JAMA cardiology最新文献

{"title":"Finerenone in Heart Failure With Improved Ejection Fraction: The FINEARTS-HF Randomized Clinical Trial.","authors":"Maria A Pabon,Orly Vardeny,Muthiah Vaduganathan,Akshay S Desai,Brian L Claggett,Ian J Kulac,Pardeep S Jhund,Carolyn S P Lam,Michele Senni,Sanjiv J Shah,Adriaan A Voors,Faiez Zannad,Bertram Pitt,Clara I Saldarriaga,Mark C Petrie,Béla Merkely,Maria Borentain,Katharina Mueller,Prabhakar Viswanathan,Flaviana Amarante,Alanna Morris,John J V McMurray,Scott D Solomon","doi":"10.1001/jamacardio.2025.1101","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1101","url":null,"abstract":"ImportancePatients with chronic heart failure (HF) and left ventricular ejection fraction (LVEF) less than 40% who experience LVEF improvement to 40% or higher (HFimpEF) may still face residual risks.ObjectiveTo assess the clinical profiles, risk, and treatment response to finerenone in participants with HFimpEF.Design, Setting, and ParticipantsA total of 6001 patients with HE, LVEF of 40% or higher, New York Heart Association class II to IV symptoms, and elevated natriuretic peptide levels, were enrolled between September 14, 2020, and January 10, 2023. Patients with a prior history of LVEF less than 40% were included. Data analysis was conducted between September 1 to December 10, 2024.InterventionParticipants received finerenone (titrated to 20 mg or 40 mg) or placebo.Main Outcomes and MeasuresThe primary end point was the composite of cardiovascular (CV) death and total (first and recurrent) worsening HF events.ResultsOf the 6001 participants (mean [SD] age, 72 [9.7], years; 3269 male [55%]), 273 (5%) had a prior LVEF less than 40%. Among those with a prior LVEF of less than 40%, the median recorded prior LVEF was 35% [IQR, 30%-37%], with a median improvement of 12% [IQR, 8%-17%]. Over a median follow-up of 2.6 years, those with a history of LVEF of less than 40% experienced higher rates of the primary outcome of a composite of CV death and worsening of HF events (21.4 per 100 patient-years vs 16.0 per 100 patient-years) than did those whose LVEF was consistently 40% or higher. After adjustment for clinically relevant covariates; however, this rate ratio (RR) was not statistically different (absolute RR, 1.13; 95% CI, 0.85-1.49, P = .39). The treatment effect of finerenone on the primary outcome was consistent among those with a history of LVEF less than 40% and those with LVEF that was consistently 40% or higher (P for interaction = .36). Owing to higher baseline risk, the absolute risk reduction was greater among those with HFimpEF (9.2 vs 2.5 per 100 patient-years). Patients with HFimpEF tended to develop more hypotension with finerenone treatment, but otherwise, the safety profile of finerenone was similar in patients with and without previous LVEF less than 40%.Conclusions and RelevanceIn this prespecified analysis of a randomized clinical trial, patients with HFimpEF remained at high risk of CV events, underscoring the need for continued management despite LVEF improvement. The treatment benefits of finerenone observed among the overall population of patients with HF with preserved EF were consistent among patients with HFimpEF.Trial RegistrationClinicalTrials.gov Identifier: NCT04435626.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"31 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Noncompaction Cardiomyopathy","authors":"Muhammad Adnan Zaman, Sidra Kalsoom, Lou Mastrine","doi":"10.1001/jamacardio.2025.1368","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1368","url":null,"abstract":"This case report describes an echocardiography-based diagnosis of left ventricular noncompaction cardiomyopathy in a male patient in his 40s who presented with sudden-onset dyspnea.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"19 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144104687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Limitations and Risks Associated With Semaglutide Treatment.","authors":"Vanita Rahman","doi":"10.1001/jamacardio.2025.1095","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1095","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"96 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Limitations and Risks Associated With Semaglutide Treatment-Reply.","authors":"Ivy Shi,Sadiya S Khan,Dhruv S Kazi","doi":"10.1001/jamacardio.2025.1098","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1098","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"33 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimbursement for AI-Balancing Innovation, Adoption, and the Medicare Trust Fund.","authors":"Lee A Fleisher","doi":"10.1001/jamacardio.2025.1016","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1016","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"9 Suppl 2 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Childhood Food Insecurity and Cardiovascular Health in Young Adulthood.","authors":"Emily L Lam,Abigail M Gauen,Namratha R Kandula,Daniel A Notterman,Noreen Goldman,Donald M Lloyd-Jones,Norrina B Allen,Nilay S Shah","doi":"10.1001/jamacardio.2025.1062","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1062","url":null,"abstract":"ImportanceFood insecurity is a social risk factor that may be associated with cardiovascular health across the life course.ObjectiveTo evaluate the association of food insecurity in early childhood with cardiovascular health (CVH) in young adulthood and whether associations are modified by participation during childhood in the Supplemental Nutrition Assistance Program (SNAP).Design, Setting, and ParticipantsThe Future of Families-Cardiovascular Health Among Young Adults cohort study was conducted in 20 US cities among 1071 individuals enrolled at birth (February 1998 to September 2000), evaluated in childhood (age, 3-5 years), and followed up to young adulthood (September 2021 to September 2023; mean [SD] participant age, 22.3 [0.7] years).Main Outcomes and MeasuresHousehold food insecurity (assessed by the US Department of Agriculture Food Insecurity survey) and SNAP participation at ages 3 to 5 years and CVH (assessed by the American Heart Association Life's Essential 8 [LE8] score, component LE8 scores, and clinical CVH risk factors).ResultsOf the 1071 participants, 570 were female (53%), 422 (39%) lived in households with food insecurity, and 475 (44%) participated in SNAP. Early childhood food insecurity was associated with having a lower LE8 score in young adulthood (β, -2.2 [95% CI, -4.0 to -0.4]). Among component LE8 scores and clinical CVH risk factors, food insecurity was associated with a lower LE8 score for body mass index (BMI; β, -4.9 [95% CI, -9.6 to -0.3]) and higher odds of having a BMI of 30 or more (adjusted odds ratio, 1.40 [95% CI, 1.07-1.84]). Food insecurity was more strongly associated with a lower LE8 score among those whose households did not participate in SNAP (β, -4.9 [95% CI, -7.6 to -2.3]) compared with those whose households participated in SNAP (β, 1.0 [95% CI, -1.6 to 3.7]).Conclusions and SignificanceThis study suggests that early childhood food insecurity is associated with a higher BMI in young adulthood, which is associated with a worse overall LE8 score, especially among children whose families did not participate in SNAP. Policies to promote food security among children may promote healthy BMIs and better CVH across the life course.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"96 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimbursement Transformation Is Essential for Digital Health Adoption in Cardiovascular Care.","authors":"John Connolly,Seth S Martin,Karen E Joynt Maddox,Thomas M Maddox","doi":"10.1001/jamacardio.2025.1013","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1013","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"17 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment of Hypertrophic Cardiomyopathy in Ukraine During War.","authors":"Barry J Maron,Ethan J Rowin,Martin S Maron","doi":"10.1001/jamacardio.2025.1142","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1142","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"95 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and Translational Study of Calprotectin and Atherosclerotic Cardiovascular Disease.","authors":"Yu Zuo,Somanathapura K NaveenKumar,Sherwin Navaz,Wenying Liang,Kavya Sugur,Katarina Kmetova,Colby R Ayers,Lyndsay Kluge,Emily Chong,Amil M Shah,Anand Rohatgi,Jarett D Berry,Jason S Knight,James A de Lemos","doi":"10.1001/jamacardio.2025.0945","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.0945","url":null,"abstract":"ImportanceInnate immunity, particularly neutrophil activation, plays a crucial role in the pathogenesis of atherosclerotic cardiovascular disease (ASCVD). The potential of calprotectin, a biomarker of neutrophil activation, as a mechanistically informed biomarker for ASCVD in an ethnically diverse population requires further investigation.ObjectiveTo examine the prospective association between circulating calprotectin and ASCVD in a diverse, population-based cohort while also exploring calprotectin's mechanistic contributions to ASCVD in vitro.Design, Setting, and ParticipantsCirculating calprotectin was measured in plasma collected from 2412 participants during phase 2 of the Dallas Heart Study, a multiethnic, population-based cohort study. The median follow-up after plasma collection was 8 years.Main Outcomes and MeasuresAssociations with future ASCVD events (defined as first nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or death from a cardiovascular cause) were assessed using Cox proportional hazards models, adjusted for known cardiovascular disease risk factors as well as high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and high-sensitivity cardiac troponin T (hs-cTnT).ResultsHigher calprotectin levels were associated with older age, male sex, Black race, hypertension, diabetes, and smoking history. Individuals with higher calprotectin had higher hemoglobin A1c, very low-density lipoprotein cholesterol, and triglycerides, and lower high-density lipoprotein cholesterol and cholesterol efflux capacity. Log-transformed calprotectin levels were associated with an increased risk of ASCVD events over 8 years (hazard ratio [HR], 1.98 per log increase [95% CI, 1.54-2.53]). This association remained statistically significant after adjusting for prior ASCVD and traditional risk factors (HR, 1.61 [95% CI, 1.22-2.13]) and hs-CRP, NT-proBNP, and hs-cTnT (HR, 1.43 [95% CI, 1.04-1.96]). Higher calprotectin also correlated with higher coronary artery calcium scores (P < .001). In vitro studies revealed that calprotectin impaired coronary endothelial integrity, diminished nitric oxide production, and fostered endothelial to mesenchymal transition, providing potential mechanisms for ASCVD progression.Conclusions and RelevanceThe findings suggest that calprotectin may serve as a mechanistically informed biomarker for ASCVD, independent of traditional and contemporary cardiovascular risk factors and biomarkers. However, its clinical utility warrants further evaluation.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"15 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest Tube-Induced Right Ventricular Failure After Cardiac Surgery.","authors":"Stefan R van Dinter,Wilson W L Li,Nabil Saouti","doi":"10.1001/jamacardio.2025.0924","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.0924","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"47 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}