Heart Failure Reviews最新文献

{"title":"Exercise and cardiac rehabilitation after LVAD implantation.","authors":"Emily Newman, Yevgeniy Brailovsky, Indranee Rajapreyar","doi":"10.1007/s10741-024-10477-9","DOIUrl":"10.1007/s10741-024-10477-9","url":null,"abstract":"<p><p>Left ventricular assist devices (LVAD) have improved mortality and quality of life for patients with end-stage heart failure by providing an alternative to cardiac transplant or as a bridge to transplantation. The improvement in functional capacity however is minimal to modest depending on the right ventricular function, optimal hemodynamics on LVAD therapy, and comorbidities. There is improvement in submaximal exercise capacity but improvement in peak aerobic capacity is limited. Exercise capacity can be improved by referral to cardiac rehabilitation after LVAD implantation. Cardiac rehabilitation is safe and effective with improvement in functional capacity, and decrease in mortality and heart failure hospitalizations. Cardiopulmonary exercise testing (CPET) is a specialized exercise stress test that measures gas exchange during exercise to determine a variety of variables that have been shown to be predictive of mortality in patients undergoing cardiac transplant. CPET is valuable for prognostication and is a predictor of adverse outcomes, including right heart failure in the immediate post-LVAD implantation period, long-term mortality. CPET is an additional testing that can aid in the decision making for LVAD explantation or decommissioning.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"469-476"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894097","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":"Sodium zirconium cyclosilicate for MRAs optimization in HFrEF: lessons learned from the REALIZE-K trial.","authors":"Luca Monzo, Francesca Musella, Nicolas Girerd, Patrick Rossignol","doi":"10.1007/s10741-025-10490-6","DOIUrl":"10.1007/s10741-025-10490-6","url":null,"abstract":"<p><p>Mineralocorticoid receptor antagonists (MRAs) are a cornerstone of guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF), offering significant benefits in reducing mortality and hospitalizations. However, their use is often constrained by the risk of hyperkalemia, particularly in patients with chronic kidney disease. Patiromer and sodium zirconium cyclosilicate (SZC), two novel potassium binders, have emerged as highly effective and safe tools for managing hyperkalemia and enabling the optimization of MRA therapy. This mini-review critically examines the findings of the recently published REALIZE-K (Randomized Withdrawal Trial Evaluating Sodium Zirconium Cyclosilicate for the Management of Hyperkalemia in Patients With Symptomatic Heart Failure With Reduced Ejection Fraction and Receiving Spironolactone) trial, placing it within the broader context of current evidence on potassium binders and their potential role in mitigating hyperkalemia to optimize MRA treatment. Moreover, it explores other significant barriers to MRA optimization, including clinician concerns over the risk of hyperkalemia, a consistent and pervasive issue that often leads to treatment inertia. By addressing both physiological and psychological barriers, this review aims to provide a comprehensive understanding of how to enhance MRA utilization and potentially improve clinical outcomes in patients with HFrEF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"565-574"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065229","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":"Focusing on microvascular function in heart failure with preserved ejection fraction.","authors":"Ornela Velollari, Karl-Philipp Rommel, Karl-Patrik Kresoja, Philipp Lurz, Tommaso Gori","doi":"10.1007/s10741-024-10479-7","DOIUrl":"10.1007/s10741-024-10479-7","url":null,"abstract":"<p><p>Heart failure is a prevalent global health issue. Heart failure with preserved ejection fraction (HFpEF), which already represents half of all heart cases worldwide, is projected to further increase, driven by aging populations and rising cardiovascular risk factors. Effective therapies for HFpEF remain limited, particularly due to its pathophysiological heterogeneity and incomplete understanding of underlying pathomechanisms and implications. Coronary microvascular dysfunction (CMD), characterized by structural and functional changes in the coronary microcirculation, is increasingly recognized as a significant factor in HFpEF even though the exact nature of their causal relationship is still unclear. This review explores prevalence, prognostic implications, and potential therapeutic targets for CMD in HFpEF. CMD's role in HFpEF might involve impaired coronary blood flow regulation, leading to myocardial ischemia, impaired relaxation, and/or adverse remodeling. Vice versa, increased wall stress in patients with HFpEF might elevate coronary resistances, further worsening microvascular perfusion. Finally, abnormalities in substrate metabolism might cause both CMD and HFpEF. Current treatments, including pharmacotherapy and device-based therapies, show limited success, highlighting the need for more targeted approaches. New possible therapies, such as the coronary sinus reducer device, may show promise in improving myocardial perfusion and function. However, further large-scale studies are required to elucidate the mechanistic links between CMD and HFpEF and to develop specialized treatments for distinct heart failure phenotypes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"493-503"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970567","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":"Lessons learned and future perspectives from the PRO-HF trial.","authors":"Mario Enrico Canonico, Andrew P Ambrosy, Marc D Samsky","doi":"10.1007/s10741-025-10482-6","DOIUrl":"10.1007/s10741-025-10482-6","url":null,"abstract":"","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"525-527"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964562","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":"Tricuspid regurgitation after heart transplantation: where innovation and intervention are in hibernation.","authors":"Emyal Alyaydin, Alexander Gotschy, Danaë Parianos, Matthias P Nägele, Igor Tudorache, Andreas J Flammer, Julia Stehli","doi":"10.1007/s10741-025-10494-2","DOIUrl":"10.1007/s10741-025-10494-2","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a common valvular dysfunction following heart transplantation (HT), with reported prevalence rates ranging from 19 to 84%, primarily depending on the duration of follow-up. Its etiology is multifactorial and includes surgical technique, ischemic time, primary graft dysfunction, pulmonary hypertension, pacemaker leads, and endomyocardial biopsies. Severe TR can significantly impair graft function, exercise capacity, and patient survival. This mini-review explores current management strategies, including surgical techniques such as annuloplasty and tricuspid valve replacement. HT patients are often high-risk surgical candidates due to factors such as immunosuppressive therapy, prior surgeries, and various comorbidities. Therefore, we primarily focus on the evidence regarding emerging interventional methods, such as transcatheter edge-to-edge repair. Although these interventions show promising early results, they remain relatively novel in HT recipients, and the current evidence is based on case reports and small studies. Further research is essential to evaluate the long-term efficacy and safety of these management strategies to enhance outcomes for HT recipients with TR.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"619-625"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407142","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":"Advanced Markers for Hemodynamic Monitoring in Cardiogenic Shock and End-Stage Heart Failure: A Mini Review.","authors":"Konstantinos Sideris, Christos P Kyriakopoulos, Lina Brinker, Iosif Taleb, Sotiria Liori, Aliya Hutman-Zahler, Nicholas Hendren, Eric Hall, Stavros G Drakos, Josef Stehlik, James C Fang, Mark H Drazner, Spencer Carter","doi":"10.1007/s10741-025-10483-5","DOIUrl":"10.1007/s10741-025-10483-5","url":null,"abstract":"<p><p>Right heart catheterization (RHC) provides critical hemodynamic insights by measuring atrial, ventricular, and pulmonary artery pressures, as well as cardiac output (CO). Although the use of RHC has decreased, its application has been linked to improved outcomes. Advanced hemodynamic markers such as cardiac power output (CPO), aortic pulsatility index (API), pulmonary artery pulsatility index (PAPi), right atrial pressure to pulmonary capillary wedge pressure ratio (RAP/PCWP) and right ventricular stroke work index (RVSWI) have been introduced to enhance risk stratification in cardiogenic shock (CS) and end-stage heart failure (HF) patients. CPO has emerged as a potent prognostic tool, with values below 0.6 Watts significantly associated with mortality. Similarly, API and PAPi have demonstrated strong predictive power for adverse outcomes, including death and the need for advanced HF therapies. RAP/PCWP ratio is shown to be a valuable a prognostic tool for RV dysfunction, mortality, and adverse outcomes. Despite mixed evidence on the prognostic utility of RVSWI, its physiologic relevance in assessing right ventricular function remains important. A novel clinical observation, involving patients with an RAP numerically greater than pulmonary artery saturation, was associated with a 71% 30-day mortality rate, underscoring the potential prognostic value of this finding. This review aims to summarize key advanced hemodynamic markers and their role in improving risk stratification and guiding treatment in CS and end-stage HF. The integration of these markers into clinical practice holds the potential to enhance personalized care and improve outcomes for patients with CS and advanced HF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"529-535"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978059","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":"Effects of anti-inflammatory therapy in acute heart failure: a systematic review and meta-analysis.","authors":"Beth A Davison, Antonio Abbate, Gad Cotter, Domingo Pascual-Figal, Benjamin Van Tassell, Julio Núñez Villota, Lina Atabaeva, Yonathan Freund, Alberto Aimo, Jan Biegus, Michele Golino, Marco Giuseppe Del Buono, Ovidiu Chioncel, Alain Cohen-Solal, Christopher Edwards, Noelia Fernández-Villa, Gerasimos Filippatos, José Ramón González-Juanatey, Hamlet Hayrapetyan, Borja Ibáñez, Pau Llàcer Iborra, Francesco Moroni, Jozine M Ter Maaten, Roshanak Markley, Javier González-Martín, Manuel Martínez-Sellés, Mayranush Drambyan, Marco Metra, Sonia Mirabet, Andranik Mshetsyan, Maria Novosadova, Matteo Pagnesi, Piotr Ponikowski, Alejandro Riquelme-Pérez, Malha Sadoune, Manuel Anguita Sánchez, Tabassome Simon, Mikel Taibo-Urquía, Koji Takagi, Sandra Villar, Chao Liu, Adriaan A Voors, Alexandre Mebazaa, Douglas L Mann, Antoni Bayés-Genís","doi":"10.1007/s10741-025-10491-5","DOIUrl":"10.1007/s10741-025-10491-5","url":null,"abstract":"<p><p>We examined current evidence regarding the effects of anti-inflammatory therapies in patients with acute heart failure (AHF) on the risk of cardiovascular outcomes, inflammatory markers, natriuretic peptides, and renal function. Despite growing evidence that inflammation plays a pivotal role in both the development and progression of heart failure, including AHF, only a few trials have been conducted to date in patients with AHF. A systematic literature search of PubMed, Medline, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov was conducted in November 2024 to identify randomized controlled trials (RCTs) evaluating anti-inflammatory therapies in adult patients with AHF. Meta-analyses were conducted to estimate effects on clinical outcomes (death, HF readmission, or worsening HF) and inflammatory and other markers. Five RCTs were identified that enrolled a total of 289 patients to an anti-inflammatory intervention and 273 to a control. Prednisone was examined in two RCTs, anakinra in two, and colchicine in one. Three of the five trials required elevated C-reactive protein (CRP) level for entry. Anti-inflammatory therapy was associated with a reduced risk of the composite outcome (hazard ratio 0.55 [95% CI 0.35-0.86]) and an overall 54% greater reduction in CRP to end of therapy (ratio of geometric mean ratios 0.46 [95% CI 0.29-0.73]), which varied across studies. NT-proBNP and creatinine were not significantly affected. The analysis is limited by the small number of studies but suggests that anti-inflammatory therapy reduces inflammation and may reduce the risk of adverse clinical outcomes in patients with AHF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"575-587"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407141","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 SARAH trial: more evidence on the role of neurohormonal blockers in prevention of anthracycline-induced cardiotoxicity.","authors":"Albulena Mecinaj, Victoria Vinje-Jakobsen, Doan T M Ngo, Aaron L Sverdlov, Peder L Myhre","doi":"10.1007/s10741-025-10495-1","DOIUrl":"10.1007/s10741-025-10495-1","url":null,"abstract":"<p><p>This mini-review highlights the results of the SARAH trial, which evaluated the efficacy of sacubitril/valsartan in preventing subclinical cardiac dysfunction in patients undergoing anthracycline-based chemotherapy. The trial demonstrated a significant reduction in GLS decline in the treatment group compared to placebo. The findings are discussed in context with other trials investigating neurohormonal blockade for the prevention of cancer therapy-related cardiac dysfunction.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"627-631"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440708","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":"https://doi.org/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":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-30","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":"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":"https://doi.org/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":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-29","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}