JACC. Heart failure最新文献

{"title":"Prevalence and Associations of Systemic Inflammation in Heart Failure Across the Spectrum of Ejection Fraction.","authors":"Barry A Borlaug,Cecilie Holse,Mette Holme Jung,A Michael Lincoff,Sharon L Mulvagh,Jacob Stærk-Østergaard,Katherine R Tuttle,Mark C Petrie","doi":"10.1016/j.jchf.2025.102712","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102712","url":null,"abstract":"BACKGROUNDSystemic inflammation contributes to the pathophysiology of heart failure (HF). Inflammation in heart failure with mildly reduced ejection fraction (HFmrEF) or heart failure with preserved ejection fraction (HFpEF) has been linked to cardiovascular-kidney-metabolic conditions, whereas inflammation in heart failure and reduced ejection fraction (HFrEF) is thought to develop secondary to cardiac stress and circulatory derangements.OBJECTIVESThis study aims to characterize the prevalence and correlates of systemic inflammation across the spectrum of HF.METHODSPatients with HF participating in 3 large outcome trials (SELECT, SOUL, and FLOW) were examined to identify the prevalence of systemic inflammation, defined as elevated high-sensitivity C-reactive protein (hsCRP) ≥2 mg/L. Clinical characteristics associated with elevated hsCRP were examined by HF subtype and across the HF spectrum.RESULTSAcross the 3 trials, 3,204 patients had HFpEF, 1,246 had HFmrEF, and 1,018 had HFrEF. Elevated hsCRP was observed in 2,335 patients (52.5%) with HFpEF/HFmrEF and 503 patients (49.4%) with HFrEF. Compared with patients with lower hsCRP levels, those with higher hsCRP levels were more likely to be female and have obesity, diabetes, lower estimated glomerular filtration rate, higher albuminuria, and chronic obstructive pulmonary disease, without meaningful differences by HF subtype. hsCRP level was unrelated to ejection fraction (R2 < 0.001; P = 0.73) but increased linearly with the number of comorbidities for all HF subtypes (R2 = 0.94; P < 0.001).CONCLUSIONSSystemic inflammation is present in one-half of patients with HF, and is associated with excess body fat, chronic kidney disease, albuminuria, and diabetes, and increases with comorbidity burden. These relationships are not specific to HFpEF/HFmrEF but are also common to HFrEF (Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity [SELECT]; NCT03574597; A Research Study to See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney Disease [FLOW]; NCT03819153; A Heart Disease Study of Semaglutide in Patients With Type 2 Diabetes [SOUL]; NCT03914326).","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"32 1","pages":"102712"},"PeriodicalIF":13.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296193","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":"Streamlined Heart Failure Optimization Protocol for Patients With Reduced Left Ventricular Ejection Fraction: Insights From the SHORT Trial.","authors":"Cong Ying Hey,Yin Aye,May Ko,Megha Chopra,Kilanalei Bishop,Ahsanul Haque,Mable Chalil,Samarjit Saha,Joyce Monk,Jac Billington,Elif Ustun,Kamalan Jeevaratnam,Sharad Agarwal,Ashwin Reddy,Unni Krishnan,Sérgio Barra,Stephen Pettit,Rudolf Duehmke","doi":"10.1016/j.jchf.2025.102663","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102663","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"64 1","pages":"102663"},"PeriodicalIF":13.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296194","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":"Beyond the Pump: Reframing Cardiogenic Shock in Heart Failure Through a Multisystem Mechanistic Lens.","authors":"Ameesh Isath,Akshay S Desai,Mandeep R Mehra","doi":"10.1016/j.jchf.2025.102711","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102711","url":null,"abstract":"Management of patients with cardiogenic shock (CS) has long focused on hemodynamic optimization, yet outcomes remain poor, particularly for those with acute-on-chronic heart failure (ACHF)-CS. This hemodynamic-centric paradigm is largely derived from ST-segment elevation myocardial infarction (STEMI)-CS, which inadequately captures the complex, multisystem physiology of ACHF-CS. The syndrome of ACHF-CS emerges from the simultaneous convergence of central hemodynamic abnormalities in concert with systemic inflammation and microcirculatory dysfunction. This primed convergence of aberrations fuels ongoing organ injury despite hemodynamic recovery-a phenomenon of hemodynamic dissonance. Unlike the acute and abrupt sequential trajectory of STEMI-CS, ACHF-CS is a distinctive mechanistic process shaped by longer-standing central and peripheral maladaptation with systemic stress at onset. This paper distinguishes ACHF-CS as a distinct shock phenotype, and highlights emerging therapeutic strategies aimed at modifying disease biology beyond a focus on solely rescuing hemodynamics. A mechanism-specific approach is essential to improve outcomes in ACHF-CS.","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"21 1","pages":"102711"},"PeriodicalIF":13.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296195","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":"Surveillance Patterns for Allograft Vasculopathy in Heart Transplant Recipients in PET Myocardial Perfusion Imaging Performing Centers in the United States.","authors":"Attila Feher, Maria Alwan, Catherine X Wright, Kevin J Clerkin, Andrew J Einstein, Edward J Miller, Mouaz H Al-Mallah","doi":"10.1016/j.jchf.2025.102718","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102718","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":"102718"},"PeriodicalIF":11.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300907","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":"Novel 4-Stage Classification to Estimate Right Atrial Pressure by Point-of-Care Ultrasound of Neck Vasculature.","authors":"Diana de Oliveira-Gomes,Rachel M Drazner,Michelle Dimza,Colby Ayers,Angela Duvalyan,Tiffany L Brazile,Robert Morlend,Faris Araj,E Ashley Hardin,Nicholas Hendren,Justin L Grodin,Jennifer T Thibodeau,Mark H Drazner","doi":"10.1016/j.jchf.2025.102707","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102707","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"103 3 1","pages":"102707"},"PeriodicalIF":13.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277198","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":"Primary Graft Dysfunction in Patients Supported With Durable Left Ventricular Assist Devices Before Heart Transplantation.","authors":"Lauren K Truby,Yasbanoo Moayedi,Marisa Signorile,Chun-Po Steve Fan,Farid Foroutan,Heather Ross,Joan Guzman-Bofarull,Joseph B Lerman,Adam D DeVore,Shelley Hall,Koji Takeda,Sharon Chih,Eduard Rodenas-Alesina,Mercedes Rivas-Lasarte,Jiho Han,Gene Kim,Roxana Moayedifar,David Couto-Mallon,Helen Luikart,Erik Henricksen,Mario Sabatino,Maxime Tremblay-Gravel,Pierre-Emmanuel Noly,Robert Miller,Luciano Potena,Maria Crespo-Leiro,Javier Segovia-Cubero,Marta Farrero,Andreas Zuckermann,Kiran K Khush,Maryjane Farr","doi":"10.1016/j.jchf.2025.102618","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102618","url":null,"abstract":"BACKGROUNDPrevious single-center studies identified an association between pretransplant durable left ventricular assist device (LVAD) support and severe primary graft dysfunction (PGD) following heart transplantation (HT).OBJECTIVESThe current study leverages data from the International Consortium on PGD data to identify trends, quantify outcomes, and identify clinical risk factors of high-risk LVAD-supported patients.METHODSClinical data and outcomes of interest, including severe PGD, were compared between patients with and without LVAD support at the time of HT. Among LVAD-supported patients, univariate and multivariable logistic regression analysis was performed on a priori defined variables to determine their association with severe PGD.RESULTSThe final analysis included 4,125 transplant recipients from 14 HT centers, receiving donor hearts by the donation after brain death strategy, with 1,091 (26%) patients supported by LVADs before HT. A total of 365 patients (8.6%) developed severe PGD: 7.4% of those patients without LVAD support and 12.7% of those with LVAD support (P < 0.001). Mortality at 1 year was significantly lower among patients with severe PGD who were bridged to transplantation with a durable LVAD: 28.8% (95% CI: 22.0%-37.1%) vs 40.7% (95% CI: 34.6%-47.7%); log-rank P = 0.025). Risk factors for severe PGD among LVAD-supported patients included pre-HT creatinine, ratio of central venous pressure to pulmonary capillary wedge pressure (CVP/PCWP ratio), and overall donor ischemic time.CONCLUSIONSHT recipients supported by durable LVADs before HT are at increased risk of PGD, but they experience less mortality associated with this post-transplant complication. Surrogates of venous congestion, including pre-HT creatinine and CVP/PCWP ratio, identify high-risk LVAD-supported patients.","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"45 1","pages":"102618"},"PeriodicalIF":13.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261396","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":"Finerenone and Quality of Life Assessed Using the EuroQol 5-Dimension Questionnaire Level-Sum-Score in Patients With Heart Failure and Mildly Reduced or Preserved Ejection Fraction.","authors":"Mingming Yang,Misato Chimura,Carolyn S P Lam,Michele Senni,Adriaan A Voors,Faiez Zannad,Muthiah Vaduganathan,Pardeep S Jhund,Scott D Solomon,John J V McMurray","doi":"10.1016/j.jchf.2025.102705","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102705","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"86 1","pages":"102705"},"PeriodicalIF":13.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261399","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":"How to Rescue the Field of Heart Failure.","authors":"Mark H Drazner,Nosheen Reza","doi":"10.1016/j.jchf.2025.102701","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102701","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"38 1","pages":"102701"},"PeriodicalIF":13.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261402","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":"Eplerenone for Nonobstructive Hypertrophic Cardiomyopathy: The (T1)me Is Now?","authors":"Iacopo Olivotto,Annamaria Del Franco","doi":"10.1016/j.jchf.2025.102684","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102684","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"115 1","pages":"102684"},"PeriodicalIF":13.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261167","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":"Clinical Implications of the P.V142I TTR Variant: Insights From CARS.","authors":"Isabel R Wees,Colby Ayers,Frederick L Ruberg,Mathew S Maurer,Yevgeniy Brailovsky,Lily K Stern,Jan M Griffin,Michel G Khouri,Lori R Roth,Justin L Grodin","doi":"10.1016/j.jchf.2025.102704","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102704","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"53 1","pages":"102704"},"PeriodicalIF":13.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261212","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}