JACC. Heart failure最新文献

{"title":"Aldosterone, Subclinical Cardiac Dysfunction, and Heart Failure Subtypes","authors":"Dayawa D. Agoons MD, MPH , Joshua J. Joseph MD, MPH , Arnaud D. Kaze MD, MPH , Alain G. Bertoni MD, MPH , Ervin R. Fox MD, MPH , Michael E. Hall MD , Jarett D. Berry MD, MS , Robert J. Mentz MD , Justin B. Echouffo-Tcheugui MD, PhD","doi":"10.1016/j.jchf.2025.102670","DOIUrl":"10.1016/j.jchf.2025.102670","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102670"},"PeriodicalIF":11.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209143","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":"Frailty and Effects of Semaglutide in Obesity-Related HFpEF","authors":"Ambarish Pandey MD, MSCS ,&nbsp;Dalane W. Kitzman MD ,&nbsp;Khaja M. Chinnakondepalli MS ,&nbsp;Shachi Patel PhD ,&nbsp;Barry A. Borlaug MD ,&nbsp;Javed Butler MD ,&nbsp;Melanie J. Davies MD ,&nbsp;Sanjiv J. Shah MD ,&nbsp;Subodh Verma MD ,&nbsp;Cecilia Rönnbäck MD, PhD ,&nbsp;Anne Domdey PhD ,&nbsp;Karoline Liisberg MS ,&nbsp;Morten Schou MD, PhD ,&nbsp;Eduardo Perna MD ,&nbsp;Fozia Z. Ahmed MD ,&nbsp;Michael Fu MD, PhD ,&nbsp;Mark C. Petrie MD ,&nbsp;Mikhail N. Kosiborod MD","doi":"10.1016/j.jchf.2025.102610","DOIUrl":"10.1016/j.jchf.2025.102610","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is common in heart failure with preserved ejection fraction (HFpEF). In the STEP-HFpEF (Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure and Obesity) program, semaglutide improved heart failure (HF) symptoms and physical limitations and reduced body weight (BW) in participants with obesity-related HFpEF. Whether the efficacy and safety of semaglutide vary by frailty and the effects of semaglutide on frailty are unknown.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate the efficacy of semaglutide in participants with obesity-related HFpEF according to frailty status at baseline.</div></div><div><h3>Methods</h3><div>The authors performed a prespecified, pooled, participant-level analysis of the STEP-HFpEF program that included participants with obesity-related HFpEF. Participants were randomized to once-weekly semaglutide, 2.4 mg, or placebo for 52 weeks. Dual primary endpoints were changes in Kansas City Cardiomyopathy Questionnaire–Clinical Summary Score (KCCQ-CSS) and BW. Frailty was estimated using a cumulative deficit-derived frailty index comprising 34 variables across multiple domains at baseline and follow-up. Efficacy and safety of semaglutide were evaluated in participants across 3 baseline frailty strata. Effects of semaglutide on frailty burden were also assessed.</div></div><div><h3>Results</h3><div>Of the 1,145 participants, 110 (9.6%) were nonfrail, 343 (30.0%) were more frail, and 692 (60.4%) were most frail. Semaglutide-mediated weight loss was similar across frailty strata (<em>P</em>_interaction = 0.38). However, the effects of semaglutide on KCCQ-CSS varied by frailty status; participants who were most frail had the greatest improvement at 52 weeks (nonfrail mean difference: −1.5 [95% CI: −8.4 to 5.4]; more frail mean difference: 3.7 [95% CI: −0.2 to 7.6]; most frail mean difference: 11.0 [95% CI: 8.1-13.8]; <em>P</em>_interaction &lt; 0.001). Semaglutide reduced the burden of frailty during follow-up (OR for being nonfrail at 52 weeks: 3.16 [95% CI: 2.44-4.09]; <em>P &lt;</em> 0.0001).</div></div><div><h3>Conclusions</h3><div>Semaglutide resulted in a similar reduction in BW across frailty subgroups but greater improvements in HF-related symptoms. Moreover, semaglutide reduced frailty burden after 52 weeks of treatment. (Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure and Obesity [STEP-HFpEF]; <span><span>NCT04788511</span><svg><path></path></svg></span>) (Research Study to Look at How Well Semaglutide Works in People Living With Heart Failure, Obesity and Type 2 Diabetes [STEP-HFpEF DM]; <span><span>NCT04916470</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102610"},"PeriodicalIF":11.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068387","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":"Improved Ejection Fraction Does Not Imply Recovery From Heart Failure","authors":"Johann Bauersachs MD","doi":"10.1016/j.jchf.2025.102673","DOIUrl":"10.1016/j.jchf.2025.102673","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102673"},"PeriodicalIF":11.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089764","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","authors":"Haoquan Huang MS ,&nbsp;Chuwen Hu MS ,&nbsp;Rong Zhang MS,&nbsp;Hui Xu MD,&nbsp;Minghui Cao MD, PhD,&nbsp;Yanni Fu MS","doi":"10.1016/j.jchf.2024.12.005","DOIUrl":"10.1016/j.jchf.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary arterial hypertension (PAH) and associated heart failure (HF) are emerging global health challenges.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102385"},"PeriodicalIF":11.8,"publicationDate":"2025-10-01","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":"Full issue PDF","authors":"","doi":"10.1016/S2213-1779(25)00625-0","DOIUrl":"10.1016/S2213-1779(25)00625-0","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102695"},"PeriodicalIF":11.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262727","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":"Navigating the Global Burden of Pulmonary Arterial Hypertension","authors":"Ajith Nair MD","doi":"10.1016/j.jchf.2025.102545","DOIUrl":"10.1016/j.jchf.2025.102545","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102545"},"PeriodicalIF":11.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251079","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":"Hypertension in Patients With Obstructive Hypertrophic Cardiomyopathy Treated With Mavacamten","authors":"Nosheen Reza MD, MS ,&nbsp;Nadim Mahmud MD, MS, MPH, MSCE ,&nbsp;Melissa A. Austin MD ,&nbsp;Estherland Duqueney MD ,&nbsp;Parth Patel MD ,&nbsp;Ellen Boakye MD, MPH ,&nbsp;Nicole Hornsby CRNP ,&nbsp;Alejandro de Feria MD ,&nbsp;Amy Marzolf CRNP ,&nbsp;Anjali Tiku Owens MD","doi":"10.1016/j.jchf.2025.102666","DOIUrl":"10.1016/j.jchf.2025.102666","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102666"},"PeriodicalIF":11.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203622","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":"Congestion and Low Cardiac Output Hemodynamic Phenotype Drives Outcomes in Overweight and Obese HFpEF","authors":"Vivek P. Jani MS ,&nbsp;Joban Vaishnav MD ,&nbsp;Soumya Vungarala MD ,&nbsp;Virginia S. Hahn MD ,&nbsp;Danielle Hopkins BS ,&nbsp;Rishi Trivedi MD, PhD ,&nbsp;Wendy Ying MD ,&nbsp;David A. Kass MD ,&nbsp;Dhananjay Vaidya MBBS, PhD ,&nbsp;Kavita Sharma MD","doi":"10.1016/j.jchf.2025.102586","DOIUrl":"10.1016/j.jchf.2025.102586","url":null,"abstract":"<div><h3>Background</h3><div>Hemodynamic assessment of congestion and perfusion in overweight and obese patients with heart failure with preserved ejection fraction (HFpEF), and the respective impact of hemodynamic phenotypes on clinical outcomes has been limited to date.</div></div><div><h3>Objectives</h3><div>The authors characterized predominantly overweight and obese HFpEF patients by hemodynamic assessment of congestion and perfusion status and correlated these hemodynamic phenotypes with clinical outcomes.</div></div><div><h3>Methods</h3><div>A total of 227 patients referred to the Johns Hopkins HFpEF Clinic meeting clinical criteria for HFpEF and with right heart catheterization assessment were included. Hemodynamic-based groups were assigned as follows: dry-warm (pulmonary capillary wedge pressure [PCWP] &lt;15 mm Hg, cardiac index &gt;2.2 L/min/m²), wet-warm (PCWP ≥15 mm Hg, cardiac index &gt;2.2 L/min/m²), dry-cold (PCWP &lt;15 mm Hg, cardiac index ≤2.2 L/min/m²), and wet-cold (PCWP ≥15 mm Hg, cardiac index ≤2.2 L/min/m²).</div></div><div><h3>Results</h3><div>Compared to “warm” profile patients, HFpEF subjects classified as “cold” profile (dry-cold + wet-cold) accounted for 34% of the cohort and were more likely to be older (cold: 68 ± 11 years vs warm: 62 ± 12 years; <em>P</em> = 0.002), male (cold: 51% vs warm 66%; <em>P</em> = 0.04), have atrial fibrillation (<em>P</em> = 0.0007), with higher N-terminal pro–B-type natriuretic peptide (<em>P</em> = 0.03), and higher pulmonary vascular resistance indices. Of the 4 hemodynamic groups, wet-cold patients had the highest N-terminal pro–B-type natriuretic peptide levels (469 pg/mL [Q1-Q3: 257-1,389 pg/mL]; overall <em>P =</em> 0.0001), highest rate of atrial fibrillation (54%, overall <em>P</em> = 0.001), and were more likely to be on beta-blocker therapy (68%; <em>P =</em> 0.05). Kaplan-Meier survival analysis (median follow-up time: 39 months) revealed that HFpEF patients with low cardiac perfusion (thermodilution method and Fick method) had worse mortality even after accounting for potential overcorrection from body mass index.</div></div><div><h3>Conclusions</h3><div>In a predominantly overweight and obese HFpEF cohort meeting standard diagnostic criteria for clinical HFpEF, 34% had a depressed cardiac index on hemodynamic testing. Hemodynamic assessment may identify an under-recognized low-output hemodynamic phenotype in HFpEF, which in combination with congestion, is associated with worse clinical outcomes.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102586"},"PeriodicalIF":11.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209065","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":"Exploring the Nexus of Genotype and Phenotype in Nexilin-Related Genetic Cardiomyopathy","authors":"Nosheen Reza MD, MS ,&nbsp;Daniel P. Judge MD","doi":"10.1016/j.jchf.2025.102602","DOIUrl":"10.1016/j.jchf.2025.102602","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102602"},"PeriodicalIF":11.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199446","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":"Temporary Mechanical Circulatory Support Before Durable Left Ventricular Assist Device","authors":"Anju Bhardwaj MD ,&nbsp;Shelley Hall MD","doi":"10.1016/j.jchf.2025.102699","DOIUrl":"10.1016/j.jchf.2025.102699","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102699"},"PeriodicalIF":11.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194884","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}