Journal of Cardiac Failure最新文献

{"title":"Have We Been Failing the Right Ventricle? How A Comprehensive Protection Strategy Might Succeed Where Prior Efforts Have Failed.","authors":"Peter S Natov, Steven Hsu, Michele L Esposito","doi":"10.1016/j.cardfail.2025.08.024","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.08.024","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanded Results from a Dedicated Guideline-Directed Medical Therapy Clinic.","authors":"Laura P Cohen, Charlotte Paquette, Michelle Vassilopoulos, Ashley Tringale, Kathryn E Sheppard, Christine Ko, Lana Tsao, Safia Chatur, Claire Lin, Aferdita Spahillari, Yuxi Liu, James L Januzzi","doi":"10.1016/j.cardfail.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.09.019","url":null,"abstract":"<p><strong>Background: </strong>Implementation of guideline directed medical therapy (GDMT) for heart failure (HF) care in general cardiology environments is suboptimal. A dedicated GDMT clinic was expanded to include individuals with HF across the full spectrum of left ventricular ejection fraction (LVEF).</p><p><strong>Methods: </strong>Referred individuals were seen by advanced practice providers until maximally tolerated therapy was achieved. Achievement of optimal GDMT was evaluated and compared to patients from usual care matched in a 1:2 fashion. Key prognostic HF indicators were assessed.</p><p><strong>Results: </strong>The mean (SD) age of 92 GDMT-eligible clinic participants was 66.5 (15.4) years, 25 (27.2%) were female;18 (19.6%) had LVEF ≥50%. From baseline to follow-up visit (12.9 weeks), the number of patients eligible for optimal GDMT with LVEF <50% increased from 12.0% to 91.3% (p<0.001); among eligible individuals with LVEF ≥50%, optimal GDMT increased from 5.6% to 77.8% (p=0.001). There was an increase in the proportion on optimal GDMT at ≥50% target dose (1.1% to 50.0%) and at target dose (0.0% to 30.4%). These changes were substantially greater than in the matched cohort of usual care patients. Among GDMT patients, significant improvements were observed in symptoms, NT-proBNP and important echocardiographic measurements. Kansas City Cardiomyopathy Questionnaire Overall and Clinical Summary Scores both significantly increased by 8 points (p=0.01) and 6-minute walk distance increased by 37 meters (p=0.03). GDMT administration was safe and well tolerated.</p><p><strong>Conclusions: </strong>Successful implementation of GDMT in a dedicated clinic embedded within a general cardiology practice was well-tolerated and effective to improve key outcomes across the entire spectrum of LVEF.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Aficamten in Patients With Nonobstructive Hypertrophic Cardiomyopathy: A 96-Week Analysis From FOREST-HCM.","authors":"Ahmad Masri, Mark V Sherrid, Lubna Choudhury, Pablo Garcia-Pavia, Christopher M Kramer, Roberto Barriales-Villa, Robert M Cooper, Perry M Elliott, Sheila M Hegde, Martin S Maron, Michael E Nassif, Artur Oreziak, Anjali T Owens, Scott D Solomon, Albree Tower-Rader, Stephen B Heitner, Daniel L Jacoby, Stuart Kupfer, Fady I Malik, Chiara Melloni, Tyrell Simkins, Jenny Wai, Sara Saberi","doi":"10.1016/j.cardfail.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.09.016","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Pre- to Postdischarge Transition of Care in Patients Hospitalized for Heart Failure: Part 3 of the International Expert Opinion Series on Acute Heart Failure Management.","authors":"Husam M Salah, Andrew P Ambrosy, Jan Biegus, Edimar A Bocchi, Javed Butler, Ovidiu Chioncel, Gad Cotter, Beth Davison, Anastase Dzudie, Yonathan Freund, Sivadasanpillai Harikrishnan, Ivna G C V Lima, Alexandre Mebazaa, Robert J Mentz, Òscar Miró, Anika S Naidu, Siti E Nauli, Matteo Pagnesi, Mauro Riccardi, Naoki Sato, Gianluigi Savarese, Karen Sliwa-Hahnle, Yuhui Zhang, Jingmin Zhou, Marat Fudim","doi":"10.1016/j.cardfail.2025.09.020","DOIUrl":"10.1016/j.cardfail.2025.09.020","url":null,"abstract":"<p><p>Hospitalization for heart failure (HF) represents a pivotal event in the disease course, often signaling decompensation and an elevated risk of readmission, mortality, and functional decline. Despite advances in inpatient management, the transition from hospital to home remains a vulnerable period characterized by residual congestion, incomplete implementation of guideline-directed medical therapy (GDMT), unmanaged comorbidities, and fragmented care coordination. This expert consensus provides a comprehensive, evidence-based framework to optimize the pre- to postdischarge transition in patients hospitalized with HF. Key priorities include confirmation of decongestion using biomarkers, lung ultrasound examination, and validated risk scores; in-hospital initiation and up-titration of foundational GDMT; and identification of reversible etiologies such as ischemic heart disease. Early evaluation for device therapy, arrhythmia management, including anticoagulation and rhythm control in atrial fibrillation, and structured management of comorbidities such as chronic kidney disease, diabetes, chronic obstructive pulmonary disease, iron deficiency, frailty, and depression are emphasized. Multidisciplinary collaboration across pharmacy, rehabilitation, mental health, and social services is essential to support safe discharge and continuity of care. Proactive strategies such as medication reconciliation, simplified dosing regimens, caregiver engagement, and attention to social determinants of health are critical to improving adherence and preventing avoidable readmissions. Early postdischarge follow-up (ideally within 7 days), remote monitoring, and ongoing GDMT optimization are central to management during the high-risk vulnerable phase. Cardiac rehabilitation, timely evaluation for advanced therapies, and integration of palliative care complete the continuum of care. This consensus proposes a structured, patient-centered approach that bridges inpatient stabilization with longitudinal outpatient management to decrease rehospitalizations, improve clinical outcomes, and enhance quality of life for patients living with HF.• Enhancing early outcomes: this document outlines practical strategies to ensure patients hospitalized with heart failure are discharged with appropriate therapy, clear instructions, and timely follow-up, thus reducing early readmission risk and improving recovery trajectories.• Addressing health equity: by recognizing the impact of social determinants and advocating for team-based, community-adaptable transitional care models, this framework aims to improve access and adherence among underserved and high-risk populations.• Sustaining guideline-directed therapy: emphasis on in-hospital initiation and structured outpatient follow-up supports long-term persistence with life-saving therapies and reinforces a continuity-of-care approach across health care settings.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Derivation of a Personalized Congestion Score Using a Chronic Implantable Inferior Vena Cava Management System in Heart Failure: An Analysis from the FUTURE-HF Trial Portfolio.","authors":"Marat Fudim, Mandeep R Mehra, Kevin Damman, Nir Uriel, Paul R Kalra, Fiachra Sweeney, Daire Carmody, James Tucker, Barry R Greene, Jeffrey M Testani","doi":"10.1016/j.cardfail.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.09.018","url":null,"abstract":"<p><strong>Background: </strong>Congestion is a principal driver of worsening heart failure (HF) and hospitalisation. The large, compliant Inferior Vena Cava (IVC) enables detection of congestion before increases in filling pressures. We developed a novel, patient-individualised congestion score (NORM Score) using daily ambulatory IVC measurements-area and collapsibility-from an implantable sensor.</p><p><strong>Methods: </strong>Using clinical data from 2 early feasibility trials (FUTURE-HF; NCT04203576 and FUTURE-HF2; NCT05763407), a congestion Score (range: 0-100) was derived from daily supine IVC area (breath hold and free breathing) and collapsibility in patients implanted with a novel IVC sensor. A clinical alert was triggered if the score exceeded 70% of a patient's maximum for 5 of 7 days. Performance was evaluated against adjudicated HF events (HFEs) and NT-proBNP levels.</p><p><strong>Results: </strong>Among 63 patients (mean age 66-years, 75% NYHA III), 30 HFEs occurred in 18 individuals. Score predicted HFEs with 92.6% sensitivity, high predictive accuracy (C-statistic: 0.83) and low unexplained alert rate (0.57 per patient-year). Breaching the alert threshold was associated with an Odds Ratio of 18 (95% CI: 3.5-93.8) for hospitalization within 7 days. The congestion score was significantly associated with log-transformed NT-proBNP (β=5.64;95% CI: 3.23-8.05; p<0.001).</p><p><strong>Conclusions: </strong>The unique congestion score, derived from an ambulatory implantable IVC management system, was associated with NT-proBNP levels and predicted worsening HF events with high sensitivity. These findings, once validated in a pivotal randomized trial, will support use of this novel congestion score for early detection of HF decompensation, streamline clinical response, and enable personalized patient self-management.</p><p><strong>Lay summary: </strong>Heart failure often causes fluid buildup, a leading reason for hospitalization. Traditional monitors may miss early signs. This study evaluated the NORM score, which uses an implantable sensor in the inferior vena cava to track daily vein size and movement. The score accurately detected early congestion and monitored NT-proBNP levels, suggesting it could enable earlier intervention and reduce hospital visits for heart failure patients.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of a Future Heart Failure Cardiologist in Expanding Access to Transplantation.","authors":"Stephanie Golob","doi":"10.1016/j.cardfail.2025.09.021","DOIUrl":"10.1016/j.cardfail.2025.09.021","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous Ferric Carboxymaltose in Ischemic Versus Non-Ischemic Heart Failure and Iron Deficiency: Insights From FAIR-HF2.","authors":"Muhammad Shahzeb Khan, Javed Butler, Mahir Karakas, Marius Placzek, Gerd Hasenfuß, Khawaja M Talha, Antoni Bayes-Genis, Andrew Js Coats, Michael Böhm, Giuseppe Rosano, Gianluigi Savarese, Markus S Anker, Piotr Ponikowski, Tim Friede, Stefan D Anker","doi":"10.1016/j.cardfail.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.09.017","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have suggested that patients with ischemic etiology of heart failure (HF) and iron deficiency may derive greater benefits with intravenous ferric carboxymaltose (FCM). We aim to assess the effects of FCM versus placebo in patients with ischemic versus non-ischemic etiology of HF.</p><p><strong>Methods and results: </strong>The FAIR-HF2 trial included 1105 patients with HF, with a left-ventricular ejection fraction ≤45%, and concomitant iron deficiency. Patients were randomized 1:1 to either intravenous FCM or placebo. Ischemic etiology was defined as investigator reported or prior coronary revascularization or myocardial infarction. The primary endpoints were time-to-first event of cardiovascular death or HF hospitalization, total HF hospitalizations, and time-to-first event of cardiovascular death or HF hospitalization in patients with transferrin saturation <20% at baseline. Of 1105 patients, 858 (78%) had ischemic etiology of HF. These were more frequently older, men and had more co-morbidities. For the first primary endpoint, FCM was associated with a hazard ratio (HR) of 0.85 (95%CI: 0.66-1.10, p=0.23) for ischemic HF and 0.61 (95% CI: 0.39-0.98, p=0.038) for non-ischemic HF (P-interaction=0.26). The HR for the second primary endpoint was 0.87 (95% CI: 0.63-1.21, p=0.41) for ischemic HF and 0.57 (95% CI: 0.35-0.94, p=0.028) for non-ischemic HF (P-interaction=0.17), while HR for the third primary endpoint was 0.84 (95% CI: 0.62-1.14, p=0.27) for ischemic HF and 0.63 (95% CI: 0.37-1.07, p=0.087) for non-ischemic HF (P-interaction=0.35).</p><p><strong>Conclusions: </strong>Effect of intravenous iron supplementation is likely similar in patients with ischemic or non-ischemic etiology of HF, just like other HF guideline-directed medical therapies.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building and Growing a Multi-Disciplinary Program as Early Career Faculty: Lessons Learned and Practical Strategies.","authors":"Spencer J Carter","doi":"10.1016/j.cardfail.2025.09.014","DOIUrl":"10.1016/j.cardfail.2025.09.014","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic Profiles during Pulmonary Artery Pressure Sensor Implantation: Risk Stratification in Chronic HFrEF.","authors":"Daniel Jabr, Rachel Pedersen, Amogha Dahal, Manuel Paredes-Flores, Ali A Valika, Nasir Z Sulemanjee, Sunil Pauwaa, Muhyaldeen Dia, Gregory P Macaluso, Jessica Pillarella, Anjali Joshi, Christopher Sciamanna, Mark Dela Cruz, William G Cotts, Azmey A Matarieh, Hetal A Gandhi, Shoeb M Hussain, Afoma P Ezidinma, Nikhil Narang, Vinh Q Chau","doi":"10.1016/j.cardfail.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.09.002","url":null,"abstract":"<p><strong>Background: </strong>Invasive hemodynamics may facilitate outpatient identification of ambulatory advanced HF. We analyzed cardiac failure risk stratified by four hemodynamic profiles recorded during implantation of the pulmonary artery pressure (PAP) sensor, CardioMEMS™ HF system.</p><p><strong>Methods: </strong>This multicenter, retrospective cohort study included HFrEF patients who underwent PAP sensor implantation from 2015 to 2022. Hemodynamic profiles were categorized using the Stevenson HF classification, defining \"cold\" (impaired systemic perfusion) as cardiac index <2.2L/min/m2; and \"wet\" (hemodynamic congestion) as pulmonary capillary wedge pressure ≥18mmHg. The primary endpoint was 1-year cardiac failure, including all-cause mortality, inotrope dependence, need for durable VAD or heart transplantation.</p><p><strong>Results: </strong>Among 512 patients (median age 71 years, 28% female, 77% NYHA class III, median NT-proBNP 2554 pg/mL), the hemodynamic profiles were as follows: 30% Warm-Dry, 22% Warm-Wet, 21% Cold-Dry, and 27% Cold-Wet. Overall, 118 patients (23%) experienced cardiac failure, of which 57 required chronic inotrope, durable VAD implantation, or heart transplantation and 61 died with medical therapy. One-year event-free survival differed across the profiles: Warm-Dry (90%), Warm-Wet (74%), Cold-Dry (80%), and Cold-Wet (61%) (P<0.001). Multivariable analysis (reference: Warm-Dry) showed increased cardiac failure risk in Cold-Wet (adjusted HR [95%CI]: 4.4 [2.4-7.8], P<0.001), Cold-Dry (adjusted HR [95%CI]: 2.2 [1.1-4.2], P=0.019), and Warm-Wet (adjusted HR [95%CI]: 2.8 [1.5-5.4], P=0.001).</p><p><strong>Conclusion: </strong>At time of PAP sensor placement, an abnormal hemodynamic profile - especially Cold-Wet - was associated with increased cardiac failure risk, indicating subgroups who might have already progressed to ambulatory advanced heart failure.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Between Two Signals: The Intersection of Electrophysiology and Heart Failure.","authors":"Jose Lopez","doi":"10.1016/j.cardfail.2025.09.015","DOIUrl":"10.1016/j.cardfail.2025.09.015","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}