Ambarish Pandey MD, MS , Olivia N. Gilbert MD , Dalane W. Kitzman MD , Alain G. Bertoni MD , Pamela W. Duncan PT, PhD , Robert J. Mentz MD , Gordon R. Reeves MD , David J. Whellan MD , M. Benjamin Nelson MS , Haiying Chen PhD , Vinayak Subramanian MD , Shelby D. Reed PhD , Bharati Upadhya MD , Christopher M. O’Connor MD , Amy M. Pastva PT, PhD
{"title":"Sex Differences in Efficacy of Multidomain Rehabilitation Among Older Adults With Acute HF","authors":"Ambarish Pandey MD, MS , Olivia N. Gilbert MD , Dalane W. Kitzman MD , Alain G. Bertoni MD , Pamela W. Duncan PT, PhD , Robert J. Mentz MD , Gordon R. Reeves MD , David J. Whellan MD , M. Benjamin Nelson MS , Haiying Chen PhD , Vinayak Subramanian MD , Shelby D. Reed PhD , Bharati Upadhya MD , Christopher M. O’Connor MD , Amy M. Pastva PT, PhD","doi":"10.1016/j.jchf.2025.102547","DOIUrl":"10.1016/j.jchf.2025.102547","url":null,"abstract":"<div><h3>Background</h3><div>A multidomain physical rehabilitation intervention (REHAB-HF [Rehabilitation Therapy in Older Acute Heart Failure Patients] intervention) has been associated with significant improvements in physical function and quality of life (QOL) among older patients with acute decompensated heart failure (ADHF).</div></div><div><h3>Objectives</h3><div>This study aims to evaluate sex differences in the treatment effect of a multidomain rehabilitation intervention among participants of the REHAB-HF trial.</div></div><div><h3>Methods</h3><div>In this prespecified secondary analysis of the REHAB-HF trial, sex differences in the treatment effect of the REHAB-HF intervention (vs attention control) on key 3-month outcomes of the Short Physical Performance Battery (SPPB, primary), frailty burden, 6-minute walking distance (6MWD), and QOL were assessed. Statistical significance for treatment effect interaction (sex∗intervention) was set at 0.1.</div></div><div><h3>Results</h3><div>Among the 349 trial participants, female patients (n = 183) had a significantly lower baseline SPPB score and 6MWD and a higher frailty burden than male patients (n = 166). Female (vs male) participants had a significantly greater improvement in SPPB (effect size: 1.9 [95% CI: 1.1-2.7] vs 1.0 [95% CI: 0.1-1.8]; <em>P</em> for interaction = 0.1) and frailty burden, as assessed by Fried phenotype criteria (effect size: −0.5 [95% CI: −0.9 to −0.2] vs 0.00 [95% CI: −0.4 to 0.4]; <em>P</em> for interaction = 0.04) with the REHAB-HF intervention. The magnitude of the improvement in 6MWD and QOL (Kansas City Cardiomyopathy Questionnaire score) with the REHAB-HF intervention was also greater among female (vs male) participants without a significant treatment effect interaction by sex. There was no significant difference in rates of adverse clinical outcomes associated with the intervention across both sex groups. There was no difference in intervention adherence by sex.</div></div><div><h3>Conclusions</h3><div>Female (vs male) participants with ADHF had a significantly greater improvement in physical function in response to the REHAB-HF intervention.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102547"},"PeriodicalIF":11.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130877","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}
Pedro Marques MD, MSc , Christoforos K. Travlos MD , Paula Matias MD , João Sérgio Neves MD, PhD , Michael A. Tsoukas MD , Thomas A. Mavrakanas MD , Jacqueline Joza MD , João Pedro Ferreira MD, PhD , Abhinav Sharma MD, PhD
{"title":"Effects of Glucagon-Like Peptide 1 Receptor Agonist Initiation in Patients With Heart Failure With Reduced Ejection Fraction and Implantable Cardiac Devices","authors":"Pedro Marques MD, MSc , Christoforos K. Travlos MD , Paula Matias MD , João Sérgio Neves MD, PhD , Michael A. Tsoukas MD , Thomas A. Mavrakanas MD , Jacqueline Joza MD , João Pedro Ferreira MD, PhD , Abhinav Sharma MD, PhD","doi":"10.1016/j.jchf.2025.102573","DOIUrl":"10.1016/j.jchf.2025.102573","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide 1 receptor agonists (GLP1RAs) may increase heart rate in patients with heart failure with reduced ejection fraction (HFrEF), which could induce deleterious effects in this population. Information retrieved from implanted cardiac devices may provide more insights into GLP1RA-associated effects on heart rate and arrhythmic events.</div></div><div><h3>Objectives</h3><div>This study aims to analyze the effects of GLP1RA on device-related rhythm parameters in patients with HFrEF and implanted cardiac devices.</div></div><div><h3>Methods</h3><div>The authors performed a retrospective analysis of outpatients with HFrEF with implanted cardiac devices followed in cardiorenal clinics from a single-center quaternary care hospital in Canada. GLP1RA users were compared with GLP1RA nonusers with similar baseline characteristics for longitudinal changes (1-year follow-up) in heart rate, using data from electrophysiology interrogation reports. Secondary endpoints included relevant arrhythmic events, changes in body mass index (BMI), and laboratory biomarkers.</div></div><div><h3>Results</h3><div>Among 253 patients with HFrEF and implanted cardiac devices, 53 new GLP1RA users were compared with 53 GLP1RA nonusers. The mean age was 66 ± 10 years, 81% were men, 93% had diabetes, and 36% had atrial fibrillation. The mean BMI was 31.4 kg/m<sup>2</sup>, and the mean ejection fraction was 28% ± 10%. After adjustment, GLP1RA use (vs no use) significantly increased heart rate by +7 beats/min (95% CI: 4-10 beats/min; <em>P <</em> 0.01). GLP1RA use (vs no use) was associated with a numeric increase in ventricular tachycardia/fibrillation events (13 vs 2; <em>P =</em> 0.07) and a significant increase in nonsustained ventricular events and total shock/antitachycardia pacing therapies (33 vs 3; <em>P =</em> 0.01).</div></div><div><h3>Conclusions</h3><div>In this retrospective analysis of patients with HFrEF and implanted cardiac devices, GLP1RA use was associated with significant increase in heart rate and increased number of nonsustained ventricular events and total shock/antitachycardia pacing therapies. These findings highlight the need for further evaluation of GLP1RA use in HFrEF.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102573"},"PeriodicalIF":11.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106791","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}
Tae Kyung Yoo MD, MS , Rachael Steinhauer MD , Michael Wu BS, MPH , In-Cheol Kim MD, PhD , Jong-Chan Youn MD, PhD , Brian C. Downey MD , Indranee N. Rajapreyar MD , Amanda R. Vest MBBS, MPH
{"title":"Mortality Across the Pre– and Post–Heart Transplant Continuum for Patients With Severe Obesity","authors":"Tae Kyung Yoo MD, MS , Rachael Steinhauer MD , Michael Wu BS, MPH , In-Cheol Kim MD, PhD , Jong-Chan Youn MD, PhD , Brian C. Downey MD , Indranee N. Rajapreyar MD , Amanda R. Vest MBBS, MPH","doi":"10.1016/j.jchf.2025.102651","DOIUrl":"10.1016/j.jchf.2025.102651","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102651"},"PeriodicalIF":11.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043638","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}
Selma F. Mohammed MD, PhD , Rosita Zakeri MBChB, PhD
{"title":"Resting Hemodynamics and Prognosis in Heart Failure With Preserved Ejection Fraction","authors":"Selma F. Mohammed MD, PhD , Rosita Zakeri MBChB, PhD","doi":"10.1016/j.jchf.2025.102644","DOIUrl":"10.1016/j.jchf.2025.102644","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102644"},"PeriodicalIF":11.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043635","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}