Sara R.O. Siqueira MD , Maria A. Pabon MD , Muthiah Vaduganathan MD, MPH , Brian L. Claggett PhD , Carolyn S.P. Lam MBBS, PhD , Mikhail N. Kosiborod MD , Rudolf A. de Boer MD , Sanjiv J. Shah MD , James C. Fang MD , Akshay S. Desai MD, MPH , Pardeep S. Jhund MBChB, MSc, PhD , Silvio E. Inzucchi MD , Felipe Martinez MD , Adrian F. Hernandez MD , Magnus Petersson MD, PhD , John J.V. McMurray MD , Scott D. Solomon MD , Orly Vardeny PharmD, MS
{"title":"Achieved Ejection Fraction and Effects of Dapagliflozin in Heart Failure With Improved Ejection Fraction","authors":"Sara R.O. Siqueira MD , Maria A. Pabon MD , Muthiah Vaduganathan MD, MPH , Brian L. Claggett PhD , Carolyn S.P. Lam MBBS, PhD , Mikhail N. Kosiborod MD , Rudolf A. de Boer MD , Sanjiv J. Shah MD , James C. Fang MD , Akshay S. Desai MD, MPH , Pardeep S. Jhund MBChB, MSc, PhD , Silvio E. Inzucchi MD , Felipe Martinez MD , Adrian F. Hernandez MD , Magnus Petersson MD, PhD , John J.V. McMurray MD , Scott D. Solomon MD , Orly Vardeny PharmD, MS","doi":"10.1016/j.jchf.2025.102585","DOIUrl":"10.1016/j.jchf.2025.102585","url":null,"abstract":"<div><h3>Background</h3><div>Patients with heart failure with improved ejection fraction (HFimpEF) remain understudied and face residual risks comparable with those with a left ventricular ejection fraction (LVEF) consistently >40% (no prior heart failure with reduced ejection fraction). The implications of achieved LVEF after improvement on prognosis and treatment response remains unclear.</div></div><div><h3>Objectives</h3><div>This study examines whether the degree of LVEF improvement influences prognosis and the therapeutic effects of dapagliflozin in HFimpEF.</div></div><div><h3>Methods</h3><div>The DELIVER trial randomized patients with heart failure and LVEF >40% to dapagliflozin or placebo, including those with HFimpEF. In the HFimpEF subset, we examined the association between baseline LVEF (≤49% [reference group], 50%-59%, and ≥60%) and the primary outcome (worsening HF or cardiovascular death) and whether the degree of LVEF improvement modified the treatment response to dapagliflozin.</div></div><div><h3>Results</h3><div>Of 6,263 participants, 1,151 (18%) had HFimpEF: 624 (54%), 328 (29%), and 199 (17%) had improved LVEF at baseline of ≤49%, 50%-59%, and ≥60%, respectively. Over a median follow-up of 2.3 years, primary outcome rates (per 100 person-years) in HFimpEF vs LVEF consistently >40% were 9.9 vs 10.5 (≤49%), 6.7 vs 8.4 (50%-59%), and 9.3 vs 7.5 (≥60%). Dapagliflozin safely and consistently reduced the risk of the primary outcome across LVEF groups (<em>P</em> for interaction = 0.19).</div></div><div><h3>Conclusions</h3><div>In patients with HFimpEF, the efficacy and safety of dapagliflozin in reducing cardiovascular death or worsening HF events were consistent irrespective of the degree of LVEF improvement before enrollment, including in those who achieve an LVEF ≥60% who appear to face significant residual risks of clinical events. (Dapagliflozin Evaluation to Improve the LIVEs of Patients With Preserved Ejection Fraction Heart Failure [DELIVER]; <span><span>NCT03619213</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102585"},"PeriodicalIF":11.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863993","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}
Michael P Girouard, Alan S Go, Jane Y Liu, Rishi V Parikh, Thida C Tan, Emily S Lee, Grace Sun, Rami Halaseh, Ankeet S Bhatt, Leonid Pravoverov, Sijie Zheng, Jana Svetlichnaya, Jesse K Fitzpatrick, Harshith R Avula, Keane K Lee, Sirtaz Adatya, David Ouyang, Parag Goyal, Alexander T Sandhu, Andrew P Ambrosy
{"title":"Incident Heart Failure in Adults With Mild to Moderate Chronic Kidney Disease.","authors":"Michael P Girouard, Alan S Go, Jane Y Liu, Rishi V Parikh, Thida C Tan, Emily S Lee, Grace Sun, Rami Halaseh, Ankeet S Bhatt, Leonid Pravoverov, Sijie Zheng, Jana Svetlichnaya, Jesse K Fitzpatrick, Harshith R Avula, Keane K Lee, Sirtaz Adatya, David Ouyang, Parag Goyal, Alexander T Sandhu, Andrew P Ambrosy","doi":"10.1016/j.jchf.2025.102616","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102616","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":"102616"},"PeriodicalIF":11.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954635","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}
Rahul Aggarwal, Deepak L Bhatt, Alexandre Mebazaa, Beth Davison, Ovidiu Chioncel, Marco Metra, Piotr Ponikowski, Karen Sliwa, Christopher Edwards, Gad Cotter
{"title":"Rapid Titration of Heart Failure Therapies by Etiology: An Analysis of STRONG-HF.","authors":"Rahul Aggarwal, Deepak L Bhatt, Alexandre Mebazaa, Beth Davison, Ovidiu Chioncel, Marco Metra, Piotr Ponikowski, Karen Sliwa, Christopher Edwards, Gad Cotter","doi":"10.1016/j.jchf.2025.102615","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.102615","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":"102615"},"PeriodicalIF":11.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954658","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}
Andrew Xanthopoulos MD, PhD , Kiyotaka Fukamachi MD, PhD , Randall C. Starling MD, MPH
{"title":"Challenges for Research in the LVAD Population","authors":"Andrew Xanthopoulos MD, PhD , Kiyotaka Fukamachi MD, PhD , Randall C. Starling MD, MPH","doi":"10.1016/j.jchf.2025.102604","DOIUrl":"10.1016/j.jchf.2025.102604","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102604"},"PeriodicalIF":11.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831627","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}
Balimkiz Senman MD , Sean van Diepen MD, MSc , P. Elliott Miller MD, MHS , Guido Tavazzi MD , Samir Soneji PhD , William Ratliff MBA , Carlos L. Alviar MD , Ajar Kochar MD, MHS , Allison Dupont MD , Jason N. Katz MD, MHS
{"title":"Association of Early Intra-Aortic Balloon Pump Diastolic Augmentation With Survival in Patients With Cardiogenic Shock","authors":"Balimkiz Senman MD , Sean van Diepen MD, MSc , P. Elliott Miller MD, MHS , Guido Tavazzi MD , Samir Soneji PhD , William Ratliff MBA , Carlos L. Alviar MD , Ajar Kochar MD, MHS , Allison Dupont MD , Jason N. Katz MD, MHS","doi":"10.1016/j.jchf.2025.102613","DOIUrl":"10.1016/j.jchf.2025.102613","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102613"},"PeriodicalIF":11.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831628","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}
Chandu Sadasivan MD , Josiane Dion MD , Cecile L. Phan MD , Gavin Y. Oudit MD, PhD
{"title":"Screening for Cardiac Involvement and Early Initiation of Therapies in Limb-Girdle Muscular Dystrophy R9","authors":"Chandu Sadasivan MD , Josiane Dion MD , Cecile L. Phan MD , Gavin Y. Oudit MD, PhD","doi":"10.1016/j.jchf.2025.102612","DOIUrl":"10.1016/j.jchf.2025.102612","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102612"},"PeriodicalIF":11.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831629","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}
Israel Safiriyu MD , Santiago Callegari MD , Maria Gabriela Gastanadui MD , Talal El Zarif MD , Tariq Ali MD , Mark Jacobs MD , Nihar R. Desai MD, MPH , Ann Gage MD , Jacob Jentzer MD , Andrea Elliott MD , Jason N. Katz MD, MHS , P. Elliott Miller MD, MHS
{"title":"Pulmonary Artery Catheter Timing and Outcomes for Patients With Cardiogenic Shock","authors":"Israel Safiriyu MD , Santiago Callegari MD , Maria Gabriela Gastanadui MD , Talal El Zarif MD , Tariq Ali MD , Mark Jacobs MD , Nihar R. Desai MD, MPH , Ann Gage MD , Jacob Jentzer MD , Andrea Elliott MD , Jason N. Katz MD, MHS , P. Elliott Miller MD, MHS","doi":"10.1016/j.jchf.2025.102609","DOIUrl":"10.1016/j.jchf.2025.102609","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102609"},"PeriodicalIF":11.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831621","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}
Sandip Zalawadiya MBBS , Jacob Abraham MD , Lisa Rathman CRNP , Kunjan Bhatt MD , Gillian Grafton DO , Joyce Chuang PhD , Nessa Johnson PhD , Allison Connolly PhD , JoAnn Lindenfeld MD
{"title":"Early Reduction of Pulmonary Artery Pressures Is Associated With Improved Mortality Among Medicare Beneficiaries With Heart Failure","authors":"Sandip Zalawadiya MBBS , Jacob Abraham MD , Lisa Rathman CRNP , Kunjan Bhatt MD , Gillian Grafton DO , Joyce Chuang PhD , Nessa Johnson PhD , Allison Connolly PhD , JoAnn Lindenfeld MD","doi":"10.1016/j.jchf.2025.102589","DOIUrl":"10.1016/j.jchf.2025.102589","url":null,"abstract":"<div><h3>Background</h3><div>The early hemodynamic trajectories of heart failure patients receiving implantable pulmonary artery pressure monitor and the clinical implications of those trajectories are unknown in a contemporary real-world population.</div></div><div><h3>Objectives</h3><div>This study aims to determine whether baseline pulmonary artery diastolic pressure (PAD) and its early trajectories predict risk of mortality.</div></div><div><h3>Methods</h3><div>Patients in Merlin.net implanted with the CardioMEMS sensor between 2017 and 2022 were linked to Medicare claims. Patients were categorized by PAD being acceptable (≤20 mm Hg) or elevated (>20 mm Hg). Multivariable regression was used to evaluate the impact of baseline PAD (cohort A) and its early changes at 90 days (cohort B) on long-term mortality.</div></div><div><h3>Results</h3><div>In cohort A (N = 9,579), baseline PAD was elevated in 64.1%. The 2-year risk of mortality was lower for those with acceptable vs elevated PAD at baseline (HR: 0.68 [95% CI: 0.62-0.73]; <em>P <</em> 0.001). In cohort B (N = 8,452), 63.3% had elevated PAD at baseline; of those, 24.0% improved to having acceptable PAD (Δ: −6.5 ± 4.3 mm Hg), and 76.0% remained persistently elevated at 90 days despite experiencing a reduction (ΔPAD: −1.6 ± 4.3 mm Hg). Those with improved PAD (acceptable at 90 days from elevated at baseline) had lower mortality compared with those with persistently elevated PAD (HR: 0.72 [95% CI: 0.64-0.81]; <em>P <</em> 0.001). Lower baseline PAD and no history of chronic obstructive pulmonary disease or atrial arrhythmia were associated with higher odds of improved PAD.</div></div><div><h3>Conclusions</h3><div>Among Medicare beneficiaries, CardioMEMS-guided management was associated with a reduction in PAD. Achieving acceptable PAD within 90 days of implant was associated with better survival. Our study highlights the need to develop novel strategies, including standardization of management algorithms that target elevated PAD.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102589"},"PeriodicalIF":11.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831626","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}