Heart Failure Reviews最新文献

{"title":"Subcutaneous sensors for monitoring congestion and to reduce heart failure hospitalizations-a viable middle ground between deep implantable intravascular monitoring devices and wearable technologies?","authors":"Friedrich Wetterling, Bartlomiej Fryc, Ilaria Facchi, Toshimasa Okabe, E Kevin Heist, Marat Fudim","doi":"10.1007/s10741-025-10529-8","DOIUrl":"10.1007/s10741-025-10529-8","url":null,"abstract":"<p><p>Congestive heart failure (CHF) remains a leading cause of hospitalization and mortality worldwide. Continuous monitoring is crucial for early detection of decompensation, potentially reducing hospital admissions and improving outcomes. Cardiac implantable electronic devices (CIEDs) have been established as useful therapeutic interventions that also support continuous monitoring in order to detect early signs of decompensation. However, prior to CIED implantation, effective continuous monitoring solutions are lacking. They exist at two extremes: deep implantable intravascular solutions such as pulmonary artery pressure sensors, which are effective but costly and complex, and wearables, which are inexpensive but lack evidence of their effectiveness and depend on ongoing active patient adherence. Subcutaneous sensors may represent a promising intermediate solution-offering continuous monitoring with lower invasiveness and cost, while maintaining higher adherence compared to wearables. This review explores the role of subcutaneous sensors in CHF management, comparing existing daily trend data to deep implantable sensors measuring direct filling pressure and CIEDs for multi-parametric risk scoring. We discuss their feasibility, limitations, and future integration into routine clinical practice.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"1113-1122"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247562","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":"Infective endocarditis complicated by shock: a systematic review and meta-analysis.","authors":"Roxana-Bianca Pîrîianu-Masgras, Alexandre Mebazaa, Gianluigi Savarese, Emanuel Stoica, Oliviana Geavlete, Andrew P Ambrosy, Elena-Laura Antohi, Mehmet Birhan Yilmaz, Razvan-Ilie Radu, Marianna Adamo, Beth A Davison, Jan Biegus, Gad Cotter, Javed Butler, Sean P Collins, Ovidiu Chioncel","doi":"10.1007/s10741-025-10556-5","DOIUrl":"https://doi.org/10.1007/s10741-025-10556-5","url":null,"abstract":"<p><p>Infective endocarditis (IE) complicated by septic or cardiogenic shock is linked to a marked increase in morbidity and mortality rates. This systematic review and meta-analysis sought to evaluate clinical outcomes, identify prognostic factors, and assess the effects of valve surgical intervention in patients with infective endocarditis complicated by shock. Systematic searches were performed in PubMed, Cochrane Library, and Google Scholar databases, following PRISMA and MOOSE guidelines. Included were observational studies published from January 2015 to May 2025 that reported on adult patients with infective endocarditis complicated by septic or cardiogenic shock. A random-effects model was utilized for data synthesis (restricted maximum likelihood with Hartung-Knapp adjustment), and meta-regression was conducted to assess sources of heterogeneity. Seven observational studies were included (n = 183-255,838). In-hospital mortality among patients with shock was 62.3% (95% CI 48.3-74.5%). Compared with IE without shock, the pooled odds ratio for in-hospital mortality (HK-REML) was 5.83 (95% CI 1.35-25.23; 95% prediction interval 0.26-129.69), with substantial heterogeneity (I² = 90.3%). Valve surgical intervention was associated with reduced mortality, particularly in cardiogenic shock. Staphylococcus aureus was the most common pathogen in available microbiological data. Shock was frequently accompanied by acute kidney injury, neurological complications, and multiorgan dysfunction. Infective endocarditis complicated by shock carries an extremely poor prognosis, with pooled mortality exceeding 60%. Prompt recognition of shock, timely initiation of appropriate antimicrobial therapy, hemodynamic stabilization, and early valve surgery are crucial to improve outcomes in this high-risk population. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD420250652570.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951860","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":"Pharmacological options to relieve congestion in acute heart failure.","authors":"Chris J Kapelios, Ali Vazir, Lars H Lund, Gerasimos Filippatos, James C Fang","doi":"10.1007/s10741-025-10548-5","DOIUrl":"https://doi.org/10.1007/s10741-025-10548-5","url":null,"abstract":"<p><p>Although congestion is present in the large majority of patients hospitalized with acute heart failure (AHF), the pharmacological options to treat it remain poorly studied, with heterogeneity in real-world practices and outcomes. The best available evidence supports that patients with AHF and congestion should be initially treated with i.v. loop diuretics with their dose tailored to early (within 2-6 h) diuretic response, as assessed by spot urine sodium and/or hourly urine output. If diuretic response is sub-optimal, the next best steps seem to be increases in i.v. loop diuretics and addition of a thiazide and/or i.v. acetazolamide. Irrespective of the above, sodium-glucose co-transporter-2 inhibitors and spironolactone should be started in all patients with AHF as early as possible. Changes in serum creatinine in this scenario do not typically represent true worsening in renal function and should, thus, not lead to de-escalation of decongestion therapy.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951869","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":"Transthyretin cardiac amyloidosis: advances and ambiguities.","authors":"Alexandrina Danilov, Lorenzo D'Angelo, Enklajd Marsela, Juan Pablo Costabel, Ulrich P Jorde, Yogita Rochlani","doi":"10.1007/s10741-025-10552-9","DOIUrl":"https://doi.org/10.1007/s10741-025-10552-9","url":null,"abstract":"<p><p>Cardiac amyloidosis is a fatal disorder caused by deposition of abnormally folded protein in the interstitial space. One of the proteins most associated with the disease is transthyretin (TTR), which leads to a progressive infiltrative cardiomyopathy (CM). Previously thought to be a rare disorder, there is growing recognition of it as a common cause of heart failure in the elderly and African Americans. The application of bone scintigraphy to the diagnosis of ATTR amyloidosis now allows for accurate and non-invasive diagnosis of the disease, rather than the previously necessary tissue biopsy. Targeted pharmacotherapies have been developed in the past few years that stabilize TTR, silence genes responsible for TTR production, or remove abnormal protein deposited in tissues. As of March 2025, Vutrisiran is the latest addition to the FDA-approved medications for ATTR-CM, alongside Tafamidis and Acoramidis. Several emerging therapies, including novel drugs and promising gene editing techniques are currently under investigation. As the number of available treatments continues to grow, maintaining a high index of suspicion and timely screening for the disease using laboratory tests, electrocardiography, and imaging has become increasingly important. In addition, with advancements in artificial intelligence (AI), new methods are in development to enhance screening of patients with suspected ATTR amyloidosis. These AI-driven tools could be integrated into electronic medical record systems to flag at-risk patients and allow for more rapid diagnosis. This review provides an overview of the current landscape and future directions of the diagnosis, treatment, and screening of ATTR-CM.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951832","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":"Pressure applied: Mechanisms affecting heart-lung interactions and cardiac filling in patients with HFpEF during rest and exercise.","authors":"Michael G Leahy, Satyam Sarma","doi":"10.1007/s10741-025-10557-4","DOIUrl":"https://doi.org/10.1007/s10741-025-10557-4","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is characterized by elevated left-ventricular (LV) filling pressures largely owing to diastolic dysfunction and stiffness. The measurement of filling pressure presents unique challenges as cardiac structures live within the context of the thorax. The heart and pulmonary vasculature are therefore subjected to the same changes in external volume as the lung. Here, we review the mechanisms by which LV filling pressure interacts with the thoracic space, with a particular focus on patients with HFpEF during rest and exercise. Specifically, we discuss the means by which intrathoracic volume impacts ventricular filling and function. We outline the interacting compliances within the thoracic cavity which can alter intrathoracic and therefore cardiac filling pressures. We also detail means by which intrathoracic pressure can be modulated by different conditions and body positions, such as supine posture, gravity, and obesity. Throughout, we highlight gaps in the literature as well as perspective towards possible future directions.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951814","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":"Mobile integrated health for heart failure: insights from the MIGHTy-Heart trial.","authors":"Christian Basile, Marc D Samsky, Abdelghani El Rafei, Josephine Harrington, Andrew P Ambrosy, Aldo Pietro Maggioni, Marc P Bonaca, Mario Enrico Canonico","doi":"10.1007/s10741-025-10555-6","DOIUrl":"https://doi.org/10.1007/s10741-025-10555-6","url":null,"abstract":"","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951830","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":"Hyperkalemia in Heart Failure with Reduced Ejection Fraction: Implications and Management.","authors":"Craig J Beavers, Stephen J Greene","doi":"10.1007/s10741-025-10549-4","DOIUrl":"https://doi.org/10.1007/s10741-025-10549-4","url":null,"abstract":"<p><p>Hyperkalemia is a potentially life-threatening electrolyte imbalance that has traditionally posed significant challenges in the management of heart failure (HF). This review explores the complex interplay between hyperkalemia and the use of guideline-directed medical therapies (GDMT), such as renin-angiotensin-aldosterone system inhibitors (RAASi) and steroidal mineralocorticoid receptor antagonists (sMRAs), including spironolactone and eplerenone, which are currently recommended in guidelines for improving outcomes in heart failure with reduced ejection fraction (HFrEF). While these therapies reduce mortality and hospitalizations in HFrEF, their benefit in patients with heart failure with left ventricular ejection fraction (LVEF) ≥ 40% remains less conclusive. Nevertheless, their use in clinical practice is often limited by the risk of hyperkalemia, potentially leading to dose reduction or discontinuation of life-saving treatments. The prevalence of hyperkalemia in HF patients is notably higher compared to the general population, particularly in those with comorbid chronic kidney disease (CKD) and diabetes mellitus, further complicating management. This review emphasizes the importance of regular potassium monitoring, the potential benefits of combining therapies such as sodium-glucose cotransporter 2 (SGLT2) inhibitors with RAASi to reduce the risk of hyperkalemia, and the emergence of the newer non-steroidal MRA (nsMRA), finerenone, which may have a lower risk of hyperkalemia. Additionally, potassium binders such as patiromer and sodium zirconium cyclosilicate (SZC) are highlighted for their role in managing and preventing hyperkalemia, allowing patients to continue optimal RAASi and MRA therapy without interruption. By synthesizing current evidence on the incidence, risks, and management strategies of hyperkalemia in HF, this review aims to provide a comprehensive guide for clinicians to optimize patient outcomes while mitigating the risks associated with hyperkalemia.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951849","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":"An overview of the association between socioeconomic deprivation and heart failure.","authors":"Edidiong I Akpabio, Onyedika J Ilonze, Duke Appiah, Ida T Fonkoue, Imo A Ebong","doi":"10.1007/s10741-025-10550-x","DOIUrl":"https://doi.org/10.1007/s10741-025-10550-x","url":null,"abstract":"<p><p>Although geographic variations exist in heart failure (HF), the prevalence of HF is increasing worldwide with a higher rise in low-income countries (LICs) and lower-middle-income countries (L-MICs). HF has enormous socioeconomic impact and is a leading contributor to global healthcare expenditure. Individual and composite measures of socioeconomic deprivation (SED) have consistently been linked to HF incidence as well as HF-related hospitalization and mortality. In socioeconomically disadvantaged populations, composite measures of SED are more powerful predictors of HF outcomes than individual indices. The relationship between SED and HF is bi-directional. While SED predisposes to HF, HF on its part aggravates economic hardship due to increased time away from work, job loss, and financial instability. In this review, we will discuss the associations between individual and composite measures of SED and HF, while highlighting the differences that exist between LICs, L-MICs, upper-middle-income countries (U-MICs), and high-income countries (HICs). We will also propose actionable items that could be pursued to mitigate the adverse effects of SED on HF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821191","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 the gut microbiota and metabolites in heart failure and possible implications for treatment.","authors":"Ahmed Emad Ahmed Shoukry, Alaa Rahhal, Constantina Constantinou","doi":"10.1007/s10741-025-10546-7","DOIUrl":"https://doi.org/10.1007/s10741-025-10546-7","url":null,"abstract":"<p><p>The prevalence of heart failure has increased significantly in recent years, prompting investigations into novel contributory factors. Among these, alterations in the gut microbiota composition have garnered attention due to their potential association with heart failure. Disruption in the bacterial environment associated with heart failure is characterized by heightened levels of Proteobacteria and Firmicutes and decreased levels of Bifidobacteria and Bacteroides. Reduced blood supply weakens the gut barrier, facilitating the transportation of bacteria and metabolites into the bloodstream. This breach can trigger an immune response and inflammation, subsequently contributing to the pathogenesis of heart failure through the generation of harmful organic compounds in the gastrointestinal tract and bloodstream. Specific metabolites, including short-chain fatty acids, trimethylamine, and trimethylamine N-oxide also contribute to the development of heart failure. Management of heart failure includes pharmacological management, surgery, and lifestyle modifications including recommendations for the consumption of a diet high in fruits and low in animal products. Heart failure can be managed by modulating the gut microbiota. Clinical interventions include antibiotics, prebiotics, and dietary changes. However, other approaches including fecal microbial transplantation, probiotics, and natural phytochemicals are still under study in animal models. This review highlights the significant yet underexplored link between gut microbiota and heart failure, suggesting that further research could lead to new therapeutic strategies and dietary recommendations to mitigate heart failure progression.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707307","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":"Demographic disparities in heart failure with preserved ejection fraction.","authors":"Adhvithi Pingili, Maneeth Mylavarapu, Mounika Reddy Vadiyala, Roopeessh Vempati, Poojan Parmar, Naga Vamsi Krishna Machineni, Mahboob Younus Shaik, Srikanth Puli, Bhagya Lakshmi Devarala, Jyotsna Gummadi, Sumanth Bandaru, Rupak Desai, Erika Feller","doi":"10.1007/s10741-025-10547-6","DOIUrl":"https://doi.org/10.1007/s10741-025-10547-6","url":null,"abstract":"<p><p>This review comprehensively examines the complex influence of demographic factors on heart failure with preserved ejection fraction (HFpEF), an increasingly common clinical syndrome. We examine the impact of age, sex, race/ethnicity, and socioeconomic status on HFpEF, investigating how these factors contribute to disparities in prevalence, risk profiles, diagnostic challenges, treatment responses, and clinical outcomes. Key findings highlight the significant role of age, with HFpEF incidence rising with advancing age advances and distinct pathophysiological mechanisms noted across age groups. Gender disparities are also evident, with women showing a greater predisposition to HFpEF, possibly linked to physiological differences and sex-specific risk factors. The review also addresses racial and ethnic disparities, recognizing the limitations in current data while stressing the need for more inclusive research to comprehend the specific impact of race on HFpEF. Finally, the essential role of socioeconomic factors is examined, illustrating how income and education can affect access to care, treatment adherence, and overall outcomes. Furthermore, we aim to underscore the importance of a holistic approach to HFpEF, recognizing the interplay of demographic factors in shaping disease trajectory and patient experiences. By synthesizing current evidence and identifying key knowledge gaps, we aim to inform future research directions, promote equitable healthcare delivery, and ultimately improve the lives of individuals affected by this complex condition.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659044","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}