Heart Failure Reviews最新文献

{"title":"Reframing obesity-related HFpEF as a multiorgan syndrome: incretin-based therapies and imaging endpoints.","authors":"Masliza Mahmod, Andrea Dennis, Jie Lian, Caitlin Langford, Kazem Rahimi, Malgorzata Wamil","doi":"10.1007/s10741-026-10629-z","DOIUrl":"10.1007/s10741-026-10629-z","url":null,"abstract":"<p><p>Obesity-related heart failure with preserved ejection fraction (HFpEF) is increasingly recognised as a multiorgan cardio–renal–hepatic–metabolic (CRHM) syndrome. Obesity promotes HFpEF through metabolic dysfunction, systemic inflammation, haemodynamic overload and ectopic adiposity. Increased visceral and epicardial fat has been linked with downstream involvement of the heart, liver and kidneys, resulting in a distinct phenotype with high symptom burden and functional limitation. Incretin based therapies such as glucagon-like peptide-1 receptor agonist (GLP-1 RA) are growing in popularity in CRHM conditions owing to positive effects on glycaemia, weight loss and systemic inflammation, leading to reduced adverse clinical outcomes. In obesity-related HFpEF, emerging data suggest GLP-1 RA and glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 agonists (also called incretin-based therapies) improve symptoms, exercise capacity, congestion, and reduce heart failure events, while also leading to reduced ectopic fat depositions in multiple organs and favourable cardiac remodelling. Incretin-based, weight-directed therapies therefore represent a promising strategy for a therapeutically challenging HFpEF phenotype. Future clinical trials incorporating multiorgan imaging endpoints across the heart, liver, adipose tissue and kidneys are needed to clarify the mechanisms of benefit and to better define the role of weight-reduction therapies in obesity-related HFpEF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672483","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":"Tailoring heart failure management in cardiac amyloidosis.","authors":"Ernesto Ruiz Duque, Nikolaos-Lason Tepetes, Chris Kourek, Ibrahim Mortada, Adamantia Papamichail, Efstathios Kastritis, Kimon Stamatelopoulos, Alexandros Briasoulis, Rabea Asleh","doi":"10.1007/s10741-026-10624-4","DOIUrl":"10.1007/s10741-026-10624-4","url":null,"abstract":"<p><p>Cardiac amyloidosis is an infiltrative cardiomyopathy caused by extracellular deposition of amyloid fibrils, most commonly from immunoglobulin light chain (AL) or transthyretin (ATTR) proteins. Cardiac involvement dictates prognosis, with restrictive physiology, diastolic dysfunction, and conduction disease leading to progressive heart failure. Management of heart failure in cardiac amyloidosis differs fundamentally from conventional heart failure strategies. Due to preload dependence, autonomic dysfunction, and poor tolerance of standard therapies, treatment focuses on cautious volume control using low-dose diuretics, while β-blockers and ACE inhibitors, are used sparingly. Mineralocorticoid receptor antagonists are generally well tolerated and commonly used, with monitoring for hyperkalemia and renal dysfunction. Disease-specific therapy has revolutionized outcomes: daratumumab-based chemotherapy in AL amyloidosis achieves rapid and deep hematologic responses, improving cardiac biomarkers, imaging parameters, and survival. In the ATTR-subtype, transthyretin stabilizers and silencers significantly reduce mortality, cardiovascular hospitalizations, and functional decline, especially when initiated early. Atrial fibrillation and conduction disease are common; anticoagulation is indicated irrespective of CHA₂DS₂-VASc score. Ιmplantable cardioverter-defibrillator and cardiac resynchronization therapy are reserved for standard indications, with limited survival benefit. Inotropes serve as palliative or bridge therapy in end-stage disease, while transplantation remains viable in selected patients with controlled systemic disease. Emerging TTR stabilizers, gene silencers, and fibril-clearing antibodies may further transform prognosis. Advances in imaging, digital monitoring, and multidisciplinary care aim to enhance early detection and individualized management. Timely diagnosis, evidence-based therapy, and coordinated multidisciplinary care are essential to optimize survival and quality of life in cardiac amyloidosis.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645058","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":"Insular cortex and takotsubo syndrome: certainties, controversies, and opportunities.","authors":"John E Madias","doi":"10.1007/s10741-026-10623-5","DOIUrl":"10.1007/s10741-026-10623-5","url":null,"abstract":"","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591801","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":"International Utah Cardiac Recovery Symposium (U-CARS) 2025: Clinical Science Proceedings.","authors":"Ioannis Kyriakoulis, Ian Nickel, Manreet K Kanwar, Thomas C Hanff, Josef Stehlik, Craig H Selzman, Stavros G Drakos","doi":"10.1007/s10741-026-10621-7","DOIUrl":"10.1007/s10741-026-10621-7","url":null,"abstract":"<p><p>The 13th Annual Utah Cardiac Recovery Symposium (UCARs) was held in Salt Lake City on February 20–21, 2025 and brought together national and international experts in the field of heart failure and myocardial recovery. Along with basic/translational science, a wide range of clinical research was presented and discussed. Topics ranged from left ventricular assist device-driven myocardial recovery (including predictive scores, explant durability, and the updated International Society for Heart and Lung Transplantation guidelines), to cardiogenic shock management, multidisciplinary shock team models, donor heart selection, and emerging approaches in advanced heart failure care. This proceedings paper aims to summarize the key clinically relevant presentations from UCARS 2025 and provide a concise overview of the latest insights, evidence and expert opinions shared during the symposium.Clinical trial number: not applicable.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591859","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":"You evaluation of the PARACHUTE-HF trial: role of sacubitril/valsartan compared to enalapril on outcomes in patients with heart failure from Chagas' disease.","authors":"Dmitry Abramov, Abdul Mannan Khan Minhas, Tamas Alexy, Patricia Oliveira Guimaraes, Mitja Lainscak, Peder L Myhre","doi":"10.1007/s10741-026-10617-3","DOIUrl":"10.1007/s10741-026-10617-3","url":null,"abstract":"<p><p>Heart failure is a common manifestation of Chagas’ disease and results in significant morbidity and mortality in affected patients. In light of limited data on therapeutic options for heart failure due to Chagas’ disease, the PARACHUTE-HF trial aimed to compare the effects of sacubitril/valsartan versus enalapril on clinical endpoints and changes in natriuretic peptides in this population. This mini-review contextualizes the results of the trial, which demonstrated that sacubitril/valsartan led to significant improvements in outcomes driven primarily by a reduction in natriuretic peptides.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573638","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":"Predicting sudden cardiac death in heart failure with reduced ejection fraction.","authors":"Norayr Mkrtchyan, Alirameen Akram, Neal Dixit, Alexander Hajduczok, Antoinette Birs","doi":"10.1007/s10741-026-10619-1","DOIUrl":"10.1007/s10741-026-10619-1","url":null,"abstract":"<p><p>Sudden cardiac death (SCD) accounts for up to half of all mortality in patients with heart failure with reduced ejection fraction, yet contemporary clinical practice continues to rely primarily on left ventricular ejection fraction (LVEF) despite its well-recognized limitations as a predictor of arrhythmic risk. Many patients who experience SCD have only mildly reduced or even preserved LVEF, while a substantial proportion with severely reduced LVEF never develop life-threatening arrhythmias, underscoring the need for more precise risk assessment tools. This review synthesizes current evidence on clinical features, comorbidities, biomarkers, electrocardiographic abnormalities, and advanced imaging markers that independently inform SCD risk, including high-risk indicators such as syncope, chronic kidney disease, ventricular arrhythmias, impaired global longitudinal strain, and myocardial fibrosis on cardiac MRI. We also summarize emerging multiparametric risk models that integrate these variables into clinically usable frameworks, offering more individualized risk estimates than ejection fraction alone. Finally, we outline contemporary prevention strategies that optimize guideline-directed medical therapy and targeted device therapy, while discuss the evolving role of precision-medicine approaches in guiding ICD decision-making. Collectively, these data highlight the importance of moving beyond LVEF-centric algorithms toward more nuanced, multimodal strategies to better identify high-risk patients and reduce the ongoing burden of SCD in heart failure patients.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573602","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 contractility modulation in heart failure management: unraveling molecular mechanisms to improve patient selection in heart failure management.","authors":"Faro R Verelst, Lauranne Van Assche, Ward Heggermont, Sander Trenson, Wim Huybrechts, Hein Heidbuchel, Andreas B Gevaert, Emeline M Van Craenenbroeck","doi":"10.1007/s10741-026-10610-w","DOIUrl":"10.1007/s10741-026-10610-w","url":null,"abstract":"<p><p>Managing patients with heart failure remains continues to be a global health challenge despite advances in medical therapy. For patients with heart failure and reduced ejection fraction (HFrEF) who are ineligible for cardiac resynchronization therapy, cardiac contractility modulation (CCM) represents a promising device-based therapeutic alternative. CCM delivers non-excitatory, high-voltage electrical impulses during the absolute refractory period of the cardiac cycle, thereby enhancing myocardial contractility without increasing myocardial oxygen demand. Clinical studies have shown that CCM can improve exercise tolerance, quality of life, and left ventricular function. However, its long-term effects on mortality and heart failure hospitalizations in the diverse patient populations ranging from end-stage HFrEF to heart failure with preserved ejection fraction, remain inconclusive. This review explores the underlying molecular mechanisms of CCM contributing to reverse cardiac remodeling, including improved intracellular calcium handling, phosphorylation of key proteins related to contractility, and reversal of maladaptive gene expression. We also highlight the results of clinical trials using CCM and emphasize the need for improved patient selection criteria. Early identification of potential responders may be based on left ventricular ejection fraction and fibrosis burden. Furthermore, the expanding role of CCM in patients with heart failure with preserved ejection fraction and specific cardiomyopathies underscores its evolving therapeutic potential. Future research should focus on large-scale randomized controlled trials to establish efficacy on hard clinical endpoints and evaluate long-term benefits, alongside targeted studies aimed at refining patient selection.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573126","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":"Clinical and imaging profiling of restrictive cardiomyopathies: insights into amyloid, sarcoid, and iron overload phenotypes.","authors":"Syed Bukhari, Farooq H Sheikh, Sebastian Kelle, Joban Vaishnav, Nisha A Gilotra, Allison G Hays, Edward Hulten","doi":"10.1007/s10741-026-10620-8","DOIUrl":"10.1007/s10741-026-10620-8","url":null,"abstract":"<p><p>Restrictive cardiomyopathy is a rare and heterogeneous group of myocardial disorders characterized by increased myocardial stiffness, impaired diastolic filling, and elevated ventricular pressures. Infiltrative diseases are among the most common etiologies of RCM. This review highlights the importance of recognizing characteristic clinical patterns and the role of multimodality imaging in cardiac amyloidosis, cardiac sarcoidosis, and iron overload cardiomyopathy. Heart failure and cardiac arrhythmias are frequent manifestations of these diseases, often resulting in poor prognosis and death if left untreated. Early and accurate diagnosis is crucial for effective management; however, these diseases are often underdiagnosed or misdiagnosed due to overlapping features with other forms of cardiomyopathies, such as hypertrophic cardiomyopathy, hypertensive heart disease, ischemic cardiomyopathy, heart failure with preserved ejection fraction, and other nonischemic cardiomyopathies. With the development of novel therapies that are most effective when initiated early, accurate and prompt diagnosis has become increasingly important to optimize outcomes in these patients. Despite some shared features, each of these conditions has distinct \"red flag\" clinical characteristics that can raise suspicion for the disease. Advances in multimodality imaging have further improved diagnostic accuracy. Echocardiography can reveal features consistent with restrictive physiology, which is common across all infiltrative diseases, but it has limited ability to differentiate between them. Cardiac magnetic resonance imaging, with detailed tissue characterization, can identify unique and disease-specific characteristics for each of these conditions. Finally, radionuclide imaging can play a pivotal role, not only as a confirmatory test but also in monitoring the response to therapy.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528429","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 diagnosis and subclassification of heart failure with preserved ejection fraction: a review.","authors":"D Creegan, R C Starling, A Hameed, M J Daly, James O'Neill","doi":"10.1007/s10741-026-10618-2","DOIUrl":"10.1007/s10741-026-10618-2","url":null,"abstract":"<p><p>The incidence and prevalence of Heart Failure with Preserved Ejection Fraction (HFpEF) continues to rise and has a mortality rate comparable to that of Heart Failure with Reduced Ejection Fraction (HFrEF). Whilst there is general agreement on the diagnostic criteria for HFrEF, the diagnostic criteria for HFpEF vary significantly which has resulted in inconsistent and varying inclusion criteria in clinical trials for this challenging syndrome. The HFpEF population is diverse and heterogeneous and various schemes of subcategorisation have been proposed. Failure of treatment trials to date can be explained, in part, by failure to consider the underlying sub-phenotypes within the HFpEF population. This review discusses the diagnostic uncertainty surrounding HFpEF and details the historical progression in the understanding of diastolic dysfunction and its role in the heart failure syndrome. An analysis of diagnostic criteria and suggested phenotypic subcategorisation is accompanied by a discussion of echocardiographic and invasive haemodynamic criteria. A detailed summary of the varied inclusion criteria and definitions employed in recent clinical trials is provided.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528440","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 multidimensional needs of chronic heart failure patients and caregivers from a dyadic perspective: a scoping review.","authors":"Cosimo Chelazzi, Daniele Marelli, Carla Ida Ripamonti, Matteo Pagnesi, Marco Metra, Philip Larkin, Geert-Jan Geersing, Carlo Leget, Klaus K Witte, Everlien de Graaf","doi":"10.1007/s10741-026-10616-4","DOIUrl":"10.1007/s10741-026-10616-4","url":null,"abstract":"<p><p>Despite advances in medical and device management, people with chronic heart failure continue to experience persistent physical and non-physical symptoms. Consequently, heart failure guidelines advocate for the early integration of palliative care. Nevertheless, the multidimensional needs of patients and their informal caregivers remain insufficiently examined. This scoping review aimed to explore the physical and non-physical needs of adults living with chronic heart failure, along with those of their informal caregivers, across Europe. Following Arksey and O’Malley’s framework, a systematic search of PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, and Web of Science was undertaken. Eligible studies, published January 2000-January 2024, reported on the multidimensional needs of adult patients and their informal caregivers in Europe. Findings were meta-aggregated to identify dyad-level mechanisms. Across the 34 included studies, involving 886 patients and 525 caregivers, both groups reported several multidimensional burdens. Patients commonly experienced physical symptoms, alongside significant psychological, social-financial, and spiritual/existential concerns. Informal caregivers faced considerable physical, emotional, and socio-financial strain, with their quality of life closely linked to the patient’s condition. Although most studies were qualitative and did not formally analyse dyadic interdependence, co-occurrence across reports allowed identification of shared dyad-level concerns, including shared prognostic uncertainty, role renegotiation, system navigation burden, and existential adaptation. Mapping these issues supports a needs-based rationale for earlier and more structured integration of palliative care within routine chronic heart failure management.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528412","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}