intravenous vasodilators; and (3) applying hemodynamic profiling for personalized care. The first part of the discussion centered on enhanced diuresis strategies, covering contemporary real-world practice patterns, the relationship between residual congestion and hospital readmissions, findings from clinical trials of diuretic strategies, and recent insights into the role of GDMT in the acute setting. The panel also highlighted the limitations of existing evidence and proposed a research roadmap to optimize diuretic strategies in conjunction with GDMT in AHF, with the ultimate goal of facilitating decongestion in order to restore euvolemia and improve post-discharge outcomes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"883-898"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007944","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":"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":"923-930"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","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}