JACC. Heart failure最新文献

{"title":"Association of Extracoronary Calcification and Incident Heart Failure in the Multiethnic Study of Atherosclerosis (MESA).","authors":"Sandeep Brar, Rahul Goli, Joshua P Barrios, Michael J Blaha, Sina Kianoush, Mark J Pletcher, Sarah O Nomura, Michael Y Tsai, Rong Duan, Matthew J Budoff, Moyses Szklo, Geoffrey H Tison","doi":"10.1016/j.jchf.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.12.007","url":null,"abstract":"<p><strong>Background: </strong>Extracoronary calcification (ECC) is a prevalent cardiovascular risk factor.</p><p><strong>Objectives: </strong>The aim of this study was to examine the association between ECC and heart failure (HF), including heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Methods: </strong>MESA (Multi-Ethnic Study of Atherosclerosis) participants with computed tomographic imaging at baseline for calcification of the aortic valve, aortic root, mitral valve, and thoracic aorta were included. ECC score was calculated by rescaling Agatston scores from 0 to 1 for each ECC site and summing the rescaled scores. Multivariable Cox proportional hazards regression was performed to examine the association between ECC quartiles and incident HF.</p><p><strong>Results: </strong>Of all MESA participants, 3,617 (53.1%) and 3,192 (46.9%) had ECC scores of 0 and >0, respectively. During a mean follow-up period of 12.9 ± 4.2 years, 358 HF events were observed, 179 HF with reduced ejection fraction and 135 HFpEF. After controlling for demographics and risk factors, the highest ECC quartile (compared with the lowest quartile) had 1.7-fold greater hazard of incident HF (adjusted HR: 1.72 [95% CI: 1.16-2.55]; P = 0.007), though this was attenuated to borderline significance after additional adjustment for coronary artery calcification. In contrast for HFpEF, the highest ECC quartile (compared with the lowest quartile) remained independently and statistically significantly associated with 3-fold greater hazard of incident HFpEF (adjusted HR: 3.09 [95% CI: 1.45-6.60]; P = 0.003) after full adjustment, including for coronary artery calcification.</p><p><strong>Conclusions: </strong>ECC is associated with increased risk for HF, in particular HFpEF. If this finding is confirmed in other studies, ECC could help improve traditional risk factor estimation and clinical risk assessments for HF and HFpEF.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719398","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":"Where Are All the Heart Failure GDMT Clinics?: A Call to Action.","authors":"Robert L Page, Prateeti Khazanie","doi":"10.1016/j.jchf.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.01.010","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673412","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":"Stroke in Heart Failure With Reduced Ejection Fraction: Systematic Review and Meta-Analysis of Randomized Trials.","authors":"Guglielmo Gallone, Federica Savoca, Davide Miccoli, Michael Böhm, Gaetano Maria De Ferrari, Stephen S Gottlieb, Patrizio Lancellotti, JoAnn Lindenfeld, Clara Saldarriaga, Zainab Samad, John R Teerlink, Gianluigi Savarese, Enrico Ammirati","doi":"10.1016/j.jchf.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.12.008","url":null,"abstract":"<p><strong>Background: </strong>Patients with heart failure with reduced ejection fraction (HFrEF) have a heightened stroke risk. However, stroke as an endpoint in heart failure trials remains under-reported.</p><p><strong>Objectives: </strong>The authors sought to define the incidence, characteristics, predictors, modifier treatments, and prognostic impact of stroke in patients with HFrEF who were enrolled in randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>The authors systematically reviewed MEDLINE for RCTs of pharmacologic and nonpharmacologic treatments in HFrEF. The annualized stroke incidence was the primary outcome. Subgroup analyses and meta-regressions were performed to determine the baseline modulating characteristics and to assess the association of stroke with other clinical outcomes.</p><p><strong>Results: </strong>Of 7,104 records, 188 RCTs fulfilled inclusion criteria for the systematic review. Of these, 158 studies (84.0%) did not report stroke outcomes and were excluded from the meta-analysis, leading to a final cohort of 30 studies, with 61 arms and 75,327 patients. Stroke incidence was 1.1% (95% CI: 0.9%-1.3%; I²: 74%) with high heterogeneity across trials. Higher NYHA functional class (P < 0.001), lower systolic blood pressure (P < 0.001), diuretic use (P = 0.001), and diabetes (P < 0.001) were associated with stroke. No association of renin-angiotensin-aldosterone inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and transcatheter mitral valve replacement with stroke was observed. Stroke was associated with higher risk of all-cause and cardiovascular mortality, heart failure hospitalization and acute coronary syndromes (P < 0.001 for all).</p><p><strong>Conclusions: </strong>Stroke was reported in a vast minority of HFrEF RCTs with heterogeneous definitions and no reference to underlying mechanisms. Despite under-reporting, stroke incidence is non-negligible. Stroke is associated with HFrEF-specific characteristics and outcomes, whereas it is not impacted by current HFrEF treatments. There is a need for dedicated research into preventive strategies and effective treatments to address this debilitating and deadly comorbidity. (Stroke Events in Heart Failure With Reduced Ejection Fraction-A Systematic Review and Meta-Analysis of Pharmacologic Randomized Trial; CRD42023418422).</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633887","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":"Direct-to-Physician Marketing and Uptake of Optimal Medical Therapy for Heart Failure With Reduced Ejection Fraction.","authors":"Colette DeJong, Kosuke Inoue, Matthew S Durstenfeld, Anubha Agarwal, Justin C Chen, Chien-Wen Tseng, R Adams Dudley, Priscilla Y Hsue, Dhruv S Kazi","doi":"10.1016/j.jchf.2024.11.020","DOIUrl":"10.1016/j.jchf.2024.11.020","url":null,"abstract":"<p><strong>Background: </strong>Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction remains underused. The role of direct-to-physician marketing in accelerating uptake of GDMT is unknown.</p><p><strong>Objectives: </strong>The authors investigated the association between industry marketing meals and GDMT prescribing rates under Medicare Part D.</p><p><strong>Methods: </strong>The authors linked Medicare data sets to identify general and advanced heart failure (AHF) cardiologists' prescriptions for angiotensin receptor-neprilysin inhibitors (ARNIs), sodium-glucose cotransporter 2 inhibitors (SGLT2is), angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists (MRAs), and beta-blockers from 2019 to 2021. Using negative binomial regression analyses, they examined the association between marketing meals and prescribing rates of marketed and un-marketed classes of GDMT.</p><p><strong>Results: </strong>Of 11,277 general and 329 AHF cardiologists, 60% received marketing payments for ARNI and 50% for SGLT2i from 2019 to 2021. Among general cardiologists, but not AHF cardiologists, exposure to ARNI marketing meals in 2020 was associated with a greater prescribing volume of ARNI in 2021 (1-4 ARNI meals; relative ratio: 1.43 [95% CI: 1.34-1.53]; 5-9 ARNI meals; relative ratio: 1.69 [95% CI: 1.48-1.93]; ≥10 ARNI meals; relative ratio: 2.09 [95% CI: 1.80-2.43]). Findings were similar for SGLT2i. The association between marketing and prescribing of other pillars of GDMT was inconsistent across drug classes. Neither ARNI nor SGLT2i marketing was consistently associated with increased prescribing of MRAs.</p><p><strong>Conclusions: </strong>Industry marketing to general cardiologists is associated with increased uptake of ARNIs and SGLT2is, but not with increased uptake of all pillars of GDMT. Improvements in comprehensive therapy for heart failure will require other mechanisms to accelerate uptake of MRAs and beta-blockers, as well as ARNIs and SGLT2is once multiple generic formulations become available in the United States.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673222","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":"Exercise Training for Patients With Heart Failure: The Details Matter.","authors":"Gordon R Reeves, Dalane W Kitzman","doi":"10.1016/j.jchf.2024.11.019","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.11.019","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633768","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":"Vericiguat Adherence for Heart Failure With Reduced Ejection Fraction in Routine Clinical Care in the U.S.","authors":"Naira Ikram, Ankeet Bhatt, Muthiah Vaduganathan, Rishi J Desai","doi":"10.1016/j.jchf.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.01.013","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673354","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":"Standardizing Histopathological Evaluation of Resected Myocardium in Obstructive Hypertrophic Cardiomyopathy.","authors":"Ahmad Masri","doi":"10.1016/j.jchf.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.01.012","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673258","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 of Pulmonary Arterial Hypertension and Associated Heart Failure: Global Burden of Disease 2021 Analysis.","authors":"Haoquan Huang, Chuwen Hu, Rong Zhang, Hui Xu, Minghui Cao, Yanni Fu","doi":"10.1016/j.jchf.2024.12.005","DOIUrl":"10.1016/j.jchf.2024.12.005","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) and associated heart failure (HF) are emerging global health challenges.</p><p><strong>Objectives: </strong>This study aimed to analyze the global, regional, and national burden of PAH and PAH-related HF from 1990 to 2021 with the use of GBD (Global Burden of Disease) 2021 estimates, to observe temporal trends, and to predict future patterns through 2050.</p><p><strong>Methods: </strong>Data on prevalence, incidence, disability-adjusted life years (DALYs), and deaths were derived from GBD 2021. Joinpoint regression was adopted for analyzing trends and changes, decomposition analysis for quantifying impacts of age structure, population growth, and epidemiologic changes, and the Bayesian age-period-cohort model for predictions.</p><p><strong>Results: </strong>In 2021, global PAH prevalence was 2.28 per 100,000, slightly down from 1990 (average annual percent change [AAPC]: -0.03; 95% CI: -0.05 to -0.01), and incidence rose to 0.52 per 100,000 (AAPC: 0.10; 95% CI: 0.10-0.11). DALYs fell to 8.24 per 100,000 (AAPC: -1.52; 95% CI: -1.64 to -1.40), and deaths dropped to 0.27 per 100,000 (AAPC: -0.82; 95% CI: -0.95 to -0.68). Increased PAH deaths from aging and growth. Women had higher PAH prevalence and incidence, and by 2021 surpassed men in DALYs and deaths rates. For PAH-related HF, prevalence rose to 191,808 cases and years lived with disability rose from 9,788 to 17,765, although rates declined. These trends are projected to persist through 2050, with cases and deaths rising but rates stable from 2019 to 2021.</p><p><strong>Conclusions: </strong>The burden of PAH persists due to aging and population growth, despite declining age-standardized rates. Future interventions should address regional and sex disparities in PAH.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567152","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":"Influence of Obesity on Invasive Hemodynamics and Prognosis in Patients With Heart Failure.","authors":"Benjamin Lautrup Hansen, Tania Deis, Johan E Larsson, Mads Ersbøll, Kasper Rossing, Morten Schou, Hoong Sern Lim, Finn Gustafsson","doi":"10.1016/j.jchf.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.12.009","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have suggested that obesity may cause heart failure with preserved left ventricular ejection and report strong association between body mass index (BMI) and invasive hemodynamics. However, sparse information exists in patients who have heart failure with reduced ejection fraction (HFrEF).</p><p><strong>Objectives: </strong>This study aimed to investigate associations between BMI and invasive hemodynamics in patients with HFrEF and the influence of obesity on clinical outcomes.</p><p><strong>Methods: </strong>Referred patients with HFrEF evaluated for advanced heart failure were studied. All patients had right heart catheterization performed. Obesity was defined as BMI ≥30 kg/m². Clinical events included death, heart transplantation, and durable left ventricular assist device implantation.</p><p><strong>Results: </strong>The study population comprises 578 patients with a mean age of 52 ± 13 years and BMI of 26 ± 5 kg/m². Patients with obesity (BMI range: 30-45 kg/m²) counted 126 (22%) and had significantly higher cardiac output and slightly higher central venous pressure compared to patients without obesity. Cardiac output increased by 89 mL/min per 1-U increase in BMI. Vascular resistances were significantly inversely related to BMI. Pulmonary arterial pressure and pulmonary capillary wedge pressure were not associated with BMI. In patients with obesity, symptoms seem to be dissociated from filling pressures and cardiac index, whereas a clear association is observed in patients without. Obesity did not predict survival over a median follow-up of 5.9 years (Q1-Q3: 2.0-10.1 years).</p><p><strong>Conclusions: </strong>In patients with HFrEF, BMI and CO correlate significantly. Symptoms and hemodynamics appear dissociated in patients with obesity. Finally, survival in patients with obesity did not differ from those without.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673239","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":"Long-Term Response of Obstructive Hypertrophic Cardiomyopathy Patients to Mavacamten Based on Sex: Insights From the VALOR-HCM Trial.","authors":"Milind Y Desai, Sara Saberi, Jeffrey B Geske, Andrew Wang, Paul Cremer, David R Fermin, Mark A Zenker, Neal K Lakdawala, Albree Tower-Rader, Srihari S Naidu, Kathy Lampl, Anjali Owens","doi":"10.1016/j.jchf.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.02.005","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657183","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}