JACC. Heart failure最新文献

{"title":"Moving From Prompts to Praxis With Remote Monitoring","authors":"Adam D. DeVore MD, MHS , Anuradha Lala MD","doi":"10.1016/j.jchf.2025.03.027","DOIUrl":"10.1016/j.jchf.2025.03.027","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 984-986"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194909","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":"Effects of Sacubitril/Valsartan According to Natriuretic Peptide Levels in Patients Enrolled in PARADIGM-HF and PARAGON-HF","authors":"Toru Kondo MD, PhD ,&nbsp;Pardeep S. Jhund MB ChB, MSc, PhD ,&nbsp;Inder S. Anand MD, DPhil ,&nbsp;Brian L. Claggett PhD ,&nbsp;Akshay S. Desai MD, MPH ,&nbsp;Kieran F. Docherty MB ChB, PhD ,&nbsp;Carolyn S.P. Lam MBBS, PhD ,&nbsp;Martin P. Lefkowitz MD ,&nbsp;Aldo P. Maggioni MD ,&nbsp;Felipe A. Martinez MD ,&nbsp;Margaret M. Redfield MD ,&nbsp;Jean L. Rouleau MD ,&nbsp;Dirk J. Van Veldhuisen MD, PhD ,&nbsp;Faiez Zannad MD, PhD ,&nbsp;Michael R. Zile MD ,&nbsp;Milton Packer MD ,&nbsp;Scott D. Solomon MD ,&nbsp;John J.V. McMurray MD","doi":"10.1016/j.jchf.2024.12.010","DOIUrl":"10.1016/j.jchf.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Recent trials of new heart failure (HF) treatments suggest the effect of therapy may vary by N-terminal pro–B type natriuretic peptide (NT-proBNP) level.</div></div><div><h3>Objectives</h3><div>The authors examined the efficacy of sacubitril/valsartan according to NT-proBNP levels in patients with reduced, mildly reduced, and preserved left ventricular ejection fraction (LVEF) enrolled in PARADIGM-HF (Prospective Comparison of Angiotensin Receptor–Neprilysin Inhibitor with Angiotensin-Converting–Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial) and PARAGON-HF (Prospective Comparison of Angiotensin Receptor–Neprilysin Inhibitor with Angiotensin-Receptor Blockers Global Outcomes in HF with Preserved Ejection Fraction).</div></div><div><h3>Methods</h3><div>Individual patient data from PARADIGM-HF and PARAGON-HF were pooled and participants were divided into categories defined by quintiles of NT-proBNP level. The primary outcome examined was the composite of HF hospitalization or cardiovascular death.</div></div><div><h3>Results</h3><div>Among the 13,195 patients enrolled in both trials, 13,142 (99.6%) had a baseline NT-proBNP level measured. The rate of the primary outcome (per 100 person-years) increased with NT-proBNP levels: quintile 1, 5.9 (95% CI: 5.3-6.5); quintile 2, 7.5 (95% CI: 6.9-8.2); quintile 3, 9.0 (95% CI: 8.2-9.7); quintile 4, 12.0 (95% CI: 11.1-12.9); and quintile 5, 20.8 (95% CI: 19.6-22.2). The relative risk reduction in the primary outcome with sacubitril/valsartan was consistent across NT-proBNP levels: the HR in quintile 1 was 0.79 (95% CI: 0.65-0.96); quintile 2, 0.87 (95% CI: 0.72-1.04); quintile 3, 0.79 (95% CI: 0.66-0.93); quintile 4, 0.85 (95% CI: 0.73-0.99); and quintile 5, 0.86 (95% CI: 0.76-0.97; <em>P</em> for interaction = 0.86). The absolute risk reduction was greatest in NT-proBNP quintile 5; the number needed to treat for the primary outcome over the median follow-up of 31 months was 16 in quintile 5 vs 37 in quintile 1.</div></div><div><h3>Conclusions</h3><div>The relative risk reductions with sacubitril/valsartan were consistent irrespective of NT-proBNP level in HF patients across the range of LVEF. Consequently, the absolute risk reductions were greatest in patients with higher NT-proBNP levels. (PARADIGM-HF [Prospective Comparison of Angiotensin Receptor–Neprilysin Inhibitor with Angiotensin-Converting–Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial]; <span><span>NCT01035255</span><svg><path></path></svg></span>; and PARAGON-HF [Prospective Comparison of Angiotensin Receptor–Neprilysin Inhibitor with Angiotensin-Receptor Blockers Global Outcomes in HF with Preserved Ejection Fraction]; <span><span>NCT01920711</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 927-939"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633639","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":"Guideline Recommendations for Sudden Cardiac Death Prevention in Patients With Hypertrophic Cardiomyopathy","authors":"Sana M. Al-Khatib MD, MHS","doi":"10.1016/j.jchf.2025.04.002","DOIUrl":"10.1016/j.jchf.2025.04.002","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 1027-1029"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078188","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)00365-8","DOIUrl":"10.1016/S2213-1779(25)00365-8","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages i-clxiv"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194446","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 Enigma of Natriuretic Peptides","authors":"Priya Umapathi MD","doi":"10.1016/j.jchf.2025.03.026","DOIUrl":"10.1016/j.jchf.2025.03.026","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 940-942"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194871","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":"Management of Patients With Impella 5.5 Left Ventricular Assist Devices on a Cardiovascular Stepdown Unit","authors":"Anthony P. Carnicelli MD ,&nbsp;Brian A. Houston MD ,&nbsp;Jennifer Hajj RN ,&nbsp;Kaylen Dodson RN ,&nbsp;Lindsey Bull RN ,&nbsp;Meg Ospina MD ,&nbsp;Thomas G. di Salvo MD, MPH, MBA ,&nbsp;Jeffrey D. McMurray MD ,&nbsp;Jeffrey Yourshaw MD ,&nbsp;Ryan J. Tedford MD ,&nbsp;Lucas J. Witer MD ,&nbsp;Arman Kilic MD","doi":"10.1016/j.jchf.2025.02.002","DOIUrl":"10.1016/j.jchf.2025.02.002","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 1034-1036"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399253","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 Atrial-to-Coronary Sinus Shunting in Heart Failure With Mildly Reduced or Preserved Ejection Fraction","authors":"Francesco Fioretti MD ,&nbsp;Benjamin Hibbert MD, PhD ,&nbsp;Peter M. Eckman MD ,&nbsp;Trevor Simard MD, PhD ,&nbsp;Marino Labinaz MD ,&nbsp;Babak Nazer MD ,&nbsp;Mark Wiley MD ,&nbsp;Bhanu Gupta MD ,&nbsp;Andrew J. Sauer MD ,&nbsp;Hirak Shah MD ,&nbsp;Paul Sorajja MD ,&nbsp;Andres M. Pineda MD ,&nbsp;Emil Missov MD ,&nbsp;Lillian Aldaia MD ,&nbsp;Konstantinos Koulogiannis MD ,&nbsp;William A. Gray MD ,&nbsp;Firas Zahr MD ,&nbsp;Javed Butler MD, MPH, MBA","doi":"10.1016/j.jchf.2025.02.003","DOIUrl":"10.1016/j.jchf.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>The ALT-FLOW trial EFS (Early Feasibility Study) evaluated safety, hemodynamics and outcomes for the APTURE system in patients with HF and mildly reduced or preserved ejection fraction.</div></div><div><h3>Objectives</h3><div>In this study, the authors sought to examine the 2-year health status, functional capacity, and outcomes of ALT-FLOW EFS.</div></div><div><h3>Methods</h3><div>Device safety, performance, patency, hemodynamics, echocardiographic parameters, and outcomes were assessed in patients with LVEF &gt;40% (n = 95); NYHA functional class, Kansas City Cardiomyopathy Questionnaire (KCCQ) Clinical Summary Score (CSS), Total Symptom Score (TSS), and Overall Summary Score (OSS), 6-minute walk distance, and the ratio of pulmonary capillary wedge pressure at peak exercise to workload normalized to body weight (PCWL) were evaluated.</div></div><div><h3>Results</h3><div>Major adverse cardiac, cerebral, and renal events and reintervention through 30 days occurred in 2.8% of patients. All implanted shunts were patent for up to 5 years. The mean PCWL decreased from 131 ± 74 mm Hg/W/kg at baseline to 76 ± 57 mm Hg/W/kg after 6 months (<em>P &lt;</em> 0.0001). After 2 years, NYHA functional class improvement was reported in 51/62 patients (82.3%). Mean KCCQ CSS, TSS, and OSS at baseline were 45 ± 17, 46 ± 19, and 38 ± 18 points, respectively, and improved at 2 years by 25 ± 20, 26 ± 23, and 31 ± 23 points, respectively. The reduction in PCWL and improvement in NYHA functional class and KCCQ scores were consistent in patients with or without pulmonary vascular disease. No detrimental changes in right or left ventricular function were observed.</div></div><div><h3>Conclusions</h3><div>In patients with HF and LVEF &gt;40%, the APTURE shunt confirmed an acceptable safety profile with improvements in HF symptoms, quality of life, and functional capacity without negatively affecting right and left heart function after 2 years, regardless of pulmonary vascular disease. (Exploratory Study of the Edwards APTURE Transcatheter Shunt System [ALT-FLOW Canada]; <span><span>NCT04000607</span><svg><path></path></svg></span>; Early Feasibility Study—Edwards APTURE Transcatheter Shunt System [ALT-FLOW US]; <span><span>NCT03523416</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 987-999"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523571","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":"Facts and Fallacies of Body Composition Analysis in Heart Failure","authors":"Melana Yuzefpolskaya MD,&nbsp;Paolo C. Colombo MD","doi":"10.1016/j.jchf.2025.03.025","DOIUrl":"10.1016/j.jchf.2025.03.025","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 955-957"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078186","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":"Failure to Launch","authors":"Paula Rambarat MD ,&nbsp;Adam D. DeVore MD, MHS ,&nbsp;Ankeet S. Bhatt MD, MBA, ScM ,&nbsp;Larry A. Allen MD, MHS ,&nbsp;Colleen K. McIlvennan PhD, DNP, ANP ,&nbsp;Gad Cotter MD ,&nbsp;Amrita Mukhopadhyay MD, MS ,&nbsp;Tariq Ahmad MD, MPH ,&nbsp;Faraz S. Ahmad MD, MS ,&nbsp;Mitchell A. Psotka MD, PhD","doi":"10.1016/j.jchf.2025.02.023","DOIUrl":"10.1016/j.jchf.2025.02.023","url":null,"abstract":"<div><div>There is a pressing need to translate evidence for heart failure (HF) therapies into contemporary practice. Medications that improve HF morbidity and mortality remain underused because of complex barriers at multiple levels across the health care ecosystem. High-quality implementation trials demonstrate that specific interventions can increase prescription, intensification, and persistence of HF medication. However, evidence-based interventions have not been widely implemented across health care organizations in the United States. This review explores 5 key strategies—patient activation, audit and feedback, rapid intensive initiation of medical therapy, virtual care teams, and clinical decision support tools—and discusses barriers to their widespread adoption. Although some barriers are specific to an intervention, others stem from systemic limitations among health care organizations and the health policy landscape. Using lessons learned from recent trials, this review also highlights future investigations needed to address these barriers, encourages uptake of successful implementation strategies, and discusses common approaches that should be abandoned.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 887-900"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194448","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":"Exercise Training for Patients With Heart Failure","authors":"Gordon R. Reeves MD, MPT ,&nbsp;Dalane W. Kitzman MD","doi":"10.1016/j.jchf.2024.11.019","DOIUrl":"10.1016/j.jchf.2024.11.019","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 6","pages":"Pages 923-926"},"PeriodicalIF":10.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633768","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}