Heart Failure Reviews最新文献

{"title":"Heart failure evidence update 2026.","authors":"Sotiria Liori, Chris J Kapelios, Gianluigi Savarese, Gerasimos Filippatos","doi":"10.1007/s10741-026-10609-3","DOIUrl":"10.1007/s10741-026-10609-3","url":null,"abstract":"<p><p>The interval since the 2021 European Society of Cardiology (ESC) Guidelines and 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America (AHA/ACC/HFSA) Guidelines publications has witnessed an unprecedented volume of evidence that substantially expands the therapeutic landscape across the entire ejection fraction (EF) spectrum. Major developments include the emergence of non-steroidal mineralocorticoid receptor antagonists and incretin-based therapies for heart failure (HF) with mildly reduced and preserved EF, the validation of rapid guideline-directed medical therapy optimization strategies in acute HF, and new evidence supporting digitalis glycosides in HF patients with reduced EF. Device-based care has evolved with transcatheter edge-to-edge repair for valvular heart disease. These data are likely to reshape contemporary clinical practice.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432586","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":"Dapagliflozin effect on pericardial fat deposition: lessons from the DAPA EAT.","authors":"Alberto Palazzuoli, Kaveh Hossein, Parham Dastjerdi, Kimia Najafi, Irene Carlino, Kalliopi Keramida","doi":"10.1007/s10741-026-10607-5","DOIUrl":"10.1007/s10741-026-10607-5","url":null,"abstract":"<p><p>Epicardial adipose tissue (EAT) is increasingly recognized as an active cardio-metabolic organ that contributes to early myocardial dysfunction through inflammatory, oxidative, and fibrotic pathways. In heart failure (HF), expanded EAT has been associated with higher risks of HF hospitalization and mortality, and several cohort studies and meta-analyses now support EAT as an independent prognostic marker with incremental value beyond conventional clinical parameters. Importantly, EAT is modifiable: glucagon-like peptide-1 receptor agonists, thiazolidinediones, and more recently sodium–glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated reductions in EAT, with dapagliflozin showing consistent effects across patients with type 2 diabetes, coronary artery disease, and HF.Against this background, the DAPA-EAT trial examined the impact of dapagliflozin on EAT in individuals with subclinical stage B HF. This multicenter, randomized, study enrolled 229 adults with asymptomatic structural HF and randomized them to dapagliflozin or standard therapy for 24 weeks, with blinded evaluation of cardiac CT and echocardiographic endpoints. Dapagliflozin produced significant reductions in EAT volume, myocardial fibrosis, and left-ventricular mass, together with modest improvements in diastolic indices, without significant change in NT-proBNP or hs-CRP.The study’s strengths include its randomized design, blinded image analysis, and comprehensive structural assessment. Although participants were classified as stage B HF, they represented a clinically high-risk cohort - older individuals with a predominance of ischemic disease and multiple cardiometabolic comorbidities. Several limitations warrant consideration, including the relatively short duration, modest sample size, and the reliance on CT and echocardiography rather than cardiac MRI for tissue characterization. Additionally, the lack of phenotype-specific analyses (HFrEF vs. HFmrEF vs. HFpEF) prevents phenotype-specific insight into how dapagliflozin affects remodeling. Despite these constraints, DAPA-EAT indicates that dapagliflozin is associated with reductions in EAT and selected early structural indices, although the clinical relevance of these changes remains to be fully established.Words counts: 293.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432554","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 amyloid depletion therapy: lessons from the phase 2 trial of coramitug.","authors":"Alexander H Gunn, Maira Haque, Michel G Khouri, Senthil Selvaraj","doi":"10.1007/s10741-026-10598-3","DOIUrl":"10.1007/s10741-026-10598-3","url":null,"abstract":"<p><p>This focused review contextualizes the results of the phase 2 randomized clinical trial of the monoclonal antibody coramitug (formerly PRX004 and NNC6019) in transthyretin amyloid cardiomyopathy (ATTR-CM). Coramitug, a humanized monoclonal antibody directed against misfolded transthyretin, represents a novel amyloid-depleting approach aimed at promoting phagocytic clearance of fibrillar deposits. In the phase 2 trial enrolling 105 patients with ATTR-CM, treatment with 60 mg/kg coramitug significantly reduced N-terminal pro-B-type natriuretic peptide levels at 52 weeks compared with placebo, though no change was observed in the co-primary endpoint of six-minute walk distance or secondary endpoints. Coramitug was generally well tolerated. These results support continued evaluation in a larger phase 3 trial to determine its clinical efficacy and effect on myocardial function.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389916","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":"Intensive blood pressure control in heart failure with preserved ejection fraction: a symptom-modifying strategy.","authors":"Muhammad Sameer Arshad, Muhammad Saad, Philipp Lurz, Karl-Philipp Rommel, Muhammad Shahzeb Khan, Sripal Bangalore, Herbert D Aronow, Rajesh V Swaminathan, Jorge Antonio Gutierrez, Marat Fudim","doi":"10.1007/s10741-026-10600-y","DOIUrl":"10.1007/s10741-026-10600-y","url":null,"abstract":"<p><p>Patients with heart failure with preserved ejection fraction (HFpEF) account for over half of heart failure (HF) cases globally and the presence of HFpEF is closely linked with systemic hypertension, which contributes to the structural, hemodynamic, and symptomatic burden of the disease. HFpEF is a heterogeneous syndrome in which concentric remodeling/hypertrophy and diastolic dysfunction commonly arise from chronic pressure overload (often hypertension) and/or age-related arterial stiffening, metabolic comorbidity, and other myocardial substrates. This review critically examines the rationale for intensive blood pressure (BP) management in HF, particularly HFpEF, emphasizing its dual role in disease prevention and symptom alleviation. Drawing from landmark trials and mechanistic studies, the review demonstrates how acute and sustained BP reductions can improve hemodynamic profiles, reverse remodeling, and enhance functional capacity. It further explores the pathophysiologic underpinnings of hypertensive HFpEF, including left ventricular remodeling, arterial stiffness, pulmonary hypertension, right ventricular dysfunction, and metabolic-renal comorbidities; all of which amplify symptomatic burden. In addition, this review evaluates pharmacologic agents with antihypertensive and HF benefits, such as mineralocorticoid receptor antagonists (MRAs), angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARBs), and sodium–glucose cotransporter 2 inhibitors (SGLT2i). It also presents emerging evidence for renal denervation (RDN) as a novel adjunctive therapy, particularly in patients with resistant hypertension or autonomic imbalance. Preclinical and early clinical findings suggest that RDN may reduce sympathetic overactivity, enhance arterial compliance, and promote reverse cardiac remodeling in HFpEF. Ultimately, this review highlights BP modulation as a modifiable target capable of altering the trajectory of HFpEF, advocating for earlier and more intensive intervention strategies to improve both clinical and patient-reported outcomes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389895","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":"Comparative efficacy of mineralocorticoid receptor antagonists in prevention of adverse cardiovascular events: a network meta-analysis.","authors":"Morvarid Taebi, Parisa Fallahtafti, Nasim Kakavand, Soroush Nematollahi, Yasaman Daryabari, Tor Biering-Sørensen, Kaveh Hosseini","doi":"10.1007/s10741-026-10594-7","DOIUrl":"10.1007/s10741-026-10594-7","url":null,"abstract":"<p><p>Mineralocorticoid receptor antagonists (MRAs) potentially reduce adverse cardiovascular events by modulating proinflammatory signaling pathways. However, their efficacy varies across agents and clinical populations. We compared the efficacy of different MRAs in reducing composite adverse cardiovascular events. We systematically searched MEDLINE, Embase, Web of Science, and the Cochrane Central up to 13 May 2025 for randomized controlled trials (RCTs) or cohort studies reporting hazard ratios (HRs) for composite adverse cardiovascular events comparing MRAs with placebo, another MRA, or non-MRA users. A frequentist random-effects network meta-analysis with P-score rankings was conducted, including subgroup analyses by clinical condition. Twenty-five study analyses (from 16 RCTs and 6 observational cohorts; 54,964 patients; mean age 66.1 ± 10.7 years; 65.1% male) with 4–44 months follow-up were included. All MRAs were effective in preventing composite adverse cardiovascular events. Eplerenone was most effective compared to control (HR: 0.75; 95% CI: 0.64–0.88), with consistent effects in subgroups with chronic kidney disease (HR: 0.62) and diabetes mellitus (HR: 0.54). Spironolactone was most effective in patients with heart failure (HF, HR: 0.70), HF with reduced ejection fraction (HR: 0.66), HF with preserved ejection fraction (HR: 0.73), and without HF (HR: 0.40). Head-to-head comparisons indicated eplerenone’s superiority over finerenone in the overall population and finerenone’s inferiority in non-HF patients. Sensitivity analyses yielded consistent results, except for HFpEF, where finerenone showed greatest efficacy. MRAs reduce composite adverse cardiovascular events across populations. Eplerenone and spironolactone appear most effective, while finerenone offers comparable benefits in select contexts, warranting future direct head-to-head trials to optimize agent selection.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365060","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 spongy heart paradox: balancing bleeding and clotting risk in left ventricular noncompaction cardiomyopathy.","authors":"Tagbo Charles Nduka, Andrew Ndakotsu, Kuseme Udoh, Afamefuna Obumneme Onyeogulu, Fab-Emerenini Eziokwu Bright, Elijah Oluwasegun Adetunji, Abdulkareem Opeoluwa Lukan, Esosa Odigie-Okon","doi":"10.1007/s10741-026-10602-w","DOIUrl":"10.1007/s10741-026-10602-w","url":null,"abstract":"<p><p>Left ventricular noncompaction cardiomyopathy (LVNC) is an increasingly recognized cardiomyopathy with distinctive structural features and a disproportionate risk of systemic thromboembolism. The clinical dilemma of anticoagulation is pressing: while impaired systolic function and deep trabecular recesses predispose to thrombus formation, anticoagulation simultaneously increases bleeding risk, particularly in older patients with multiple comorbidities. Conventional risk scores such as CHA₂DS₂-VASc and HAS-BLED were derived from atrial fibrillation populations and remain unvalidated in LVNC, limiting their clinical applicability. Advanced imaging modalities, particularly cardiac magnetic resonance imaging (cMRI), provide incremental value by quantifying trabeculation, identifying thrombus, and characterizing fibrosis; however, their integration into risk algorithms is inconsistent. This review synthesizes available evidence, highlights the limitations of current approaches, and emphasizes the need for individualized, dynamic assessment of both thromboembolic and bleeding risks. Future priorities include the development of LVNC-specific risk prediction models, the establishment of prospective multicenter registries, and the incorporation of imaging and biomarker data into precision anticoagulation strategies to guide therapy in this rare but high-risk population.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354706","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 70 year Odyssey of exercise training based cardiac rehabilitation with respect to medical innovations in heart failure.","authors":"Ioannis D Laoutaris, Athanasios Dritsas, Dimitris Miliopoulos, Stamatis Adamopoulos","doi":"10.1007/s10741-026-10608-4","DOIUrl":"10.1007/s10741-026-10608-4","url":null,"abstract":"<p><p>Exercise training (ET) based cardiac rehabilitation (ExCR) is considered as a ‘pillar’ of heart failure (HF) management, alongside drug and medical device treatment improving health related quality of life and reducing hospitalizations. However, it is reported that the large beneficial effects of optimal medical therapy (OMT) and device therapy may have reduced the potency of ExCR in patients with HF and reduced ejection fraction (HFrEF), associated with a non-clear benefit in mortality, as well as, with modest changes in aerobic capacity, at least compared to the pre-OMT era. The present review explores a ‘hypothesis of an OMT associated attenuation of ET effectiveness’. It investigates the evolvement and potency of ExCR during the last 70 years with respect to medical innovations in patients with HFrEF and focuses on the three largest multicenter ET randomized controlled trials, HF-ACTION, SMARTEX-HF, ARISTOS-HF, investigating ‘breakthrough’ interventions such as moderate continuous aerobic training, high intensity interval training and aerobic/resistance/inspiratory training outcomes, respectively. It is suggested that ET delivery using ‘poly-muscle training’ and a ‘high ET dosage’ may improve the effectiveness of ET programs in the era of OMT, although further confirmation is required.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343985","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: Hyperkalemia in heart failure with reduced ejection fraction: implications and management.","authors":"Craig J Beavers, Stephen J Greene","doi":"10.1007/s10741-026-10597-4","DOIUrl":"10.1007/s10741-026-10597-4","url":null,"abstract":"","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289922","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":"Atrial fibrillation and heart failure.","authors":"Pramod Kumar, Sivadasanpillai Harikrishnan","doi":"10.1007/s10741-026-10599-2","DOIUrl":"10.1007/s10741-026-10599-2","url":null,"abstract":"<p><p>Atrial fibrillation and heart failure frequently coexist and interact through shared pathophysiological mechanisms, each condition promoting the onset and progression of the other. This bidirectional relationship is mediated by structural and electrical remodelling, neurohormonal activation, and atrial myocardial disease, resulting in worse clinical outcomes compared with either condition alone. Advances in heart failure–directed medical therapy, rhythm-control strategies—particularly catheter ablation—and device-based monitoring have reshaped contemporary management, while recent trials have challenged traditional approaches to anticoagulation in patients with subclinical atrial arrhythmias. This review synthesizes current evidence on the mechanisms linking atrial fibrillation and heart failure, discusses evolving therapeutic strategies including early rhythm control and device-detected atrial high-rate episodes, and highlights areas of uncertainty and future research. An integrated, patient-centered approach addressing both arrhythmia burden and heart failure substrate is essential to improving outcomes in this complex and growing population.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147305112","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":"Artificial intelligence and digital health in heart failure: advances in diagnosis, monitoring, phenotyping, and digital biomarkers.","authors":"George Perlman, Janie Leroux, Carlos Octavio Pérez Mendoza, Abhinav Sharma","doi":"10.1007/s10741-026-10596-5","DOIUrl":"10.1007/s10741-026-10596-5","url":null,"abstract":"<p><p>Heart failure (HF) is an increasingly pressing public health concern, with projections suggesting its age-standardized prevalence will increase in coming decades. To accommodate the increasing burden that will be placed on patients and healthcare systems, applications of digital health technologies including artificial intelligence (AI) may improve aspects of HF care and monitoring. However, adoption of digital health solutions into HF clinical practice has been modest to date due to limited evidence of efficacy as well as technical, clinical implementation, and regulatory barriers. In this review, we discuss the state of the art in digital health technologies for HF, including applications of AI for medical image acquisition and processing, monitoring tools including remote patient management platforms and wearable devices, and phenotyping patients using actigraphy-enabled wearables. We further highlight potential solutions for barriers to the uptake of novel technologies and development of digital biomarkers in HF care and research. Together, this review underscores the potential for digital health and AI tools to improve HF outcomes and prepares stakeholders to implement these technologies effectively.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":"31 1","pages":"25"},"PeriodicalIF":5.3,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226652","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}