JACC. Heart failure最新文献

{"title":"Smaller Preimplant LV Size and Mortality Following HeartMate 3 Left Ventricular Assist Device","authors":"Maya H. Barghash MD , Peter M. Eckman MD","doi":"10.1016/j.jchf.2025.03.016","DOIUrl":"10.1016/j.jchf.2025.03.016","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 812-814"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907529","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":"Rationale and Design of the Dapagliflozin Effect on Cardiovascular Events in Acute Heart Failure (DAPA ACT HF)-TIMI 68 Trial","authors":"David D. Berg MD, MPH ,&nbsp;Siddharth M. Patel MD, MPH ,&nbsp;Paul M. Haller MD, PhD ,&nbsp;Jan Bělohlávek MD, PhD ,&nbsp;Akshay S. Desai MD, MPH ,&nbsp;Jarosław Drożdż MD, PhD ,&nbsp;Silvio E. Inzucchi MD ,&nbsp;John J.V. McMurray MD ,&nbsp;Béla Merkely MD, PhD ,&nbsp;Eileen O’Meara MD ,&nbsp;Subodh Verma MD, PhD ,&nbsp;Abby L. Cange BS ,&nbsp;Sabina A. Murphy MPH ,&nbsp;Marc S. Sabatine MD, MPH ,&nbsp;Stephen D. Wiviott MD","doi":"10.1016/j.jchf.2025.03.014","DOIUrl":"10.1016/j.jchf.2025.03.014","url":null,"abstract":"<div><div>Although sodium-glucose cotransporter 2 inhibitors reduce the risk of cardiovascular death or worsening heart failure (HF) in patients with chronic HF, there are limited data on initiation in hospitalized patients with HF. DAPA ACT HF-TIMI 68 (Dapagliflozin and Effect on Cardiovascular Events in Acute Heart Failure – Thrombolysis in Myocardial Infarction 68) is an international, randomized, double-blind trial evaluating the initiation of dapagliflozin (10 mg daily) vs placebo in 2,401 patients hospitalized for acute HF. Patients were enrolled irrespective of left ventricular ejection fraction, type 2 diabetes status, or chronicity of HF (de novo and worsening chronic HF). Randomized participants receive blinded treatment for 2 months. The primary efficacy endpoint is time to first occurrence of cardiovascular death or worsening HF (worsening HF during the index admission, rehospitalization for worsening HF, or urgent HF visit). Key safety endpoints include symptomatic hypotension and worsening kidney function. This is the first cardiovascular outcomes trial designed specifically to evaluate the efficacy and safety of in-hospital initiation of dapagliflozin in patients hospitalized for the management of acute HF. (Dapagliflozin and Effect on Cardiovascular Events in Acute Heart Failure – Thrombolysis in Myocardial Infarction 68 [DAPA ACT HF-TIMI 68]; <span><span>NCT04363697</span><svg><path></path></svg></span>; <span><span>EudraCT # 2022-001262-35</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 829-839"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907531","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":"Hospital-at-Home","authors":"Trejeeve Martyn MD, MSc,&nbsp;Jessica Hohman MD, MSc, MSc,&nbsp;Harsh Patolia MD,&nbsp;Michael J. Maniaci MD,&nbsp;Richard D. Rothman MD","doi":"10.1016/j.jchf.2025.01.030","DOIUrl":"10.1016/j.jchf.2025.01.030","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 877-878"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907978","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":"Small Left Ventricular Cavity Size and Big Risks for Females on Durable LVAD Support","authors":"Aditi Nayak MD, MS ,&nbsp;Nosheen Reza MD","doi":"10.1016/j.jchf.2025.01.032","DOIUrl":"10.1016/j.jchf.2025.01.032","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 883-884"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907982","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":"Not in the Gym… But at Home","authors":"Gregory T. Gibson MD,&nbsp;Ileana L. Piña MD, MPH","doi":"10.1016/j.jchf.2025.03.011","DOIUrl":"10.1016/j.jchf.2025.03.011","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 707-709"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906961","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":"Left Ventricular Dimensions and Clinical Outcomes With a Fully Magnetically Levitated Left Ventricular Assist Device","authors":"Ezequiel J. Molina MD ,&nbsp;Mustafa M. Ahmed MD ,&nbsp;Farooq H. Sheikh MD ,&nbsp;Joseph C. Cleveland Jr. MD ,&nbsp;Daniel J. Goldstein MD ,&nbsp;Nir Y. Uriel MD ,&nbsp;AiJia Wang MPH ,&nbsp;Jordan J. Revis MS ,&nbsp;Mandeep R. Mehra MD, MSc","doi":"10.1016/j.jchf.2024.09.019","DOIUrl":"10.1016/j.jchf.2024.09.019","url":null,"abstract":"<div><h3>Background</h3><div>Prior analyses have suggested that a smaller left ventricular end-diastolic diameter (LVEDD) is associated with reduced survival following HeartMate 3 left ventricular assist device implantation.</div></div><div><h3>Objectives</h3><div>In this trial-based comprehensive analysis, the authors sought to examine clinical characteristics and association with the outcome of this specific relationship.</div></div><div><h3>Methods</h3><div>The authors analyzed the presence of LVEDD &lt;55 mm among 1,921 analyzable HeartMate 3 patients within the MOMENTUM 3 (Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3) trial portfolio, on endpoints of overall survival and adverse events at 2 years. Adverse events included hemocompatibility-related (stroke, bleeding, and pump thrombosis) and non–hemocompatibility-related (right heart failure, infection) outcomes.</div></div><div><h3>Results</h3><div>Those with a smaller LVEDD (&lt;55 mm) (n = 108) were older (age 63 ± 11 years vs 60 ± 12 years; <em>P =</em> 0.005), were more often female (31% vs 20%; <em>P =</em> 0.096), and had more ischemic cardiomyopathy (60.2% vs 42.6%; <em>P =</em> 0.0004) compared with the LVEDD ≥55 mm group (n = 1,813). Death during implant hospitalization was higher (14.8 vs 5.7%; <em>P =</em> 0.0007) and survival at 2 years was lower (63.3% vs 81.8%; HR: 1.97 [95% CI: 1.39-2.79]; <em>P =</em> 0.0002) in the LVEDD &lt;55 mm group. The LVEDD &lt;55 mm group experienced more deaths due to hemocompatibility-related adverse events (2.8% vs 0.6%; HR: 4.61 [95% CI: 1.29-16.45]; <em>P =</em> 0.018) and right heart failure, both early (0-30 days; 7.4% vs 2.0%; HR: 3.70 [95% CI: 1.73-7.91]; <em>P =</em> 0.001) and late (&gt;30 days; 12.0 vs 4.8%; HR: 2.58 [95% CI: 1.37-4.84]; <em>P =</em> 0.003). Low-flow alarms rehospitalizations were higher in the LVEDD &lt;55 mm cohort (17.4 vs 8.3%; HR: 2.39 [95% CI: 1.59-3.59]; <em>P &lt;</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Although infrequent in occurrence, smaller LVEDD (&lt;55 mm) is associated with increased risk for early and late mortality, a consequence of hemocompatibility-related and right heart failure–related deaths. Rehospitalizations due to low-flow alarms are also more frequent. <strong>(</strong>MOMENTUM 3 IDE Clinical Study Protocol [HM3™]; <span><span>NCT02224755</span><svg><path></path></svg></span>; MOMENTUM 3 Continued Access Protocol [MOMENTUM 3 CAP]; <span><span>NCT02892955</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 798-811"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872113","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":"Comparison of Investigator-Reported and Centrally Adjudicated Heart Failure Outcomes in the EMPEROR-Preserved Trial","authors":"Peter Carson MD ,&nbsp;John R. Teerlink MD ,&nbsp;Michel Komajda MD ,&nbsp;Inder Anand MD ,&nbsp;Milton Packer MD ,&nbsp;Javed Butler MD ,&nbsp;Wolfram Doehner MD ,&nbsp;João Pedro Ferreira MD ,&nbsp;Gerasimos Filippatos MD ,&nbsp;Markus Haass MD ,&nbsp;Alan Miller MD ,&nbsp;Steen Pehrson MD ,&nbsp;Stuart J. Pocock PhD ,&nbsp;Tomoko Iwata MSc ,&nbsp;Martina Brueckmann MD ,&nbsp;Tomasz Gasior MD ,&nbsp;Faiez Zannad MD ,&nbsp;Stefan D. Anker MD","doi":"10.1016/j.jchf.2024.10.021","DOIUrl":"10.1016/j.jchf.2024.10.021","url":null,"abstract":"<div><h3>Background</h3><div>There is limited published information on outcome adjudication in heart failure (HF) trials, particularly in heart failure with preserved ejection fraction (HFpEF).</div></div><div><h3>Objectives</h3><div>The study sought to compare investigator reports with clinical events committee (CEC) adjudication and assess the impact of the SCTI (Standardized Data Collection for Cardiovascular Trials) criteria.</div></div><div><h3>Methods</h3><div>In the EMPEROR-Preserved (EMPagliflozin outcome tRial in Patients with chronic heart Failure With Preserved Ejection Fraction) trial, we compared investigator reports with CEC for concordance, treatment effect on primary composite outcome events and components (first event primary heart failure hospitalization [HHF] or cardiovascular [CV] mortality), prognosis after first HHF, total HHF, and trial duration with and without SCTI criteria.</div></div><div><h3>Results</h3><div>The CEC confirmed 67.4% investigator-reported events for the primary outcome (CV mortality 82.7%, HHF 66.3%). The HR for treatment effect did not differ between adjudication methods for the primary outcome: investigator reports (HR: 0.77; 95% CI: 0.69-0.87), CEC (HR: 0.79; 95% CI: 0.69-0.90), its components, or total HHFs. The prognosis after the first HHF for all-cause mortality and CV mortality also did not differ between investigator reports and the CEC, nor did investigator reports and HHFs with a different CEC cause. SCTI criteria were present in 92% of CEC HHFs with a similar treatment effect to non-SCTI criteria. The investigator-reported primary events reached the protocol target number 6 months earlier than the CEC (7 months with full SCTI criteria).</div></div><div><h3>Conclusions</h3><div>Investigator adjudication is an alternative to a CEC with similar accuracy and faster event accumulation in HFpEF. The use of granular (SCTI) criteria did not improve trial performance. Our data suggest that a broader definition of an HHF event could be particularly beneficial in HFpEF clinical trials. (EMPagliflozin outcome tRial in Patients with chronic heart Failure With Preserved Ejection Fraction; <span><span>NCT03057951</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 710-721"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080109","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":"Center- vs Home-Based Cardiac Rehabilitation in Patients With Heart Failure","authors":"Cristine Schmidt PhD ,&nbsp;Sandra Magalhães MD ,&nbsp;Priscilla Gois Basilio PhD ,&nbsp;Cláudio Santos MS ,&nbsp;Maria Isilda Oliveira MS ,&nbsp;João Pedro Ferreira MD, PhD ,&nbsp;Fernando Ribeiro PhD ,&nbsp;Mário Santos MD, PhD","doi":"10.1016/j.jchf.2024.09.024","DOIUrl":"10.1016/j.jchf.2024.09.024","url":null,"abstract":"<div><h3>Background</h3><div>Despite being an evidence-based intervention, the implementation of cardiac rehabilitation (CR) is often unsatisfactory, especially among patients with heart failure (HF). Home-based CR can serve as an alternative to improve accessibility for patients unable to participate in center-based programs.</div></div><div><h3>Objectives</h3><div>The study sought to compare the clinical impact of center- vs home-based CR in HF patients.</div></div><div><h3>Methods</h3><div>Single-center, parallel group, noninferiority trial, enrolling HF patients irrespective of ejection fraction. Patients were randomly allocated in a 1:1 ratio, then adjusted to a 1 center/2 home ratio during the COVID-19 pandemic, then adjusted to 12 weeks of a standard center-based (24 supervised exercise sessions) or home-based CR (4 supervised sessions plus 20 sessions at home, asynchronously monitored by telephone using wearable smartwatch data) program. The primary outcome was change in peak oxygen uptake (V<span>o</span>₂peak) at 12 weeks.</div></div><div><h3>Results</h3><div>Of the 120 patients (age 62 ± 11 years, 66% men, mean left ventricular ejection fraction 36 ± 11%) who were randomized to center-based (n = 45) or home-based (n = 75) CR, 95 (79%) had complete V<span>o</span>₂peak data at the 12-week assessment: 34 (76%) in the center-based group and 61 (81%) in the home-based group. No significant between-group differences were found in V<span>o</span>₂peak change from baseline to week 12 (0.8 mL/kg/min [95% CI: 1.8 to −0.16 mL/kg/min]; <em>P =</em> 0.10). Additionally, no between-group differences were found for changes in the prespecified secondary outcomes: 6-minute walking distance, Minnesota Living with Heart Failure Questionnaire scores, disease-related biomarkers, and physical fitness. Exercise adherence to the CR program was similar between groups (home-based 84% vs center-based 81%).</div></div><div><h3>Conclusions</h3><div>In a contemporary well-treated HF population, home-based CR was noninferior to the center-based program, supporting the home-based approach as an effective and feasible alternative to the traditional center-based programs. (EXercise InTervention in Heart Failure [EXIT-HF]; <span><span>NCT04334603</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 695-706"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080107","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":"Obesity and Heart Failure in Patients With a Reduced Ejection Fraction","authors":"Josephine Harrington MD ,&nbsp;Martin A. Alpert MD","doi":"10.1016/j.jchf.2025.01.026","DOIUrl":"10.1016/j.jchf.2025.01.026","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 737-739"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908259","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":"Digital Solutions for the Optimization of Pharmacologic Therapy for Heart Failure","authors":"Adam D. DeVore MD, MHS ,&nbsp;Mary Norine Walsh MD ,&nbsp;Orly Vardeny PharmD, MS ,&nbsp;Nancy M. Albert PhD ,&nbsp;Akshay S. Desai MD, MPH","doi":"10.1016/j.jchf.2024.10.014","DOIUrl":"10.1016/j.jchf.2024.10.014","url":null,"abstract":"<div><div>Data from large-scale, randomized, controlled trials demonstrate that contemporary treatments for heart failure (HF) can substantially improve morbidity and mortality. Despite this, observed outcomes for patients living with HF are poor, and they have not improved over time. The are many potential reasons for this important problem, but inadequate use of optimal medical therapy for patients with HF, an important component of guideline-directed medical therapy, in routine practice is a principal and modifiable contributor. In this state-of-the-art review, we focus on digital interventions that specifically target the rapid initiation and titration of medical therapy for HF, typically not involving face-to-face encounters. Early data suggest that digital interventions that use data collected outside of structured episodes of care can facilitate initiation and titration of guideline-directed medical therapy for patients with HF. More data are necessary, however, to understand the safety and efficacy of these interventions compared with current care models. In addition, specific efforts by key constituents are necessary to generate sufficient data on the effectiveness and sustainability of digital interventions in routine practice and to ensure that they do not exacerbate existing disparities in care.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 5","pages":"Pages 675-684"},"PeriodicalIF":10.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965049","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}