JACC. Heart failure最新文献

{"title":"Global Heart Failure Trends in Young Adults","authors":"Noelle V. Pavlovic PhD, RN , Rafael Vidal-Perez MD, PhD","doi":"10.1016/j.jchf.2025.102625","DOIUrl":"10.1016/j.jchf.2025.102625","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102625"},"PeriodicalIF":11.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922071","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":"Minimally Important Kansas City Cardiomyopathy Questionnaire Changes Across the Spectrum of Heart Failure Severity","authors":"John A. Spertus MD, MPH ,&nbsp;Philip G. Jones MS ,&nbsp;Javed Butler MD, MPH, MBA ,&nbsp;Suzanne V. Arnold MD, MHA","doi":"10.1016/j.jchf.2025.102587","DOIUrl":"10.1016/j.jchf.2025.102587","url":null,"abstract":"<div><h3>Background</h3><div>Although the Kansas City Cardiomyopathy Questionnaire (KCCQ) assesses important outcomes for patients with heart failure, whether a 5-point change in KCCQ represents a minimal clinically important difference (MCID) in an individual patient with very poor, as compared with very good, heart failure severity is unknown.</div></div><div><h3>Objectives</h3><div>This study aims to define MCIDs for the KCCQ–Overall Summary Score (OSS) and KCCQ–Clinical Summary Score (CSS) across the range of baseline health status.</div></div><div><h3>Methods</h3><div>Outpatients with heart failure with ejection fractions ≤40% recruited from 14 clinics completed KCCQs at baseline and 6 ± 2 weeks later, along with a 15-point Likert scale assessing their perceived changes in health status. Linear regression estimated MCIDs for small but important changes across the range of baseline KCCQ scores.</div></div><div><h3>Results</h3><div>Among 467 participants (aged 61 ± 13 years, 75% men, left ventricular ejection fraction 25% ± 8%, baseline KCCQ-OSS 61.0 ± 23.7), 28 reported moderate/large deteriorations, 28 small but important deteriorations, 293 no change, 35 small but important improvements, and 83 moderate/large improvements. Although MCIDs for improvement were slightly smaller, with higher baseline scores (6.0 [95% CI: 3.8-8.3] for a baseline KCCQ of 20 vs 2.1 [95% CI: −0.0 to 4.5] for 95; <em>P</em>-trend = 0.003), MCIDs for deterioration were constant (<em>P =</em> 0.87). The overall KCCQ-OSS MCIDs for improvement or deterioration was 3.9 (95% CI: 2.7-5.4), with similar results for the KCCQ-CSS.</div></div><div><h3>Conclusions</h3><div>A 5-point difference in KCCQ scores represents an important clinical change for patients, regardless of their baseline health status, and can be applied to both clinical trials and clinical practice.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 9","pages":"Article 102587"},"PeriodicalIF":11.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931806","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":"From Dispensing Pills to Building Pillars","authors":"Robert L. Page II PharmD, MSPH ,&nbsp;Orly Vardeny PharmD, MS ,&nbsp;Mona Fiuzat PharmD","doi":"10.1016/j.jchf.2025.102641","DOIUrl":"10.1016/j.jchf.2025.102641","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102641"},"PeriodicalIF":11.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922072","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":"Incretin-Based Therapies","authors":"Biykem Bozkurt MD, PhD (Editor-in-Chief, JACC: Heart Failure)","doi":"10.1016/j.jchf.2025.102631","DOIUrl":"10.1016/j.jchf.2025.102631","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 9","pages":"Article 102631"},"PeriodicalIF":11.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931810","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":"Better 3 Hours Too Soon Than 1 Minute Late","authors":"Supriya Shore MD, MSCS,&nbsp;Monica Colvin MD, MS","doi":"10.1016/j.jchf.2025.102564","DOIUrl":"10.1016/j.jchf.2025.102564","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 9","pages":"Article 102564"},"PeriodicalIF":11.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931807","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":"Too Late to Turn Back Now? Another Win for Transferrin Saturation","authors":"Niels Grote Beverborg MD ,&nbsp;Ewa A. Jankowska MD, PhD","doi":"10.1016/j.jchf.2025.102600","DOIUrl":"10.1016/j.jchf.2025.102600","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 9","pages":"Article 102600"},"PeriodicalIF":11.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931808","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":"Association Between Midlife Leisure-Time Physical Activity Volume, Intensity, and Duration on Long-Term Heart Failure Risk","authors":"Julianna West MD ,&nbsp;Djhenne Dalmacy MS ,&nbsp;David Leonard PhD ,&nbsp;Carolyn E. Barlow PhD ,&nbsp;Laura DeFina MD ,&nbsp;Jarett D. Berry MD","doi":"10.1016/j.jchf.2025.102579","DOIUrl":"10.1016/j.jchf.2025.102579","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 9","pages":"Article 102579"},"PeriodicalIF":11.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931809","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":"Adipoexosomal MicroRNAs as Adipose Tissue-Derived Messengers in Heart Failure and a Preserved Ejection Fraction.","authors":"Milton Packer","doi":"10.1016/j.jchf.2025.102656","DOIUrl":"10.1016/j.jchf.2025.102656","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":"102656"},"PeriodicalIF":11.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954599","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":"Angiotensin-Neprilysin Inhibition and Left Ventricular Assist Device Therapy","authors":"Maja Cikes MD, PhD ,&nbsp;Jasper J. Brugts MD, PhD ,&nbsp;Brian Claggett PhD ,&nbsp;Ulrich P. Jorde MD ,&nbsp;Davor Milicic MD, PhD ,&nbsp;Ivo Planinc MD, PhD ,&nbsp;Frank Ruschitzka MD, PhD ,&nbsp;Nir Uriel MD, MSc ,&nbsp;Ian Kulac MS ,&nbsp;Nina Jakus MD, PhD ,&nbsp;Filip Loncaric MD, PhD ,&nbsp;Filip Puskaric MD ,&nbsp;Dubravka Sipus MD ,&nbsp;Hrvoje Gasparovic MD, PhD ,&nbsp;Pawel Rubis MD, PhD ,&nbsp;Linda W. van Laake MD, PhD ,&nbsp;Igor Rudez MD, PhD ,&nbsp;Marketa Hegarova MD, PhD ,&nbsp;Gloria Sestan MD ,&nbsp;Sylwia Wisniowska-Smialek MD, PhD ,&nbsp;Scott D. Solomon MD","doi":"10.1016/j.jchf.2025.102657","DOIUrl":"10.1016/j.jchf.2025.102657","url":null,"abstract":"<div><h3>Background</h3><div>The role of heart failure–specific therapies in left ventricular assist device (LVAD) recipients is unclear, and observational data suggest improved outcomes with neurohormonal blockers.</div></div><div><h3>Objectives</h3><div>ENVAD-HF (Multicenter, Randomized, Open-Label, Parallel Group, Study to Evaluate the Use of Sacubitril/Valsartan in HeartMate 3 LVAD Recipients) sought to evaluate the safety and tolerability of the angiotensin-neprilysin inhibitor sacubitril/valsartan vs standard of care (SOC) for managing blood pressure (BP) in HeartMate 3 LVAD recipients.</div></div><div><h3>Methods</h3><div>ENVAD-HF was a prospective multicenter, randomized, open-label study of sacubitril/valsartan vs SOC for managing BP (mean arterial pressure goal: 75-90 mm Hg) in stable LVAD recipients with 12-month follow-up. The composite primary endpoint was time to death, deterioration in renal function, hyperkalemia, or symptomatic hypotension leading to drug withdrawal. Exploratory endpoints included clinical and biomarker assessments and patient-reported outcomes.</div></div><div><h3>Results</h3><div>In 60 randomized patients (30 in each arm), sacubitril/valsartan compared with SOC demonstrated an HR of 0.42 (95% CI: 0.08-2.18; <em>P =</em> 0.30) for the primary endpoint at 12 months. Two primary endpoints were reached in the sacubitril/valsartan group (1 death and 1 symptomatic hypotension event) compared with 5 in the SOC group (2 deaths, 2 worsening renal function events, and 1 symptomatic hypotension event). Numerical trends in favor of sacubitril/valsartan were noted for other exploratory endpoints, including a reduced number of BP medications (difference: −1.09 [95% CI: −1.52 to −0.66]; <em>P &lt;</em> 0.0001) and a significantly better Kansas City Cardiomyopathy Questionnaire–Overall Summary Score (improvement: +10.6 [95% CI: 2.6-18.7]; <em>P =</em> 0.011).</div></div><div><h3>Conclusions</h3><div>ENVAD-HF, a prospective randomized controlled trial of angiotensin-neprilysin inhibition in stable HeartMate 3 LVAD recipients, demonstrated the safety and tolerability of this therapy in this unique population. The trial forms the basis for a pivotal trial to investigate the usefulness of HF-specific therapies in the LVAD population. (Sacubitril/Valsartan in Left Ventricular Assist Device Recipients [ENVAD-HF], <span><span>NCT04103554</span><svg><path></path></svg></span>; A multicENter, randomized, open-label, parallel group, pilot study to evaluate the use of sacubitril/valsartan in HeartMate 3 LVAD recipients, <span><span>2019-003888-22</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 11","pages":"Article 102657"},"PeriodicalIF":11.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954677","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":"Nonsteroidal and Steroidal Mineralocorticoid Antagonists","authors":"Josephine L. Harrington MD ,&nbsp;Mario E. Canonico MD, PhD ,&nbsp;Abdelghani El Rafei MD, MS ,&nbsp;Scott D. Solomon MD ,&nbsp;John R. Teerlink MD ,&nbsp;Muthiah Vaduganathan MD, MPH ,&nbsp;Shelley R. Zieroth MD ,&nbsp;Marc P. Bonaca MD, MPH ,&nbsp;Andrew J. Sauer MD","doi":"10.1016/j.jchf.2025.102637","DOIUrl":"10.1016/j.jchf.2025.102637","url":null,"abstract":"<div><div>Steroidal mineralocorticoid receptor antagonists (MRAs), such as spironolactone and eplerenone, have demonstrated substantial benefits in randomized controlled trials for patients with heart failure with reduced ejection fraction. However, their effectiveness in heart failure with mildly reduced ejection fraction and heart failure with preserved ejection fraction remains uncertain, and the implementation of this class has remained low, in part due to its side effects and tolerability profile. Emerging therapies that target the mineralocorticoid receptor and/or the production of aldosterone may offer alternative strategies to treat the aldosterone–mineralocorticoid receptor axis. For instance, the nonsteroidal MRA finerenone has shown efficacy in reducing cardiovascular and renal events in patients with type 2 diabetes mellitus and chronic kidney disease, as well as decreasing the combined endpoint of cardiovascular death and heart failure hospitalizations in heart failure with mildly reduced ejection fraction and heart failure with preserved ejection fraction populations. Large-scale, direct comparative outcome studies are currently lacking that compare steroidal MRAs vs emerging therapies. This review critically assesses the structural and mechanistic distinctions between nonsteroidal and nonsteroidal MRAs as well as mineralocorticoid receptor modulators and aldosterone synthase inhibitors; summarizes available evidence across heart failure, diabetes, and chronic kidney disease populations; and highlights ongoing and forthcoming research aimed at addressing key unanswered questions in this rapidly evolving therapeutic field.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 10","pages":"Article 102637"},"PeriodicalIF":11.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917677","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}