JACC. Heart failure最新文献

{"title":"Association of Multiple Nonhypertrophic Cardiomyopathy-Related Genetic Variants and Outcomes in Patients With Hypertrophic Cardiomyopathy.","authors":"Takashi Hiruma, Shunsuke Inoue, Zhehao Dai, Seitaro Nomura, Toru Kubo, Kenta Sugiura, Atsushi Suzuki, Takeshi Kashimura, Shouji Matsushima, Takanobu Yamada, Takashige Tobita, Manami Katoh, Toshiyuki Ko, Masamichi Ito, Junichi Ishida, Eisuke Amiya, Masaru Hatano, Norifumi Takeda, Eiki Takimoto, Hiroshi Akazawa, Hiroyuki Morita, Junichi Yamaguchi, Takayuki Inomata, Hiroyuki Tsutsui, Hiroaki Kitaoka, Hiroyuki Aburatani, Norihiko Takeda, Issei Komuro","doi":"10.1016/j.jchf.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.08.005","url":null,"abstract":"<p><strong>Background: </strong>Approximately 10% of hypertrophic cardiomyopathy (HCM) patients have left ventricular systolic dysfunction (end-stage HCM) leading to severe heart-failure; however, risk stratification to identify patients at risk of progressing to end-stage HCM remains insufficient.</p><p><strong>Objectives: </strong>In this study, the authors sought to elucidate whether the coexistence of other cardiovascular disease (CVD)-related variants is associated with progression to end-stage HCM in patients with HCM harboring pathogenic or likely pathogenic (P/LP) sarcomeric variants.</p><p><strong>Methods: </strong>The authors performed genetic analysis of 83 CVD-related genes in HCM patients from a Japanese multicenter cohort. P/LP variants in 8 major sarcomeric genes (MYBPC3, MYH7, TNNT2, TNNI3, TPM1, MYL2, MYL3, and ACTC1) definitive for HCM were defined as \"sarcomeric variants.\" In addition, P/LP variants associated with other CVDs, such as dilated cardiomyopathy and arrhythmogenic cardiomyopathy, were referred to as \"other CVD-related variants.\"</p><p><strong>Results: </strong>Among 394 HCM patients, 139 carried P/LP sarcomeric variants: 11 (7.9%) carried other CVD-related variants, 6 (4.3%) multiple sarcomeric variants, and 122 (87.8%) single sarcomeric variants. In a multivariable Cox regression analysis, presence of multiple sarcomeric variants (adjusted HR [aHR]: 3.35 [95% CI: 1.25-8.95]; P = 0.016) and coexistence of other CVD-related variants (aHR: 2.80 [95% CI: 1.16-6.78]; P = 0.022) were independently associated with progression to end-stage HCM. Coexisting other CVD-related variants were also associated with heart failure events (aHR: 2.75 [95% CI: 1.27-5.94]; P = 0.010).</p><p><strong>Conclusions: </strong>Approximately 8% of sarcomeric HCM patients carried other CVD-related variants, which were associated with progression to end-stage HCM and heart failure events. Comprehensive surveillance of CVD-related variants within sarcomeric HCM patients contributes to risk stratification and understanding of mechanisms underlying end-stage HCM.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346901","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":"Patiromer and MRA Doses in Patients With Current or Past Hyperkalemia.","authors":"João Pedro Ferreira","doi":"10.1016/j.jchf.2024.07.020","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.07.020","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346902","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":"Physician-Reported Reasons for Not Initiating Guideline-Directed Medical Therapy for Heart Failure.","authors":"Stephen J Greene, Lori D Bash, Kathryn W Tebbs, Lucy N Hancock, Sophie G Barlow, Catelyn R Coyle","doi":"10.1016/j.jchf.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.08.002","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287502","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":"Coronary Revascularization in Ischemic Systolic Heart Failure","authors":"Yousif Ahmad PhD","doi":"10.1016/j.jchf.2024.06.003","DOIUrl":"10.1016/j.jchf.2024.06.003","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 9","pages":"Pages 1563-1565"},"PeriodicalIF":10.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633532","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":"Incidence and Prediction of Anoxic Brain Injury in Concomitant Cardiac Arrest and Cardiogenic Shock","authors":"","doi":"10.1016/j.jchf.2024.05.009","DOIUrl":"10.1016/j.jchf.2024.05.009","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 9","pages":"Pages 1639-1642"},"PeriodicalIF":10.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431897","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":"Continuum of Preshock to Classic Cardiogenic Shock in the Critical Care Cardiology Trials Network Registry","authors":"Siddharth M. Patel MD, MPH ,&nbsp;David D. Berg MD, MPH ,&nbsp;Erin A. Bohula MD, DPhil ,&nbsp;Vivian M. Baird-Zars MPH ,&nbsp;Jeong-Gun Park PhD ,&nbsp;Christopher F. Barnett MD, MPH ,&nbsp;Lori B. Daniels MD, MAS ,&nbsp;Christopher B. Fordyce MD, MHS, MSc ,&nbsp;Shahab Ghafghazi MD ,&nbsp;Michael J. Goldfarb MD, MSc ,&nbsp;Kari Gorder MD ,&nbsp;Younghoon Kwon MD ,&nbsp;Evan Leibner MD, PhD ,&nbsp;Venu Menon MD ,&nbsp;Brian J. Potter MD, MSc ,&nbsp;Rajnish Prasad MD ,&nbsp;Michael A. Solomon MD, MBA ,&nbsp;Jeffrey J. Teuteberg MD ,&nbsp;Andrea D. Thompson MD, PhD ,&nbsp;Sammy Zakaria MD, MPH ,&nbsp;David A. Morrow MD, MPH","doi":"10.1016/j.jchf.2024.06.009","DOIUrl":"10.1016/j.jchf.2024.06.009","url":null,"abstract":"<div><h3>Background</h3><p>The prognostic implications of phenotypes along the preshock to cardiogenic shock (CS) continuum remain uncertain.</p></div><div><h3>Objectives</h3><p>This study sought to better characterize pre- or early shock and normotensive CS phenotypes and examine outcomes compared to those with conventional CS.</p></div><div><h3>Methods</h3><p>The CCCTN (Critical Care Cardiology Trials Network) is a registry of contemporary cardiac intensive care units. Consecutive admissions (N = 28,703 across 47 sites) meeting specific criteria based on hemodynamic variables, perfusion parameters, and investigator-reported CS were classified into 1 of 4 groups or none: isolated low cardiac output (CO), heart failure with isolated hypotension, normotensive CS, or SCAI (Society of Cardiovascular Angiography and Intervention) stage C CS. Outcomes of interest were in-hospital mortality and incidence of subsequent hypoperfusion among pre- and early shock states.</p></div><div><h3>Results</h3><p>A total of 2,498 admissions were assigned to the 4 groups with the following distribution: 4.8% isolated low CO, 4.4% isolated hypotension, 12.1% normotensive CS, and 78.7% SCAI stage C CS. Overall in-hospital mortality was 21.3% (95% CI: 19.7%-23.0%), with a gradient across phenotypes (isolated low CO 3.6% [95% CI: 1.0%-9.0%]; isolated hypotension 11.0% [95% CI: 6.9%-16.6%]; normotensive CS 17.0% [95% CI 13.0%-21.8%]; SCAI stage C CS 24.0% [95% CI: 22.1%-26.0%]; global <em>P &lt;</em> 0.001). Among those with an isolated low CO and isolated hypotension on admission, 47 (42.3%) and 56 (30.9%) subsequently developed hypoperfusion.</p></div><div><h3>Conclusions</h3><p>In a large contemporary registry of cardiac critical illness, there exists a gradient of mortality for phenotypes along the preshock to CS continuum with risk for subsequent worsening of preshock states. These data may inform refinement of CS definitions and severity staging.</p></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 9","pages":"Pages 1625-1635"},"PeriodicalIF":10.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874822","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":"Effect of PCI on Health Status in Ischemic Left Ventricular Dysfunction","authors":"","doi":"10.1016/j.jchf.2024.03.010","DOIUrl":"10.1016/j.jchf.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><p>In the REVIVED-BCIS2 (Revascularization for Ischemic Ventricular Dysfunction) trial, percutaneous coronary intervention (PCI) did not reduce the incidence of death or hospitalization for heart failure (HHF).</p></div><div><h3>Objectives</h3><p>This prespecified secondary analysis investigated the effect of PCI on health status measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) combined with the primary outcome in a win ratio.</p></div><div><h3>Methods</h3><p>Participants with severe ischemic left ventricular dysfunction were randomized to either PCI in addition to optimal medical therapy (OMT) (PCI) or OMT alone (OMT). The primary outcome was a hierarchical composite of all-cause death, HHF, and KCCQ–Overall Summary Score (OSS) at 24 months analyzed using the unmatched win ratio. The key secondary endpoint was a KCCQ-OSS responder analysis.</p></div><div><h3>Results</h3><p>A total of 347 participants were randomized to PCI and 353 to OMT. Median age was 70.0 years (Q1-Q3: 63.3-76.1 years). Mean left ventricular ejection fraction was 27.0 ± 6.7%. PCI did not improve the primary endpoint (win ratio for PCI vs OMT: 1.05; 95% CI: 0.88-1.26; <em>P =</em> 0.58). PCI resulted in more KCCQ-OSS responders than OMT at 6 months (54.1% vs 40.7%; OR: 1.96; 95% CI: 1.41-2.71; <em>P &lt;</em> 0.001) and fewer deteriorators (25.2% vs 31.4%; OR: 0.69; 95% CI: 0.47-1.00; <em>P =</em> 0.048). PCI did not impact KCCQ-OSS responders or deteriorators at 12 or 24 months.</p></div><div><h3>Conclusions</h3><p>PCI did not improve the hierarchical composite of death, HHF, and health status at 2 years. PCI improved KCCQ-OSS at 6 months, but this benefit was not sustained to 1- or 2-year follow-up. (Revacularization for Ischemic Ventricular Dysfunction [REVIVED-BCIS2]; <span><span>NCT01920048</span><svg><path></path></svg></span>)</p></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 9","pages":"Pages 1553-1562"},"PeriodicalIF":10.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213177924002646/pdfft?md5=599992f76d6c9bef61a09ab764c3cd1e&pid=1-s2.0-S2213177924002646-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140604242","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":"Obesity and Weight Loss Strategies for Patients With Heart Failure","authors":"Amanda R. Vest MBBS, MPH ,&nbsp;Philip R. Schauer MD ,&nbsp;Jo E. Rodgers PharmD ,&nbsp;Emily Sanderson BA, MS ,&nbsp;Courtney L. LaChute MD ,&nbsp;Jessica Seltz MS, RD ,&nbsp;Carl J. Lavie MD ,&nbsp;Stacy A. Mandras MD ,&nbsp;W.H. Wilson Tang MD ,&nbsp;Adrian daSilva-deAbreu MD, MSc","doi":"10.1016/j.jchf.2024.06.006","DOIUrl":"10.1016/j.jchf.2024.06.006","url":null,"abstract":"<div><p>Obesity is a common comorbidity among patients with heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF), with the strongest pathophysiologic link of obesity being seen for HFpEF. Lifestyle measures are the cornerstone of weight loss management, but sustainability is a challenge, and there are limited efficacy data in the heart failure (HF) population. Bariatric surgery has moderate efficacy and safety data for patients with preoperative HF or left ventricular dysfunction and has been associated with reductions in HF hospitalizations and medium-term mortality. Antiobesity medications historically carried concerns for cardiovascular adverse effects, but the safety and weight loss efficacy seen in general population trials of glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide/GLP-1 agonists are highly encouraging. Although there are safety concerns regarding GLP-1 agonists in advanced HFrEF, trials of the GLP-1 agonist semaglutide for treatment of obesity have confirmed safety and efficacy in patients with HFpEF.</p></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 9","pages":"Pages 1509-1527"},"PeriodicalIF":10.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874824","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":"Palliative Care Utilization in Patients With Heart Failure With Preserved Ejection Fraction","authors":"Shahzad Hassan MD, MS ,&nbsp;Zara Latif MD ,&nbsp;Tracy Makuvire MD, MPH ,&nbsp;Jose Lopez MD ,&nbsp;Sarah Godfrey MD ,&nbsp;Anuradha Lala MD ,&nbsp;Haider J. Warraich MD","doi":"10.1016/j.jchf.2024.06.008","DOIUrl":"10.1016/j.jchf.2024.06.008","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 9","pages":"Pages 1643-1644"},"PeriodicalIF":10.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874789","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":"Evaluation of the Hemocompatibility of the Direct Oral Anticoagulant Apixaban in Left Ventricular Assist Devices","authors":"","doi":"10.1016/j.jchf.2024.04.013","DOIUrl":"10.1016/j.jchf.2024.04.013","url":null,"abstract":"<div><h3>Background</h3><p>Patients receiving left ventricular assist device (LVAD) support require long-term anticoagulation to reduce the risk of thromboembolic complications. Apixaban is a direct oral anticoagulant that has become first-line therapy; however, its safety in LVAD recipients has not been well described.</p></div><div><h3>Objectives</h3><p>This study sought to investigate whether, in patients with a fully magnetically levitated LVAD, treatment with apixaban would be feasible and comparable with respect to safety and freedom from the primary composite outcome of death or major hemocompatibility-related adverse events (HRAEs) (stroke, device thrombosis, major bleeding, aortic root thrombus, and arterial non–central nervous system thromboembolism) as compared with treatment with warfarin.</p></div><div><h3>Methods</h3><p>The DOAC LVAD (Evaluation of the Hemocompatibility of the Direct Oral Anti-Coagulant Apixaban in Left Ventricular Assist Devices) trial was a phase 2, open label trial of LVAD recipients randomized 1:1 to either apixaban 5 mg twice daily or warfarin therapy. All patients were required to take low-dose aspirin. Patients were followed up for 24 weeks to evaluate the primary composite outcome.</p></div><div><h3>Results</h3><p>A total of 30 patients were randomized: 14 patients to warfarin and 16 patients to apixaban. The median patient age was 60 years (Q1-Q3: 52-71 years), and 47% were Black patients. The median time from LVAD implantation to randomization was 115 days (Q1-Q3: 56-859 days). At 24 weeks, the primary composite outcome occurred in no patients receiving apixaban and in 2 patients (14%) receiving warfarin (<em>P =</em> 0.12); these 2 patients experienced major bleeding from gastrointestinal sources.</p></div><div><h3>Conclusions</h3><p>Anticoagulation with apixaban was feasible in patients with an LVAD without an excess of HRAEs or deaths. This study informs future pivotal clinical trials evaluating the safety and efficacy of apixaban in LVAD recipients. (Evaluation of the Hemocompatibility of the Direct Oral Anti-Coagulant Apixaban in Left Ventricular Assist Devices [DOAC LVAD]; <span><span>NCT04865978</span><svg><path></path></svg></span>)</p></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 9","pages":"Pages 1540-1549"},"PeriodicalIF":10.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213177924003330/pdfft?md5=d26b586cc66405aaa8c23412cd08e61b&pid=1-s2.0-S2213177924003330-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140895329","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}