Journal of Cardiac Failure最新文献

{"title":"Prognostic utility and cutoff differences of NT-proBNP level across subgroups in heart failure with preserved ejection fraction: Insights from the PURSUIT-HFpEF Registry.","authors":"Daisuke Sakamoto, Yohei Sotomi, Yuki Matsuoka, Daisaku Nakatani, Katsuki Okada, Akihiro Sunaga, Hirota Kida, Taiki Sato, Tetsuhisa Kitamura, Masahiro Seo, Masamichi Yano, Takaharu Hayashi, Akito Nakagawa, Yusuke Nakagawa, Shunsuke Tamaki, Yoshio Yasumura, Takahisa Yamada, Shungo Hikoso, Yasushi Sakata","doi":"10.1016/j.cardfail.2024.10.440","DOIUrl":"10.1016/j.cardfail.2024.10.440","url":null,"abstract":"<p><strong>Objectives: </strong>N-terminal pro brain natriuretic peptide (NT-proBNP) is a biomarker for myocardial stress used in diagnosing and prognosticating heart failure (HF). However, its interpretation is complicated by clinical factors. This study aims to clarify the prognostic value of NT-proBNP in patients with heart failure with preserved ejection fraction (HFpEF), and risk-prediction cutoffs considering various clinical factors.</p><p><strong>Methods: </strong>The study utilized data of prospective multicenter observational Asian HFpEF registry. Patients with acute decompensated HF and left ventricular ejection fraction ≥ 50% were included. NT-proBNP levels were measured at discharge. The primary endpoint was a composite of all-cause death and hospitalization for HF within 1 year after discharge.</p><p><strong>Results: </strong>A total of 1,231 patients (83 [77, 87] years, 551 (45%) male) were enrolled, with 916 eligible patients analyzed. The median NT-proBNP level was 1,060 pg/m. In multivariable logistic regression model, NT-proBNP was significantly associated with the primary endpoint (adjusted OR for log-transformed NT-proBNP:2.71, 95%CI:1.78-4.18, p<0.001). Subgroup analysis revealed varying NT-proBNP distributions and differential safety cutoffs (329-929 pg/mL) at sensitivity of 0.8 based on factors like atrial fibrillation and chronic kidney disease, maintaining its discriminatory performance (Area under the curve: 0.587-0.734).</p><p><strong>Conclusions: </strong>NT-proBNP at discharge is a significant prognostic marker for HFpEF. Although NT-proBNP showed different distributions in various subgroups and cutoff values were distinctive for each, the prognostic utility was found to be equivalent in almost all subgroups with similar moderate discriminative performance. The study highlights the necessity of personalized NT-proBNP cutoffs for better management and prognostication of HFpEF.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668067","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":"Psychosocial Risk to Predict Outcomes after LVAD implantation: A small step forward in predicting human behavior.","authors":"Matthew Cagliostro, Julie Roldan, Donna Mancini","doi":"10.1016/j.cardfail.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.002","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644310","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":"Editorial: Unlocking the Prognostic Potential: The Quest for Optimal Right Ventricular Parameters in LVAD Recipients.","authors":"Anique Ducharme, Mohammed Imran Aslam","doi":"10.1016/j.cardfail.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.004","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638048","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":"Coronary Artery Calcium for Risk Stratification of Heart Failure Mortality: The Coronary Artery Calcium Consortium.","authors":"Omar Mhaimeed, Zeina A Dardari, Michael Khorsandi, Omar Dzaye, Kavita Sharma, Khurram Nasir, Daniel S Berman, Matthew J Budoff, Leslee J Shaw, John A Rumberger, Michael D Miedema, Michael J Blaha","doi":"10.1016/j.cardfail.2024.10.437","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.10.437","url":null,"abstract":"<p><strong>Background: </strong>There is increasing interest in predicting heart failure (HF), a major cause of morbidity and mortality with a significant financial burden. The role of coronary artery calcium (CAC), an accessible and inexpensive test, in predicting long-term HF mortality amongst asymptomatic adults remains unknown. We aim to determine if CAC burden is associated with HF-related mortality in the CAC Consortium.</p><p><strong>Methods and results: </strong>The study included 66,636 primary prevention patients from the CAC Consortium. Multivariable competing risks regression was used to assess the association between CAC and HF-related mortality adjusting for demographics and traditional risk factors. The mean age was 54.4 years, 67% male, 89% white, and 55% had CAC >0. 260 HF-related mortality events were observed during a median follow up of 12.5 years, 75.3% occurred among those with a baseline CAC score >100. Compared with CAC = 0, there was a stepwise higher risk (P < 0.005) of HF mortality for CAC 1-100 (subdistribution hazard ratio [SHR]: 2.27; 95% CI: 1.3-3.99), 100-400 (SHR: 3.68; 95% CI 2.1-6.43), and >400 (SHR: 7.05; 95% CI 4.05-12.29). This increasing risk of HF mortality across higher CAC scores persisted across age groups, sex, and in the intermediate and high-risk groups as calculated by the pooled cohort (PCE) and PREVENT equations.</p><p><strong>Conclusions: </strong>Higher CAC is associated with increasing incidence of long-term HF-related mortality in the primary prevention population, particularly intermediate and high-risk patients. Early preventive approaches in patients with high CAC must focus on preventing heart failure and ASCVD with lifestyle changes and medications.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639184","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":"Patient-Centered Research Design to Increase Representativeness of Diverse Populations in Clinical Trials.","authors":"Tracy Y Wang","doi":"10.1016/j.cardfail.2024.10.438","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.10.438","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638480","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":"cDPP3 in Cardiogenic Shock: More than just a prognostic marker?","authors":"Avinainder Singh, Mark Godding, Ajar Kochar, Rachna Kataria","doi":"10.1016/j.cardfail.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.003","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639183","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":"Do We Need More Tools? Searching the Toolbox for Ways to Identify Palliative Care Needs in Patients with Heart Failure.","authors":"Colleen K McIlvennan, Adam DeVore, Larry A Allen","doi":"10.1016/j.cardfail.2024.11.001","DOIUrl":"10.1016/j.cardfail.2024.11.001","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621174","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":"Disruptions in Sleep Health and Independent Associations with Psychological Distress in Close Family Members of Cardiac Arrest Survivors: A Prospective Study.","authors":"Isabella M Tincher, Danielle A Rojas, Mina Yuan, Sabine Abukhadra, Christine E Deforge, S Justin Thomas, Kristin Flanary, Daichi Shimbo, Nour Makarem, Bernard P Chang, Sachin Agarwal","doi":"10.1016/j.cardfail.2024.10.007","DOIUrl":"10.1016/j.cardfail.2024.10.007","url":null,"abstract":"<p><strong>Background: </strong>While recent guidelines have noted the deleterious effects of poor sleep on cardiovascular health, the upstream impact of cardiac arrest-induced psychological distress on sleep health metrics among families of cardiac arrest survivors remains unknown.</p><p><strong>Methods: </strong>Sleep health of close family members of consecutive patients with cardiac arrest admitted to an academic center (August 16, 2021-June 28, 2023) was self-reported using the Pittsburgh Sleep Quality Index (PSQI). The baseline PSQI, focused on sleep in the month before cardiac arrest, was administered during hospitalization and repeated 1 month after cardiac arrest alongside the Patient Health Questionnaire-8 (PHQ-8) to assess depression severity. Multivariable linear regressions analyzed associations between total PHQ-8 scores and changes in global PSQI scores between baseline and 1 month, with higher scores indicating deterioration. A prioritization exercise explored potential interventions categorized into the family's information and well-being needs to reduce psychological distress.</p><p><strong>Results: </strong>In our sample of 102 close family members (mean age 52 ± 15 years, 70% female, 21% Black, 33% Hispanic), mean global PSQI scores showed a significant decline between baseline and 1 month after cardiac arrest (6.2 ± 3.8 vs. 7.4 ± 4.1; P < .01). This deterioration was notable for sleep quality, duration, and daytime dysfunction. Higher PHQ-8 scores were significantly associated with higher change in PSQI scores after adjusting for family members' age, sex, race/ethnicity, prior psychiatric history, and patient's discharge disposition (B = 0.4 [95% CI 0.24-0.48]; P < .01, β = 0.5). Most families expressed a higher priority for information-based interventions over well-being needs to help alleviate psychological distress during the first month following cardiac arrest (76% vs. 34%, P < .01).</p><p><strong>Conclusions: </strong>A significant sleep health decline was observed among close family members of cardiac arrest survivors during the acute period, with psychological distress associated with this disruption. Understanding these temporal associations will help guide the development of targeted interventions to support families during this uncertain time.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568688","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":"Increased Spironolactone Dosing in Acute Heart Failure Alters Potassium Homeostasis but Does not Enhance Decongestion","authors":"PETER S. NATOV MD ,&nbsp;JUAN B. IVEY-MIRANDA MD ,&nbsp;ZACHARY L. COX PharmD ,&nbsp;VEENA S. RAO PhD ,&nbsp;JAVED BUTLER MD, MPH, MBA ,&nbsp;MARVIN A. KONSTAM MD ,&nbsp;MICHAEL S. KIERNAN MD ,&nbsp;NAVIN K. KAPUR MD ,&nbsp;JEFFREY M. TESTANI MD, MTR","doi":"10.1016/j.cardfail.2024.06.008","DOIUrl":"10.1016/j.cardfail.2024.06.008","url":null,"abstract":"<div><h3>Background</h3><div>The ATHENA-HF (Aldosterone Targeted Neurohormonal Combined with Natriuresis Therapy in Heart Failure) clinical trial found no improvements in natriuretic peptide levels or clinical congestion when spironolactone 100 mg/day for 96 hours was used in addition to usual treatment for acute heart failure.</div></div><div><h3>Methods</h3><div>We performed a post hoc analysis of ATHENA-HF to determine whether spironolactone treatment induced any detectable pharmacodynamic effects and whether patients with potentially greater aldosterone activity experienced additional decongestion. Trial subjects previously treated with spironolactone were excluded. We first examined for changes in renal potassium handling. Using the baseline serum potassium level as a surrogate marker of spironolactone activity, we then divided each treatment arm into tertiles of baseline serum potassium and explored for differences in laboratory and clinical congestion outcomes.</div></div><div><h3>Results</h3><div>Among spironolactone-naïve patients, the change in serum potassium did not differ after 24 hours or 48 hours but was significantly greater with spironolactone treatment compared to placebo at 72 hours (0.23 ± 0.55 vs 0.03 ± 0.60 mEq/L; <em>P</em> = 0.042) and 96 hours (0.32 ± 0.51 vs 0.13 ± 0.72 mEq/L; <em>P</em> = 0.046). Potassium supplementation was similar at treatment start and at 24 hours, but spironolactone-treated patients required substantially less potassium replacement at 48 hours (24% vs 36%; <em>P</em> = 0.048), 72 hours (21% vs 37%; <em>P</em> = 0.013), and 96 hours (11% vs 38%; <em>P</em> &lt; 0.001). When the treatment arms were divided into tertiles of baseline serum potassium, there were no differences in the 96-hour log N-terminal pro-B-type natriuretic peptide levels, net fluid loss, urine output, or dyspnea relief in any of the potassium groups, with no effect modification by treatment exposure.</div></div><div><h3>Conclusions</h3><div>Spironolactone 100 mg/day for 96 hours in patients receiving intravenous loop diuresis for acute heart failure has no clear added decongestive ability but does meaningfully limit potassium wasting.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1522-1526"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579774","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":"Antithrombotic Strategies With Left Ventricular Assist Devices","authors":"MAJA CIKES MD, PhD, ,&nbsp;MELANA YUZEFPOLSKAYA MD, ,&nbsp;FINN GUSTAFSSON MD, DMSc, ,&nbsp;MANDEEP R. MEHRA MD, MSc","doi":"10.1016/j.cardfail.2024.07.024","DOIUrl":"10.1016/j.cardfail.2024.07.024","url":null,"abstract":"<div><div>Long-term outcomes of patients with advanced heart failure treated with durable left ventricular assist devices (LVADs) have been augmented due to improved durability and hemocompatibility on the backbone of pump engineering enhancements. The incidence of hemocompatibility-related adverse events (pump thrombosis, stroke and nonsurgical bleeding events) are device specific and vary by type of engineered pump. A fully magnetically levitated rotor containing LVAD in concert with use of antithrombotic therapy has successfully overcome an increased risk of pump thrombosis and stroke-risk, albeit with only modest reduction in bleeding events. Modifications to antithrombotic strategies have focused on reduced-dose vitamin K antagonist use or use of direct oral anticoagulants with demonstration of safety and progress in reduction of mucosal bleeding episodes with elimination of antiplatelet agents. This review outlines the current landscape of advances in anticoagulation management in LVAD patients, highlighting the need for ongoing research and cautious application of emerging therapies and technologies.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1489-1495"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000010","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}