JACC. Heart failure最新文献

{"title":"Advanced Heart Failure","authors":"Johan E. Larsson MD, PhD , Maria Generosa Crespo-Leiro MD, PhD , Finn Gustafsson MD, PhD","doi":"10.1016/j.jchf.2024.10.026","DOIUrl":"10.1016/j.jchf.2024.10.026","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 248-252"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179806","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":"Upgrading Right Ventricular Pacing to Cardiac Resynchronization in HFrEF Patients Improves Symptoms and Functional Outcomes","authors":"Eperke Merkel MD ,&nbsp;Robert Hatala MD, PhD ,&nbsp;Mátyás Szigeti PhD ,&nbsp;Walter Schwertner MD ,&nbsp;Bálint Lakatos MD, PhD ,&nbsp;Anett Behon MD ,&nbsp;Kinga Goscinska-Bis MD ,&nbsp;Goran Milasinovic MD ,&nbsp;Roland Papp MD ,&nbsp;Mihály Ruppert MD, PhD ,&nbsp;László Sághy MD, PhD ,&nbsp;Marcell Clemens MD, PhD ,&nbsp;Scott D. Solomon MD ,&nbsp;Valentina Kutyifa MD, PhD ,&nbsp;Attila Kovács MD, PhD ,&nbsp;Annamária Kosztin MD, PhD ,&nbsp;Béla Merkely MD, PhD","doi":"10.1016/j.jchf.2024.09.011","DOIUrl":"10.1016/j.jchf.2024.09.011","url":null,"abstract":"<div><h3>Background</h3><div>In the BUDAPEST (Biventricular Upgrade on left ventricular reverse remodeling and clinical outcomes in patients with left ventricular Dysfunction and intermittent or permanent APical/SepTal right ventricular pacing)-CRT Upgrade randomized trial, the authors have demonstrated improved mortality and morbidity after cardiac resynchronization therapy (CRT) upgrade in patients with heart failure with reduced ejection fraction (HFrEF) with high right ventricular (RV) pacing burden.</div></div><div><h3>Objectives</h3><div>This substudy sought to examine the impact of CRT upgrade on symptoms, functional outcome, and exercise capacity.</div></div><div><h3>Methods</h3><div>In the BUDAPEST-CRT Upgrade trial, 360 HFrEF patients with pacemaker or implantable cardioverter-defibrillator (ICD) and ≥20% RV pacing burden were randomly assigned (3:2) to cardiac resynchronization therapy with defibrillator (CRT-D) upgrade (n = 215) or ICD (n = 145). The prespecified tertiary endpoints were changes in quality of life (QoL) (EQ-5D-3L), NYHA functional class, 6-minute walk test, and N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels.</div></div><div><h3>Results</h3><div>Up to 12 months, NYHA functional class improved in the CRT-D upgrade arm compared with ICD only (adjusted OR: 0.50 [95% CI: 0.32-0.80]; <em>P =</em> 0.003). A remarkable decrease was observed in NT-proBNP levels in the CRT-D arm (adjusted difference: −1,257 pg/mL [95% CI: −2,287 to −228 pg/mL]; <em>P =</em> 0.017). The progression of age-related worsening of QoL was moderated by CRT-D upgrade (EQ-5D-3L difference by each year: 0.015 [95% CI: 0.005-0.025]; <em>P</em> interaction = 0.003). However, exercise tolerance (6-minute walk test) remained unchanged in both groups.</div></div><div><h3>Conclusions</h3><div>HFrEF patients with pacemaker/ICD and ≥20% RV pacing burden receiving CRT upgrade showed a substantial improvement in NYHA functional class and decrease in natriuretic peptide levels, as compared with ICD alone. Moreover, CRT-D upgrade could moderate the progression of worsening of QoL attributed to ageing in this vulnerable, elderly patient population. (Biventricular Upgrade on left ventricular reverse remodeling and clinical outcomes in patients with left ventricular Dysfunction and intermittent or permanent APical/SepTal right ventricular pacing [BUDAPEST]-CRT Upgrade trial; <span><span>NCT02270840</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 265-273"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768942","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 Guideline-Directed Medical Therapy","authors":"Onyedika J. Ilonze MD, MPH ,&nbsp;Daniel E. Forman MD ,&nbsp;Lisa LeMond MD ,&nbsp;Jonathan Myers PhD ,&nbsp;Scott Hummel MD ,&nbsp;Amanda R. Vest MBBS MPH ,&nbsp;Ersilia M. DeFilippis MD ,&nbsp;Eiad Habib MBBS ,&nbsp;Sarah J. Goodlin MD","doi":"10.1016/j.jchf.2024.08.018","DOIUrl":"10.1016/j.jchf.2024.08.018","url":null,"abstract":"<div><div>Heart failure (HF) is a leading cause of cardiovascular morbidity, mortality, and health care expenditure. Guideline-directed medical therapy and device-based therapy in HF are well established. However, the role of nonpharmacologic modalities to improve HF care remains underappreciated, is underused, and requires multimodal approaches to care. Diet, exercise and cardiac rehabilitation, sleep-disordered breathing, mood disorders, and substance use disorders are potential targets to reduce morbidity and improve function of patients with HF. Addressing these factors may improve symptoms and quality of life, reduce hospitalizations, and improve mortality in heart failure. This state-of-the-art review discusses dietary interventions, exercise programs, and the management of sleep-disordered breathing, mood disorders, and substance use in individuals with heart failure. The authors review the latest data and provide optimal lifestyle recommendations and recommended prescriptions for nonpharmacologic therapies.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 185-199"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500653","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":"The Clinical Trajectory of NYHA Functional Class I Patients With Obstructive Hypertrophic Cardiomyopathy","authors":"Monica Ahluwalia MD ,&nbsp;Jiankang Liu PhD ,&nbsp;Iacopo Olivotto MD ,&nbsp;Victoria Parikh MD ,&nbsp;Euan A. Ashley MRCP, DPhil ,&nbsp;Michelle Michels MD, PhD ,&nbsp;Jodie Ingles MPH, PhD ,&nbsp;Rachel Lampert MD ,&nbsp;John C. Stendahl MD, PhD ,&nbsp;Steven D. Colan MD ,&nbsp;Dominic Abrams MD ,&nbsp;Alexandre C. Pereira MD, PhD ,&nbsp;Joseph W. Rossano MD ,&nbsp;Thomas D. Ryan MD, PhD ,&nbsp;Anjali T. Owens MD ,&nbsp;James S. Ware PhD, MRCP ,&nbsp;Sara Saberi MD, MS ,&nbsp;Adam S. Helms MD ,&nbsp;Sharlene Day MD ,&nbsp;Brian Claggett PhD ,&nbsp;Neal K. Lakdawala MD","doi":"10.1016/j.jchf.2024.09.008","DOIUrl":"10.1016/j.jchf.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>An improved understanding of the natural history in NYHA functional class I patients with obstructive hypertrophic cardiomyopathy (oHCM) is needed.</div></div><div><h3>Objectives</h3><div>Using a multicenter registry (SHaRe [Sarcomeric Human Cardiomyopathy Registry]), this study described the natural history in patients with oHCM who were classified as NYHA functional class I at the initial visit compared with patients classified as NYHA functional class II and reported baseline characteristics associated with incident clinical events.</div></div><div><h3>Methods</h3><div>Incident events assessed included a composite of NYHA functional class III to IV symptoms, left ventricular ejection fraction &lt;50%, atrial fibrillation, stroke, ventricular arrhythmias, septal reduction therapy, ventricular assist device or transplantation, or death. Factors associated with incident events were determined using Kaplan-Meier, Cox proportional hazards, and restricted cubic spline models.</div></div><div><h3>Results</h3><div>Of 7,964 patients with HCM in SHaRe, 1,239 patients with oHCM met inclusion criteria; 598 were in NYHA functional class I at the initial visit (age 48 ± 17 years; 31.1% female; peak gradient, 75 ± 40 mm Hg). At 5-year follow-up, the composite event rate of NYHA functional class I patients was 28% compared with 44% (<em>P &lt;</em> 0.001) in 641 NYHA functional class II patients with oHCM (age 54 ± 16 years; 46.5% female; peak gradient, 83 ± 39 mm Hg). Left atrial (LA) diameter ≥45 mm (HR: 1.56 [95% CI: 1.14-2.12]; <em>P =</em> 0.005), female sex (HR: 1.61 [95% CI: 1.16-2.24]; <em>P =</em> 0.003), and older age (HR: 1.21 per 10 years [95% CI: 1.09-1.34]; <em>P &lt;</em> 0.001), but not the magnitude of left ventricular outflow tract obstruction, were associated with a higher risk of the composite outcome in NYHA functional class I patients.</div></div><div><h3>Conclusions</h3><div>Although NYHA functional class I patients with oHCM fared better than NYHA functional class II patients, more than one-fourth experienced adverse events over 5-year follow-up, especially if they were older, female, and/or had LA enlargement. Strategies to reduce the rate of clinical outcomes in NYHA functional class I patients warrant further study.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 332-343"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620762","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":"Patient-Reported Outcomes in Heart Failure","authors":"Gregg C. Fonarow MD ,&nbsp;Amber B. Tang MD","doi":"10.1016/j.jchf.2024.10.019","DOIUrl":"10.1016/j.jchf.2024.10.019","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 293-295"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179805","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":"Can and Should LIVE Be Revived?","authors":"Michael I. Brener MD, MS,&nbsp;Daniel Burkhoff MD, PhD","doi":"10.1016/j.jchf.2025.01.001","DOIUrl":"10.1016/j.jchf.2025.01.001","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 312-314"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143181334","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)00002-2","DOIUrl":"10.1016/S2213-1779(25)00002-2","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages i-ccx"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180846","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":"Aficamten vs Metoprolol for Obstructive Hypertrophic Cardiomyopathy","authors":"Pablo Garcia-Pavia MD, PhD ,&nbsp;Ozlem Bilen MD ,&nbsp;Melissa Burroughs MD ,&nbsp;Juan Pablo Costabel MD ,&nbsp;Edileide de Barros Correia MD ,&nbsp;Anne M. Dybro MD, PhD ,&nbsp;Perry Elliott MBBS, MD ,&nbsp;Neal K. Lakdawala MD ,&nbsp;Amy Mann BA ,&nbsp;Ajith Nair MD ,&nbsp;Michael E. Nassif MD ,&nbsp;Steen H. Poulsen MD ,&nbsp;Patricia Reant MD, PhD ,&nbsp;P. Christian Schulze MD ,&nbsp;Andrew Wang MD ,&nbsp;Indrias Berhane PhD ,&nbsp;Stephen B. Heitner MD ,&nbsp;Daniel L. Jacoby MD ,&nbsp;Stuart Kupfer MD ,&nbsp;Fady I. Malik MD, PhD ,&nbsp;Michael A. Fifer MD","doi":"10.1016/j.jchf.2024.11.011","DOIUrl":"10.1016/j.jchf.2024.11.011","url":null,"abstract":"<div><div>Beta-blockers and nondihydropyridine calcium-channel blockers have been standard-of-care (SOC) medications for patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM), even though these agents do not directly affect the underlying pathophysiology of the disease. Cardiac myosin inhibitors act by decreasing the number of myosin heads binding to actin, reducing the pathologic hypercontractility of HCM, and have been shown to improve exercise capacity and alleviate symptoms in oHCM when added to SOC medications. Cardiac myosin inhibitors are currently considered as second-line therapy in the absence of head-to-head comparison studies vs SOC medications. The aim of the ongoing phase 3 study MAPLE-HCM (Metoprolol vs Aficamten in Patients With LVOT Obstruction on Exercise Capacity in HCM) is to fill this evidence gap by evaluating aficamten as both first-line therapy for newly diagnosed oHCM and as a monotherapy alternative for patients currently on SOC drugs. The authors describe the rationale, design, and baseline characteristics of patients in this study. (Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Metoprolol Succinate in Adults With Symptomatic oHCM [MAPLE-HCM]; <span><span>NCT05767346</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 346-357"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Mitral TEER in the Management of Moderate Secondary Mitral Regurgitation Among Heart Failure Patients","authors":"Anita W. Asgar MD ,&nbsp;Gilbert H.L. Tang MD ,&nbsp;Jason H. Rogers MD ,&nbsp;Wolfgang Rottbauer MD ,&nbsp;M. Andrew Morse MD ,&nbsp;Paolo Denti MD ,&nbsp;Paul Mahoney MD ,&nbsp;Michael J. Rinaldi MD ,&nbsp;Federico M. Asch MD ,&nbsp;Jose L. Zamorano MD ,&nbsp;Melody Dong PhD ,&nbsp;Rong Huang MS ,&nbsp;Joann Lindenfeld MD ,&nbsp;Francesco Maisano MD ,&nbsp;Ralph Stephan von Bardeleben MD ,&nbsp;Saibal Kar MD ,&nbsp;Evelio Rodriguez MD","doi":"10.1016/j.jchf.2024.08.001","DOIUrl":"10.1016/j.jchf.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Moderate secondary mitral regurgitation (SMR) represents a subgroup of heart failure (HF) patients with treatment restricted to medical therapy. Outcomes in patients with moderate SMR treated with mitral transcatheter edge-to-edge repair (M-TEER) are less well known.</div></div><div><h3>Objectives</h3><div>The aim of this study was to assess the safety and effectiveness of M-TEER in subjects with moderate SMR using the EXPANDed studies.</div></div><div><h3>Methods</h3><div>One-year outcomes in subjects from the EXPANDed studies (EXPAND [A Contemporary, Prospective Study Evaluating Real-world Experience of Performance and Safety for the Next Generation of MitraClip Devices] and EXPAND G4 [A Post-Market Study Assessment of the Safety and Performance of the MitraClip G4 System] MitraClip studies) with baseline moderate SMR (2+), per echocardiographic core laboratory (ECL) assessment, were compared with subjects with baseline severe SMR (≥3+).</div></div><div><h3>Results</h3><div>There were 335 subjects with moderate SMR and 525 with severe SMR at baseline per ECL review. Baseline characteristics were similar between the 2 subgroups. After treatment with M-TEER, significant MR reduction was achieved in both groups. Significant left ventricular (LV) reverse remodeling was observed through 1 year, with a &gt;20 mL decrease in LV end-diastolic and end-systolic volumes on average in the moderate SMR group. Significant 1-year improvements in NYHA functional class (&gt;78% NYHA functional class I or II) and quality of life (&gt;20 points on the Kansas City Cardiomyopathy Questionnaire–Overall Summary) were observed in subjects with moderate SMR. Similarly, low rates of major adverse events, all-cause mortality, and HF hospitalizations were observed between the 2 subgroups through 1 year.</div></div><div><h3>Conclusions</h3><div>In the EXPANDed studies, subjects with moderate SMR treated with M-TEER had improvements similar to subjects with severe SMR in quality of life and positive LV remodeling at 1 year. Future studies are needed to evaluate if M-TEER would be beneficial for HF patients with moderate SMR.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 213-225"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Heart Failure Outcomes and Medical Therapy Use in a Virtually Managed Hospital at Home Setting","authors":"Trejeeve Martyn MD, MSc ,&nbsp;Harsh Patolia MD ,&nbsp;Nicholas Platek DO ,&nbsp;Ryan Tang MD ,&nbsp;Nancy M. Albert PhD ,&nbsp;Danielle Crow MSN ,&nbsp;Amanda R. Vest MBBS, MPH ,&nbsp;Samir Kapadia MD ,&nbsp;Raed Dweik MD ,&nbsp;Lars G. Svensson MD, PhD ,&nbsp;Jerry D. Estep MD ,&nbsp;Conor P. Delaney MD, PhD ,&nbsp;Richard D. Rothman MD ,&nbsp;Jessica Hohman MD, MSc, MSc","doi":"10.1016/j.jchf.2024.10.007","DOIUrl":"10.1016/j.jchf.2024.10.007","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 2","pages":"Pages 381-385"},"PeriodicalIF":10.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647905","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}