JACC. Heart failure最新文献

{"title":"Advances and Challenges in Holistic Treatment of Cardiometabolic Kidney Disease as One Entity","authors":"Biykem Bozkurt MD, PhD (Editor-in-Chief, JACC: Heart Failure)","doi":"10.1016/j.jchf.2024.10.002","DOIUrl":"10.1016/j.jchf.2024.10.002","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 11","pages":"Pages 1949-1951"},"PeriodicalIF":10.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578348","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":"Enhancing Dynamic Risk Prediction in LVAD Patients","authors":"Rahul Chaudhary MD, MBA , Gavin W. Hickey MD","doi":"10.1016/j.jchf.2024.07.023","DOIUrl":"10.1016/j.jchf.2024.07.023","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 11","pages":"Page 1952"},"PeriodicalIF":10.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578349","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":"Seated Pulmonary Artery Pressure Monitoring in Patients With Heart Failure","authors":"Jason L. Guichard MD, PhD ,&nbsp;Eric L. Bonno MD ,&nbsp;Michael E. Nassif MD ,&nbsp;Taiyeb M. Khumri MD ,&nbsp;David Miranda MD ,&nbsp;Orvar Jonsson MD ,&nbsp;Hirak Shah MD ,&nbsp;Tamas Alexy MD, PhD ,&nbsp;Gregory P. Macaluso MD ,&nbsp;James Sur MD ,&nbsp;Gavin Hickey MD ,&nbsp;Patrick McCann MD ,&nbsp;Jennifer A. Cowger MD, MS ,&nbsp;Amit Badiye MD ,&nbsp;Wayne D. Old MD ,&nbsp;Yasmin Raza MD ,&nbsp;Luke Masha MD, MPH ,&nbsp;Chandra R. Kunavarapu MD ,&nbsp;Mosi Bennett MD, PhD ,&nbsp;Faisal Sharif MD, PhD ,&nbsp;Liviu Klein MD, MS","doi":"10.1016/j.jchf.2024.05.017","DOIUrl":"10.1016/j.jchf.2024.05.017","url":null,"abstract":"<div><h3>Background</h3><div>Monitoring supine pulmonary artery pressures to guide heart failure (HF) management has reduced HF hospitalizations in select patients.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to evaluate the effect of managing seated mean pulmonary artery pressure (mPAP) with the Cordella Pulmonary Artery sensor on outcomes in patients with HF.</div></div><div><h3>Methods</h3><div>Following GUIDE-HF (Hemodynamic-GUIDEd Management of Heart Failure Trial), with U.S. Food and Drug Administration input, PROACTIVE-HF (A Prospective, Multi-Center, Open Label, Single Arm Clinical Trial Evaluating the Safety and Efficacy of the Cordella Pulmonary Artery Sensor System in NYHA Class III Heart Failure Patients trial) was changed from a randomized to a single-arm, open label trial, conducted at 75 centers in the USA and Europe. Eligible patients had chronic HF with NYHA functional class III symptoms, irrespective of the ejection fraction, and recent HF hospitalization and/or elevated natriuretic peptides. The primary effectiveness endpoint at 6 months required the HF hospitalization or all-cause mortality rate to be lower than a performance goal of 0.43 events/patient, established from previous hemodynamic monitoring trials. Primary safety endpoints at 6 months were freedom from device- or system-related complications or pressure sensor failure.</div></div><div><h3>Results</h3><div>Between February 7, 2020, and March 31, 2023, 456 patients were successfully implanted in modified intent-to-treat cohort. The 6-month event rate was 0.15 (95% CI: 0.12-0.20) which was significantly lower than performance goal (0.15 vs 0.43; <em>P &lt;</em> 0.0001). Freedom from device- or system-related complications was 99.2% and freedom from sensor failure was 99.8% through 6 months.</div></div><div><h3>Conclusions</h3><div>Remote management of seated mPAP is safe and results in a low rate of HF hospitalizations and mortality. These results support the use of seated mPAP monitoring and extend the growing body of evidence that pulmonary artery pressure–guided management improves outcomes in heart failure. (Multi-Center, Open Label, Single Arm Clinical Trial Evaluating the Safety and Efficacy of the Cordella Pulmonary Artery Sensor System in NYHA Class III Heart Failure Patients trial [PROACTIVE-HF]; <span><span>NCT04089059</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 11","pages":"Pages 1879-1893"},"PeriodicalIF":10.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995753","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":"Encouraging Data Encourage More Research on Optimal Medical Therapy for Patients With HFrEF","authors":"Aldo P. Maggioni MD","doi":"10.1016/j.jchf.2024.06.012","DOIUrl":"10.1016/j.jchf.2024.06.012","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 11","pages":"Pages 1876-1878"},"PeriodicalIF":10.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901789","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":"GLP-1 Receptor Agonists Among Patients With Overweight or Obesity, Diabetes, and HFpEF on SGLT2 Inhibitors","authors":"Rushin Patel MD ,&nbsp;Mark Wadid MD ,&nbsp;Bhargav Makwana MD ,&nbsp;Ashish Kumar MD ,&nbsp;Sumanth Khadke MD ,&nbsp;Ammar Bhatti MD ,&nbsp;Ahan Banker MBBS ,&nbsp;Zaid Husami MD ,&nbsp;Sherif Labib MD ,&nbsp;David Venesy MD ,&nbsp;Gregg Fonarow MD ,&nbsp;Mikhail Kosiborod MD ,&nbsp;Sadeer Al-Kindi MD ,&nbsp;Deepak L. Bhatt MD, MPH, MBA ,&nbsp;Sourbha Dani MD ,&nbsp;Anju Nohria MD ,&nbsp;Javed Butler MD, MPH ,&nbsp;Sarju Ganatra MD","doi":"10.1016/j.jchf.2024.07.006","DOIUrl":"10.1016/j.jchf.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Although the use of glucagon-like peptide-1 receptor agonist (GLP-1 RA) in patients with obesity and heart failure with preserved ejection fraction (HFpEF) has demonstrated improvement in cardiovascular outcomes, the incremental benefits of GLP-1 RA for patients already on sodium-glucose cotransporter 2 inhibitors (SGLT2is) remain underexplored.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the incremental benefits of GLP-1 RA in patients with type 2 diabetes mellitus, overweight/obesity, and HFpEF receiving SGLT2i therapy.</div></div><div><h3>Methods</h3><div>The authors conducted a retrospective cohort study using the TriNetX research database including patients ≥18 years with type 2 diabetes mellitus, body mass index ≥27 kg/m², and HFpEF on SGLT2i. Two cohorts were created based on GLP-1 RA prescription. The outcomes were heart failure exacerbation, all-cause emergency department visits/hospitalizations among others over a 12-month period.</div></div><div><h3>Results</h3><div>A total of 7,044 patients remained in each cohort after propensity score matching. There was a significantly lower risk of heart failure exacerbations, all-cause emergency department visits/hospitalizations, new-onset atrial arrhythmias, new-onset acute kidney injury, and pulmonary hypertension in the GLP-1 RA plus SGLT2i cohort compared with the SGLT2i-only cohort. The associated benefits persisted across different body mass indexes and ejection fractions as well as in patients with elevated natriuretic peptide. The risk of diabetic retinopathy was higher in the combination therapy group than with SGLT2i-only use.</div></div><div><h3>Conclusions</h3><div>GLP-1 RA, in addition to SGLT2i, was associated with a significantly lower risk of heart failure hospitalizations in this patient population, suggesting a potential incremental benefit. This highlights the need for prospective studies to confirm the clinical benefits.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 11","pages":"Pages 1814-1826"},"PeriodicalIF":10.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107492","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":"Avoiding Treatment in Hospital With Subcutaneous Furosemide for Worsening Heart Failure","authors":"Marvin A. Konstam MD ,&nbsp;Joseph Massaro PhD ,&nbsp;Ravi Dhingra MD, MPH ,&nbsp;Mary Walsh MD ,&nbsp;Linda Ordway RN, MS, NP ,&nbsp;Michael S. Pursley MD ,&nbsp;Dalton S. McLean MD ,&nbsp;Sandeep Saha MS ,&nbsp;Nicole Close PhD ,&nbsp;Jeremy M. Konstam MS ,&nbsp;Katherine H. Luepke PharmD, BCPS, CMPP ,&nbsp;John F. Mohr PharmD ,&nbsp;James E. Udelson MD","doi":"10.1016/j.jchf.2024.07.015","DOIUrl":"10.1016/j.jchf.2024.07.015","url":null,"abstract":"<div><h3>Background</h3><div>Therapies are needed to address worsening congestion, without hospitalization, in patients with chronic heart failure (HF).</div></div><div><h3>Objectives</h3><div>This pilot study assessed outcomes of a novel subcutaneous (SC) furosemide formulation compared to usual care in outpatients with worsening congestion.</div></div><div><h3>Methods</h3><div>Participants with chronic HF and worsening congestion were randomized open-label 2:1 to SC furosemide compared to usual care (UC). Decongestion was estimated by tracking body weight. The primary endpoint was a win ratio of a 30-day hierarchical composite of cardiovascular death, HF events, and change in N-terminal pro–B-type natriuretic peptide. Secondary endpoints included dyspnea severity, functional capacity, and quality of life.</div></div><div><h3>Results</h3><div>Thirty-four participants were randomized to SC furosemide and 17 to UC. SC furosemide caused greater reduction in body weight: between-group difference in least square mean change was −2.02 kg at day 3 (95% CI: −3.9 to −0.14; <em>P =</em> 0.035). SC furosemide-to-UC win ratio was 1.11 (95% CI: 0.48-2.50; <em>P =</em> 0.806). Significant between-group least square mean differences favoring SC furosemide occurred in 7-point dyspnea score (<em>P =</em> 0.017) and 6-minute walk test (<em>P =</em> 0.032), with trend in Kansas City Cardiomyopathy Questionnaire (KCCQ)-12 Overall Summary Score of 9.15 (95% CI: 1.95-20.3; <em>P =</em> 0.106). The most common related adverse event with SC furosemide was mild infusion site pain (11.8%).</div></div><div><h3>Conclusions</h3><div>SC furosemide augmented weight loss in patients with HF and worsening congestion. The composite primary endpoint was not statistically significant in this pilot investigation. However, findings of improved dyspnea scores and functional capacity, with favorable trend in KCCQ-12 score, warrant additional investigation to further document the clinical value of SC furosemide as an alternative to hospitalization (AT HOME-HF [Avoiding Treatment in the Hospital With Furoscix for the Management of Congestion in Heart Failure—A Pilot Study]; <span><span>NCT04593823</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 11","pages":"Pages 1830-1841"},"PeriodicalIF":10.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264099","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":"Pressure to Improve Heart Failure Outcomes","authors":"Randall C. Starling MD, MPH,&nbsp;Trejeeve Martyn MD, MSc","doi":"10.1016/j.jchf.2024.07.019","DOIUrl":"10.1016/j.jchf.2024.07.019","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 11","pages":"Pages 1894-1897"},"PeriodicalIF":10.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287503","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":"Cardiopulmonary Resuscitation in Patients With Left Ventricular Assist Devices","authors":"Juliane Vierecke MD, PhD ,&nbsp;Ersilia M. DeFilippis MD ,&nbsp;Michael M. Givertz MD","doi":"10.1016/j.jchf.2024.08.021","DOIUrl":"10.1016/j.jchf.2024.08.021","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"12 11","pages":"Pages 1931-1938"},"PeriodicalIF":10.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465731","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":"Hospitalized Advanced Heart Failure With Preserved vs Reduced Left Ventricular Ejection Fraction: A Global Perspective.","authors":"Vasiliki Bistola, Dimitrios Farmakis, Jasper Tromp, Wan Ting Tay, Wouter Ouwerkerk, Christiane E Angermann, John G F Cleland, Ulf Dahlström, Kenneth Dickstein, Georg Ertl, Mahmoud Hassanein, Sotiria Liori, Petros Nikolopoulos, Sergio V Perrone, Mathieu Ghadanfar, Anja Schweizer, Achim Obergfell, Sean P Collins, Carolyn S P Lam, Gerasimos Filippatos","doi":"10.1016/j.jchf.2024.09.009","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.09.009","url":null,"abstract":"<p><strong>Background: </strong>Outcomes of hospitalized patients with heart failure (HF) and characteristics of advanced HF stage may vary across left ventricular ejection fraction (LVEF) and world regions.</p><p><strong>Objectives: </strong>This study sought to analyze characteristics of hospitalized advanced HF patients across LVEF spectrum, world regions, and country income.</p><p><strong>Methods: </strong>Among 18,553 hospitalized patients with acute HF (7,902 new-onset HF and 10,651 decompensated chronic HF) enrolled in the global registry REPORT-HF (International Registry to Assess Medical Practice With Longitudinal Observation for Treatment of Heart Failure), we analyzed characteristics and outcomes of patients with advanced HF, defined as previously diagnosed HF; severe symptoms before current admission (NYHA functional class III/IV); and ≥1 HF-related hospitalization in the preceding 12 months, excluding the current. Differences among hospitalized advanced HF subgroups stratified by LVEF, world region, and country income were examined.</p><p><strong>Results: </strong>Among 6,999 patients with decompensated chronic HF and available previous NYHA functional class and HF hospitalization status, 3,397 (48.5%; 18.3% of the total population) had advanced HF. Of these, 44.5% had severely reduced (≤30%), 34.9% mildly/moderately reduced (31%-49%), and 20.7% preserved (≥50%) LVEF. Patients from Eastern Europe had the lowest 1-year mortality (23%), whereas those from Southeast Asia had the highest (37%). Patients from lower-middle-income countries were younger, with shorter HF duration and lower comorbidity prevalence, received fewer beta-blockers and HF-devices, and had higher 1-year mortality (34%) than upper-middle- (26%) or high-income countries (27%; P = 0.018). Adjusted 1-year mortality risk did not differ among LVEF subgroups (all P > 0.05), nor did 1-year HF hospitalization rate (P = 0.56).</p><p><strong>Conclusions: </strong>Hospitalized patients with advanced HF and preserved LVEF had similarly adverse outcomes as those with reduced LVEF. Patients from lower-middle-income countries had less implementation of HF therapies and higher 1-year mortality.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620685","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, Jiankang Liu, Iacopo Olivotto, Victoria Parikh, Euan A Ashley, Michelle Michels, Jodie Ingles, Rachel Lampert, John C Stendahl, Steven D Colan, Dominic Abrams, Alexandre C Pereira, Joseph W Rossano, Thomas D Ryan, Anjali T Owens, James S Ware, Sara Saberi, Adam S Helms, Sharlene Day, Brian Claggett, Carolyn Y Ho, Neal K Lakdawala","doi":"10.1016/j.jchf.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.09.008","url":null,"abstract":"<p><strong>Background: </strong>An improved understanding of the natural history in NYHA functional class I patients with obstructive hypertrophic cardiomyopathy (oHCM) is needed.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>Incident events assessed included a composite of NYHA functional class III to IV symptoms, left ventricular ejection fraction <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.</p><p><strong>Results: </strong>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% (P < 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]; P = 0.005), female sex (HR: 1.61 [95% CI: 1.16-2.24]; P = 0.003), and older age (HR: 1.21 per 10 years [95% CI: 1.09-1.34]; P < 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2024-10-25","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}