JACC. Heart failure最新文献

{"title":"Heart-Lung Interactions in HFpEF","authors":"Michael G. Leahy PhD ,&nbsp;Denis J. Wakeham PhD ,&nbsp;James P. MacNamara MD ,&nbsp;Tiffany Brazile MD ,&nbsp;Abidan Abulimiti MD, PhD ,&nbsp;Christopher M. Hearon Jr. PhD ,&nbsp;Mitchel Samels MSc ,&nbsp;Andrew R. Tomlinson MD ,&nbsp;Bryce N. Balmain PhD ,&nbsp;Tony G. Babb PhD ,&nbsp;Benjamin D. Levine MD ,&nbsp;Satyam Sarma MD","doi":"10.1016/j.jchf.2025.102523","DOIUrl":"10.1016/j.jchf.2025.102523","url":null,"abstract":"<div><h3>Background</h3><div>Patients with heart failure with preserved ejection fraction (HFpEF) are characterized by an exaggerated rise in pulmonary capillary wedge pressure (PCWP) with exercise compared with healthy similar-aged adults. Due to the multisystemic effects of the disease, patients with HFpEF often experience expiratory flow limitation (EFL), thereby perpetuating dynamic hyperinflation (DH) and ventilation at a higher percentage of total lung volume. How lung mechanics and operational lung volume affect central hemodynamics in patients with HFpEF is not fully understood.</div></div><div><h3>Objectives</h3><div>The authors sought to characterize the association and correlation of DH and EFL on PCWP in adults with HFpEF during exercise.</div></div><div><h3>Methods</h3><div>A total of 55 patients with HFpEF (71 ± 7 years of age, 70% female) were studied at rest and during 20-W and peak exercise on an upright semirecumbent cycle ergometer. Right atrial and mean pulmonary artery (mPAP) pressures as well as PCWP (via right heart catheterization), oxygen uptake (indirect calorimetry), cardiac output (direct Fick), and ventilation (flow-volume parameters) were measured at each timepoint. DH was defined as an increase in end-expiratory lung volume of ≥150 mL from rest as determined by repeated inspiratory capacity maneuvers.</div></div><div><h3>Results</h3><div>PCWP was greater in those with DH at 20-W exercise (DH 24 ± 6 mm Hg vs typical 18 ± 6; <em>P =</em> 0.033) and peak exercise (DH 44 ± 9 vs typical 31 ± 6 mm Hg; <em>P =</em> 0.002). The degree of dynamic inflation was modestly, but significantly associated with a greater PCWP at 20-W (<em>r</em>² = 0.196; <em>P =</em> 0.001) and peak (<em>r</em>² = 0.204; <em>P &lt;</em> 0.001) exercise, as was mPAP (both <em>P &lt;</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Patients with HFpEF that dynamically hyperinflate during exercise have greater PCWP as measured with reference to atmospheric pressure. The severity of hyperinflation scaled proportionally to higher exercise PCWP. Our findings suggest that the augmented exercise PCWP in patients with HFpEF may not be entirely attributed to ventricular stiffness, but also a consequence of increased intrathoracic pressure from dysfunctional ventilatory mechanics. (Mechanisms of Exercise Intolerance in Heart Failure With Preserved Ejection Fraction; <span><span>NCT04068844</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102523"},"PeriodicalIF":10.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480313","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":"Patterns of Left Ventricular Regional Wall Motion Abnormalities After Brain Death and Their Clinical Significance","authors":"Alex J. Chang MD ,&nbsp;Brian J. Wayda MD ,&nbsp;Shiqi Zhang MS ,&nbsp;Yingjie Weng MHS ,&nbsp;Kiran K. Khush MD, MAS ,&nbsp;Jonathan G. Zaroff MD","doi":"10.1016/j.jchf.2025.102511","DOIUrl":"10.1016/j.jchf.2025.102511","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular dysfunction is common in potential heart donors after brain death, but specific regional wall motion abnormality (RWMA) patterns in this population have not been well described.</div></div><div><h3>Objectives</h3><div>This study aims to define and characterize RWMA patterns in potential heart donors after brain death by using a machine learning algorithm.</div></div><div><h3>Methods</h3><div>The Donor Heart Study enrolled 4,333 potential heart donors after brain death. All had a transthoracic echocardiogram (TTE) including RWMA assessment, with each segment analyzed for WMS (Wall Motion Score). Those with any RWMA (ie, any WMS &gt;1) were classified using <em>k</em>-means clustering, and each cluster’s associations with donor clinical characteristics, heart use, and recipient survival were assessed.</div></div><div><h3>Results</h3><div>The final analytical cohort included 913 initial TTEs. We identified 4 unique RWMA phenotypes: focal basal septal (FBS) (n = 500), basal and midventricular (n = 311), apical (n = 66), and global hypokinesis (n = 36). These phenotypes exhibited similar donor characteristics but differed in troponin, N-terminal pro–B-type natriuretic peptide levels (both lowest in FBS), and left ventricular ejection fraction (LVEF) (highest in FBS). On subsequent TTEs (performed in 314 donors with any RWMA), all phenotypes demonstrated significant improvement in LVEF. The FBS phenotype had the highest donor heart acceptance for transplantation (68%). Of the hearts accepted for transplantation, there were no significant differences by RWMA phenotype in recipient survival.</div></div><div><h3>Conclusions</h3><div>Left ventricular dysfunction after brain death exhibits distinct RWMA phenotypes, which differ in terms of selected biomarkers and LVEF, but not in recipient survival of the hearts accepted for transplantation.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102511"},"PeriodicalIF":10.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480311","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":"Escaping Injury From Elevated Aldosterone","authors":"Orly Vardeny PharmD, MS ,&nbsp;Anand Vaidya MD, MMS","doi":"10.1016/j.jchf.2025.102519","DOIUrl":"10.1016/j.jchf.2025.102519","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102519"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480315","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":"Pressure From Within and Without in Heart Failure With Preserved Ejection Fraction","authors":"Barry A. Borlaug MD ,&nbsp;Ryan J. Tedford MD","doi":"10.1016/j.jchf.2025.102516","DOIUrl":"10.1016/j.jchf.2025.102516","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102516"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480314","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":"Diabetes Therapy With SGLT2i After Heart Transplant","authors":"Lina Brinker MD ,&nbsp;Konstantinos Sideris MD ,&nbsp;Guo Wei MS ,&nbsp;Ravinder Singh MS ,&nbsp;McKenna R. Nevers MPH ,&nbsp;Sydney E. Hartsell MD, MPH ,&nbsp;Amara Sarwal MD, MSCI ,&nbsp;Christos P. Kyriakopoulos MD ,&nbsp;Eleni Tseliou MD, PhD ,&nbsp;Jan Benes MD ,&nbsp;Vojtech Melenovsky MD, PhD ,&nbsp;Stavros G. Drakos MD, PhD ,&nbsp;Thomas C. Hanff MD, MSCE ,&nbsp;Spencer Carter MD ,&nbsp;James C. Fang MD ,&nbsp;Monique Cho MD ,&nbsp;Srinivasan Beddhu MD ,&nbsp;Josef Stehlik MD, MPH","doi":"10.1016/j.jchf.2025.102520","DOIUrl":"10.1016/j.jchf.2025.102520","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102520"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480312","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":"Late Cardiac Allograft Failure","authors":"Divya K. Velury MD,&nbsp;Indranee Rajapreyar MD,&nbsp;Marvin A. Konstam MD","doi":"10.1016/j.jchf.2025.102517","DOIUrl":"10.1016/j.jchf.2025.102517","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102517"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480316","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":"Global Burden and Disparities in Pediatric Heart Failure","authors":"Yuxing Yuan MD ,&nbsp;Chenyang Li MM ,&nbsp;Shiyi Lei MM ,&nbsp;Asad Nawaz MM ,&nbsp;Jiajin Li MD ,&nbsp;Muhammad Junaid Akram MD ,&nbsp;Lingjuan Liu MD ,&nbsp;Huichao Sun MD ,&nbsp;Bo Pan MD ,&nbsp;Tiewei Lv MD ,&nbsp;Xiaohua Liang MD ,&nbsp;Jie Tian MD","doi":"10.1016/j.jchf.2025.03.032","DOIUrl":"10.1016/j.jchf.2025.03.032","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) is a major global health threat; however, the disease burden of pediatric heart failure (PHF) remains poorly understood.</div></div><div><h3>Objectives</h3><div>This study aimed to comprehensively assess the global burden of PHF using the GBD (Global Burden of Disease) 2021 study.</div></div><div><h3>Methods</h3><div>Data for PHF (0-20 years) were analyzed to estimate the prevalence, years lived with disability, and estimated annual percentage changes, stratified by age, gender, region, country, and sociodemographic index.</div></div><div><h3>Results</h3><div>In 2021, the global prevalence of PHF was 6.01 million cases (rate: 228 per 100,000). The prevalence rate increased by 8.78% from 1990 to 2021, with significant differences observed by gender, age, country and region. A positive correlation between sociodemographic index and PHF prevalence was observed (<em>P &lt;</em> 0.001). The leading causes of PHF were congenital heart anomalies, other cardiomyopathies, rheumatic heart disease, and chronic kidney disease, with varying trends over time. The increase in years lived with disability mirrored the change in prevalence, forecasting a consistent upward trend in the disease burden of PHF by 2050.</div></div><div><h3>Conclusions</h3><div>This study underscores the growing burden of PHF and the urgent need for targeted interventions to alleviate its impact. It highlights the importance of addressing geographical disparities and factors such as gender, age, and underlying causes. To mitigate the impact of PHF on children's health, there is a need to draw lessons from successful regions, promote focused clinical and mechanistic research, and develop more effective prevention and treatment strategies.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102484"},"PeriodicalIF":10.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144469880","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":"MRAs, SGLT2 Inhibitors, and Kidney Outcomes in CKD and HF","authors":"Luís Mendonça MD ,&nbsp;João Sérgio Neves MD, PhD ,&nbsp;Jeffrey Testani MD ,&nbsp;Faiez Zannad MD, PhD ,&nbsp;João Pedro Ferreira MD, PhD","doi":"10.1016/j.jchf.2025.102514","DOIUrl":"10.1016/j.jchf.2025.102514","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102514"},"PeriodicalIF":10.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337474","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":"Noninvasive Pulmonary Capillary Wedge Pressure Estimation in Heart Failure Patients With the Use of Wearable Sensing and AI","authors":"Liviu Klein MD, MS ,&nbsp;Marat Fudim MD, MHS ,&nbsp;Mozziyar Etemadi MD, PhD ,&nbsp;Robert Gordon MD ,&nbsp;Anjan Tibrewala MD ,&nbsp;Jaime Hernandez-Montfort MD, MPH, MSc ,&nbsp;Patrick McCann MD ,&nbsp;Lucas Zier MD ,&nbsp;Kevin Shah MD ,&nbsp;Allman Rollins MD ,&nbsp;Darshak Karia MD ,&nbsp;Arshed Quyyumi MD ,&nbsp;Shweta R. Motiwala MD, MPH ,&nbsp;Nikolaos Diakos MD, PhD ,&nbsp;John Rommel MD ,&nbsp;Andrew P. Ambrosy MD ,&nbsp;Venu G. Ganti PhD ,&nbsp;Priyanka Soni MS ,&nbsp;Karen Larimer PhD, ACNP-BC ,&nbsp;Andrew M. Carek PhD ,&nbsp;Omer T. Inan PhD","doi":"10.1016/j.jchf.2025.102513","DOIUrl":"10.1016/j.jchf.2025.102513","url":null,"abstract":"<div><h3>Background</h3><div>Remote hemodynamics-guided management of heart failure (HF) with implantable pulmonary artery pressure sensors has been shown to reduce HF hospitalizations. The widespread clinical adoption of this procedure is constrained by its invasive nature and high cost. We present a noninvasive technology based on a wearable sensor (CardioTag; Cardiosense) and machine learning (ML) for estimating pulmonary capillary wedge pressure (PCWP) in patients with heart failure with reduced ejection fraction (HFrEF).</div></div><div><h3>Objectives</h3><div>The authors developed and evaluated (against right heart catheterization [RHC]) an ML model to estimate PCWP with the use of electrocardiography, seismocardiography, and photoplethysmography signals from CardioTag.</div></div><div><h3>Methods</h3><div>A multicenter prospective study was performed, and 310 patients with HFrEF (EF ≤40%) were recruited in both inpatient and outpatient settings. A blinded core laboratory adjudicated the RHC PCWP tracings to yield criterion-standard PCWP labels against which the model was trained and tested. The data were separated into 2 sets: a training set for model training and fine-tuning, and a held-out testing set unseen until final evaluation.</div></div><div><h3>Results</h3><div>The patients were 61± 13 years of age, 38% female, 44% White, and 39% African American, and had a PCWP of 18.1 ± 9.45 mm Hg. The model estimated PCWP values in the held-out test set with error of 1.04 ± 5.57 mm Hg (limits of agreement of −9.9 to 11.9 mm Hg), with consistent performance across sex, race, ethnicity, and body mass index.</div></div><div><h3>Conclusions</h3><div>The CardioTag and its ML algorithm estimate PCWP with accuracy approaching implantable hemodynamic sensors, potentially offering a more accessible and cost-effective option for hemodynamics-guided management in HFrEF patients.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102513"},"PeriodicalIF":10.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337489","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":"Unraveling the Adiposity-Heart Failure-Kidney Nexus","authors":"Janani Rangaswami MD ,&nbsp;Dirk J. van Veldhuisen MD, PhD","doi":"10.1016/j.jchf.2025.102518","DOIUrl":"10.1016/j.jchf.2025.102518","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 8","pages":"Article 102518"},"PeriodicalIF":10.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314256","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}