Heart Failure Reviews最新文献

{"title":"Left ventricular non-compaction in heart failure: contemporary perspective on diagnostic challenges and treatment opportunities.","authors":"Oliviana Geavlete, Carsten Tschöpe, Christiane E Angermann, Sean P Collins, Andrew P Ambrosy, Ruxandra Jurcuț, Marianna Adamo, Luca Monzo, Giuseppe Mc Rosano, Nicolas Girerd, Marija Polovina, Maurizio Volterrani, Gianluigi Savarese, Petar M Seferović, Javed Butler, Ovidiu Chioncel","doi":"10.1007/s10741-026-10647-x","DOIUrl":"10.1007/s10741-026-10647-x","url":null,"abstract":"<p><p>Left ventricular non-compaction (LVNC) remains one of the most debated phenotypes within the spectrum of cardiomyopathy. Increasing recognition of left ventricular hypertrabeculation (LVHT) in healthy individuals and in physiological adaptive states challenges the concept of LVNC as a distinct morphological entity. In patients with heart failure (HF), distinguishing adaptive trabeculation from true cardiomyopathic LVNC is clinically critical, as misclassification may lead to unnecessary interventions or failure to identify high-risk patients. This review summarizes current evidence on the pathophysiology, imaging features, genetic background, and clinical implications of LVHT and LVNC from an HF-centred perspective. We propose a pragmatic diagnostic approach integrating echocardiography, cardiac magnetic resonance, and selective genetic testing to improve clinical interpretation, risk stratification and management. Importantly, prognosis appears to be determined primarily by ventricular function, myocardial substrate, and arrhythmic burden rather than by the extent of trabeculation itself.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277223","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":"Correction to: Left atrial shunting devices: why, what, how, and… when?","authors":"Leila Anna De Lorenzo, Claudia Baratto, Davide Sala, Giovanni Battista Perego, Sergio Caravita","doi":"10.1007/s10741-026-10642-2","DOIUrl":"10.1007/s10741-026-10642-2","url":null,"abstract":"","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217606","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":"Cardiac microcurrent therapy in heart failure: Mechanistic rationale, early clinical evidence, and future directions.","authors":"Marat Fudim, Faouzi Kallel, Jesus E Eduardo Rame, Javed Butler, Jeroen J Bax, Stavros G Drakos, David E Lanfear, Daniel Burkhoff, Dipthi Bachamanda Somesh, Marija Zdravkovic, Tamara Kovačević Preradović, Milosav Tomovic, Dragana Kosevic, William T Abraham, Stefan D Anker","doi":"10.1007/s10741-026-10644-0","DOIUrl":"10.1007/s10741-026-10644-0","url":null,"abstract":"<p><p>Despite major advances in guideline-directed medical therapy (GDMT), many patients with heart failure with reduced ejection fraction (HFrEF) remain symptomatic, with persistent limitations in functional capacity and health status, underscoring the need for adjunctive therapeutic strategies. Direct cardiac microcurrent (C-MIC) therapy is a non-excitatory bioelectrical intervention device to modulate myocardial remodeling rather than rhythm or acute contractility. C-MIC therapy influence myocardial biology, including pathways related to fibrosis, inflammation, and cellular homeostasis by delivering continuous, subthreshold direct current. Preclinical studies across cardiomyocytes, animal models, and cardiac fibroblasts suggest that microcurrent exposure may attenuate profibrotic signaling, regulate extracellular matrix turnover, and improve calcium handling, providing a mechanistic rationale for reverse remodeling. Early clinical experience, including first-in-human studies and a randomized trial in carefully selected patients with non-ischemic HFrEF, demonstrates feasibility and a consistent signal of improvement in left ventricular function, functional capacity, and patient-reported outcomes. However, the current evidence base remains limited by small sample size, open-label designs, and the absence of sham-controlled evaluation. All available clinical data are derived from surgically implanted systems, and the effectiveness of less invasive configurations remains uncertain. Accordingly, C-MIC should be considered an investigational therapy. Future development will require rigorous mechanistic validation, optimization of device programming and delivery parameters, and confirmation of efficacy in adequately powered, sham-controlled trials to define its role in contemporary HF management.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198640","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":"Cardiac imaging in Chagas cardiomyopathy for phenotypic characterisation and risk stratification.","authors":"Anisha Johnson, Sai Vamshi Krishna Katraj, Vivetha Pooranachandran","doi":"10.1007/s10741-026-10645-z","DOIUrl":"10.1007/s10741-026-10645-z","url":null,"abstract":"<p><p>Chagas disease, caused by Trypanosoma cruzi, remains one of the leading infectious causes of non-ischemic cardiomyopathy worldwide. Although an estimated 6-7 million individuals are chronically infected, 20-30% will develop Chagas cardiomyopathy (CCM), a progressive myocardial disease characterised by conduction abnormalities, ventricular arrhythmias, focal aneurysm formation, diffuse fibrosis, and heart failure. Cardiac involvement often evolves silently over decades, and conventional clinical markers frequently underestimate early myocardial injury. Advances in cardiac imaging have fundamentally reshaped the understanding of CCM, demonstrating that myocardial involvement frequently precedes symptoms and may occur despite normal electrocardiography. Contemporary modalities, including transthoracic echocardiography with deformation imaging and cardiac magnetic resonance, enable detailed characterisation of ventricular mechanics, myocardial fibrosis, inflammation, and perfusion abnormalities across disease stages. These techniques have revealed a distinctive, segmental pattern of myocardial injury and provided mechanistic insight into arrhythmogenesis and disease progression. This review synthesises current evidence on the natural history of Chagas disease, with a particular focus on the expanding role of multimodality cardiac imaging in the early detection, phenotypic characterisation, and risk stratification of CCM.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between SGLT2 inhibitors and outcomes after heart transplant in patients with type 2 diabetes: A systematic review and meta-analysis.","authors":"Thomaz Alexandre Costa, Luma Maria Tavares de Sousa, Alleh Nogueira, Gabriel Cavalcante Lima Chagas, Marconi Abreu, Larry A Allen, William K Cornwell, Josephine Harrington","doi":"10.1007/s10741-026-10641-3","DOIUrl":"10.1007/s10741-026-10641-3","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended for multiple populations-type 2 diabetes (T2D), chronic kidney disease, and heart failure-but their role after heart transplant (HTX) remains unclear. We searched PubMed, Cochrane, and Embase for studies of HTX recipients with T2D comparing outcomes in SGLT2i users vs. non-users. Outcomes of interest were all-cause mortality, urinary tract infection (UTI), and estimated glomerular filtration rate (eGFR) change from baseline. Odds ratios (ORs) and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were pooled using a random-effects model for binary outcomes. Three retrospective observational studies were included in the all-cause mortality meta-analysis, four in the UTI incidence meta-analysis, and five in the qualitative analysis evaluating eGFR change (n = 3,564). Mean follow-up ranged from 9 to 83 months. SGLT2i use was associated with a lower risk of all-cause mortality compared with non-use in both unadjusted (OR 0.43; 95% CI 0.26-0.71; p < 0.001; I² = 79%) and adjusted analyses (aHR 0.69; 95% CI 0.51-0.93; p = 0.02; I² = 20%), without increasing the risk of UTI (OR 0.77; 95% CI 0.14-4.05; p = 0.75; I² = 48%). Most studies suggested stable or increased eGFR from baseline with SGLT2i exposure. SGLT2i use, compared with non-use, was associated with lower all-cause mortality without an increased incidence of UTIs in HTX recipients with T2D. Additionally, the pooled data suggest a possible renal benefit. The totality of these observational data, despite their limitations, provide important context for ongoing SGLT2i use following HTX.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175823","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":"State-of-the-art management of ischemic cardiomyopathy: integrating diagnostic pathways, revascularization strategies, and guideline-directed therapy.","authors":"Matteo Busti, Vojtech Melenovsky, Gianluigi Savarese, Ovidiu Chioncel, Andrea Colli, Andrew P Ambrosy, Filippo Crea, Nicolas Girerd, Luca Monzo","doi":"10.1007/s10741-026-10640-4","DOIUrl":"10.1007/s10741-026-10640-4","url":null,"abstract":"<p><p>Ischemic cardiomyopathy (ICM) is a major cause of cardiovascular morbidity and mortality, characterized by a complex pathophysiological substrate and heterogeneous clinical trajectories. Despite decades of investigation, its diagnosis and management remain challenging, particularly regarding the role of coronary revascularization in addition to optimal medical therapy. Recent advances in pharmacotherapy, device-based interventions, and percutaneous techniques have expanded treatment options, but important evidence gaps persist. This state-of-the-art review critically appraises the contemporary diagnosis and management of ICM. Particular emphasis is placed on the integration of multimodality non-invasive imaging into clinical decision-making, the reinterpretation of myocardial viability and revascularization in light of recent randomized evidence, and the interface between chronic coronary syndrome guidance and heart failure with reduced ejection fraction care in patients with ischemic LV dysfunction. By integrating these domains, the review supports a management approach in which guideline-directed medical and device therapy remain foundational, whereas revascularization is individualized according to myocardial substrate, coronary anatomy, symptoms, comorbidities, procedural risk, and multidisciplinary Heart Team assessment.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053800","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":"Mineralocorticoid receptor antagonists for the treatment of heart failure and kidney disease: a state-of-the-art review.","authors":"Harriette G C Van Spall, Orly Vardeny","doi":"10.1007/s10741-026-10636-0","DOIUrl":"10.1007/s10741-026-10636-0","url":null,"abstract":"<p><p>Chronic heart failure causes significant morbidity and mortality worldwide. Mineralocorticoid receptor antagonists are pivotal in the management of heart failure with reduced ejection fraction, as demonstrated in large outcomes trials that tested the efficacy of the steroidal mineralocorticoid receptor antagonists, spironolactone and eplerenone. There is still debate regarding their use in the management of heart failure with mildly reduced ejection fraction or heart failure with preserved ejection fraction. The nonsteroidal mineralocorticoid receptor antagonist finerenone was recently shown to improve outcomes in heart failure with mildly reduced ejection fraction and heart failure with preserved ejection fraction. This review of clinical trials evaluates the efficacy and safety of steroidal and nonsteroidal mineralocorticoid receptor antagonists for the treatment of heart failure across ejection fraction categories. We discuss the benefits of mineralocorticoid receptor antagonists in treating heart failure, including in the setting of chronic kidney disease, and review the benefits of nonsteroidal mineralocorticoid receptor antagonists in patients with chronic kidney disease who are at risk of developing heart failure. We outline the effect of mineralocorticoid receptor antagonists on serum potassium levels and propose strategies for minimizing the risk of hyperkalaemia. With a focus on clinical trial evidence, this review highlights that mineralocorticoid receptor antagonists have a favourable benefit-risk in the prevention and treatment of heart failure.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13212694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029609","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":"Wearable Cardioverter-Defibrillator in Adult Congenital Heart Disease: A Bridge to Decision, Recovery, and Advanced Therapies.","authors":"Berardo Sarubbi, Anna Murredda, Giovanni Domenico Ciriello, Anna Correra, Giovanni Papaccioli, Diego Colonna","doi":"10.1007/s10741-026-10638-y","DOIUrl":"10.1007/s10741-026-10638-y","url":null,"abstract":"<p><p>Sudden cardiac death (SCD) remains a major cause of mortality among adults with congenital heart disease (ACHD). Risk stratification for malignant ventricular arrhythmias in this population is challenging because of the heterogeneity of anatomical substrates, lifelong haemodynamic changes, and the limited predictive accuracy of currently risk models. Furthermore, implantation of an implantable cardioverter-defibrillator (ICD) in ACHD patients is frequently complicated by anatomical constraints, limited venous access, and a significant burden of device-related complications, including infection involving prosthetic material. Several transient cardiac or systemic conditions-including haemodynamic deterioration, acquired myocardial disease, infections, inflammatory states, pregnancy, endocrine disturbances, or peri-procedural phases-may temporarily increase arrhythmic risk or impair ventricular function. In these scenarios, the indication for permanent ICD may be uncertain or premature. The wearable cardioverter-defibrillator (WCD) provides a non-invasive option for temporary protection against life-threatening ventricular arrhythmias while allowing time for clinical stabilization, diagnostic reassessment, and individualized decision-making. This review summarizes the pathophysiological rationale, available evidence, and potential clinical applications of WCD therapy in ACHD.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015241","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 spectrum of congestion in heart failure: underlying pathophysiology and diagnostic strategies.","authors":"Alberto Palazzuoli, Matteo Beltrami, Oliviana Geavlete, Gaetano Ruocco, Masatake Kobayashi, Francesca Susini, Irene Carlino, Giuseppe Schirò, Andrew P Ambrosy, Ovidiu Chioncel","doi":"10.1007/s10741-026-10639-x","DOIUrl":"10.1007/s10741-026-10639-x","url":null,"abstract":"<p><p>Congestion is the main driver of heart failure (HF) recurrence and its relief remains the primary therapeutic target during acute management. In most studies achievement of decongestion is evaluated by clinical examination. The lack of accurately recognizing congestion, together with the incomplete understanding of its underlying pathophysiological mechanisms, may lead to a substantial discordance between de-congestion and mortality risk reduction. To avoid these concerns, a classification dividing congestion between intra vs. extravascular, has been recently purposed but it is still based on clinical signs rather than an integrated diagnostic assessment. Additionally, across several studies, congestion is evaluated at various time moments and with different diagnostic methods. Over the last decades new approaches combining ultrasonographic evaluation, invasive measurement and biomarkers have been suggested, although a universal multi-parametric diagnostic strategy is not extensively applied. The complex mechanisms and dynamic nature of fluid retention, venous capacitance, lymphatic conditions and interstitial space integrity are relevant components which contributes to create further misunderstanding. The numerous cardiac and extracardiac factors potentially involved in congestion onset and recurrence need to be addressed during the evaluation. In this paper we would gather potential approaches for early congestion detection according to HF profile, based on the assumption that hemodynamic congestion and increased cardiac pressure does not necessarily coincide with systemic fluid retention.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015248","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":"Scoping review of return to work in patients with heart failure.","authors":"Shuri Nakao, Hidehiro Someko, Masatsugu Okamura, Yasushi Tsujimoto, Tomohiko Kamo, Hirofumi Ogihara, Shinya Sato, Sokichi Maniwa","doi":"10.1007/s10741-026-10622-6","DOIUrl":"10.1007/s10741-026-10622-6","url":null,"abstract":"<p><p>Heart failure (HF) has a significant impact on quality of life and employment. For patients with HF of work age, return to work (RTW) is an important goal because of its social and economic significance. This scoping review aimed to investigate the definition of RTW, RTW rates, support programs, and factors associated with RTW in patients with HF, and to propose future research and clinical support strategies. We included 47 studies with 64,048 individuals: 21 cohort studies (five prospective studies, 16 retrospective studies), three cross sectional studies, three case series studies (two retrospective studies, one prospective study), 18 case reports, two qualitative studies. Participants were aged 18-65 years old and were employed prior to a diagnosis of HF. Only one study defined RTW in patients with HF, and it was described as \"whether or not patients were working for income.\" The overall RTW rate across the studies had a median of was 56.0%, (interquartile range 25.8-100.0%, range 0.0-100.0%) but the rate varied across studies. Support programs were reported in two studies as rehabilitation and in one study as paid leave. The facilitating and inhibiting factors of RTW were classified into medical factors (e.g., ejection fraction, comorbidities), social determinants of health (e.g., education, income), and employment or work-related factors (e.g., job type, work ability). Future research needs to consider the results of this scoping review, particularly the ambiguity in the definition of RTW and the facilitating and inhibiting factors identified.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874014","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}