Journal of Cardiac Failure最新文献

{"title":"Obesity and Change in NT-proBNP with Angiotensin-Neprilysin Inhibition in Patients with Mildly Reduced or Preserved Ejection Fraction and a Worsening Heart Failure Event: PARAGLIDE-HF.","authors":"Josephine Harrington, Kavita S Sharma, Tyler Erickson, Kirkwood F Adams, Derek Cyr, Adrian F Hernandez, Anuradha Lala, Alexander Peikert, Randall C Starling, Eric J Velazquez, Jonathan H Ward, Samiha Sarwat, Shelley Zieroth, Robert J Mentz","doi":"10.1016/j.cardfail.2026.09.018","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.09.018","url":null,"abstract":"<p><strong>Objective: </strong>To determine the relationship between obesity status and the effect of sacubitril/valsartan (sac/val) vs valsartan (val) on change in NT-proBNP and a hierarchical outcome of clinical benefit among patients with heart failure with mildly reduced or preserved ejection fraction (HFpEF).</p><p><strong>Background: </strong>In the PARAGLIDE-HF trial, patients with HFpEF and a recent worsening HF event randomized to sac/val vs. val had a greater decrease in NT-proBNP over 8 weeks and showed a trend towards clinical benefit. Patients with HFpEF and obesity represent a unique population with high symptom burden and elevated risk for HF hospitalization. The efficacy and safety of sac/val in this high-risk population following a recent worsening HF event is not well characterized.</p><p><strong>Methods: </strong>To assess the interaction between obesity status and sac/val vs val on NT-proBNP, the time-averaged proportional change in NT-proBNP from baseline to Weeks 4 and 8 was assessed with an analysis of covariance model that included the interaction of treatment-by-BMI group (obese with BMI ≥30 kg/m² vs not obese with BMI 18.5 to <30 kg/m²). A win ratio consisting of a hierarchy of cardiovascular death, total HF hospitalizations, urgent HF visits, and change in NT-proBNP was calculated for both BMI groups.</p><p><strong>Results: </strong>Overall, 65% (n=298) of participants had obesity and 35% (n=164) of participants did not have obesity. When the interaction between BMI category and the effect of sac/val vs val on the time-averaged proportional change from baseline NT-proBNP was assessed, participants with obesity had a numerically larger decrease in NT-proBNP (ratio of change 0.82 (95% CI 0.68 to 0.99) with obesity vs 0.96 (95% CI 0.71 to 1.29) without obesity that was not statistically significant, p interaction 0.37. Participants with obesity were significantly more likely to derive benefit overall from sac/val vs val as compared to participants without obesity (win ratio 1.38, 95% CI 1.01-1.90 vs 0.90, 95% CI 0.62-1.32, p-interaction = 0.09).</p><p><strong>Conclusion: </strong>In this prespecified secondary analysis of PARAGLIDE-HF, patients with HFpEF and obesity had a similar magnitude of decrease in NT-proBNP with randomization to sac/val vs val, but may derive greater clinical benefit as assessed by a win ratio. This hypothesis-generating evidence suggests that patients that patients with obesity and HFpEF may particularly benefit from sac/val.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169769","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":"Real-World Adoption and Associated Outcomes of Aspirin Avoidance After HeartMate 3 Implantation: The PRAISE HM3 Study.","authors":"Farooq H Sheikh, Ezequiel J Molina, Ulrich P Jorde, Mirnela P Byku, Jeeyun A Kim, Deepti Bettampadi, Finn Gustafsson, Mandeep R Mehra","doi":"10.1016/j.cardfail.2026.09.031","DOIUrl":"10.1016/j.cardfail.2026.09.031","url":null,"abstract":"<p><strong>Background: </strong>ARIES-HM3 (Antiplatelet Removal and Hemocompatibility Events With the HeartMate 3 Pump) demonstrated that aspirin can be safely omitted after HeartMate 3 (HM3) implantation when vitamin K antagonist anticoagulation is continued, resulting in reduced nonsurgical bleeding without an increased risk of thromboembolic events. The pace, extent, and pattern of adoption in clinical practice, and whether real-world outcomes after adoption are consistent with the trial, remain uncertain.</p><p><strong>Methods: </strong>Using the Truveta electronic health record network (30 US health systems), we identified adults undergoing de novo durable left ventricular assist device (LVAD) implantation with documented warfarin therapy from January 2016 through March 2026. Recorded early aspirin use was defined as an aspirin administration, dispense, or active order on postoperative days 2-7. Temporal trends were examined relative to ARIES-HM3 publication (November 2023) and the US Food and Drug Administration labeling revision (August 2024). Among HM3 recipients implanted after ARIES-HM3 publication and event-free at a postoperative day 14 landmark, the 12-month composite of death or first major nonsurgical hemocompatibility-related adverse event was compared using Kaplan-Meier methods and sequentially adjusted Cox regression.</p><p><strong>Results: </strong>In the overall LVAD cohort (n = 3365), recorded aspirin use declined from 90.2% in 2023 to 55.7% in 2024 and 52.7% in 2025. Of 739 post-ARIES HM3 recipients, 404 (54.7%) had recorded early aspirin use. Aspirin was continued in 67.1% of patients with prior percutaneous coronary intervention, coronary artery bypass grafting, stroke, or peripheral vascular disease vs 43.4% of those without. The 12-month composite end point occurred in 29.3% of patients with and 21.7% without recorded aspirin (unadjusted hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.51-0.94); after multivariable adjustment, no significant association remained (HR 0.86, 95% CI 0.61-1.22). Major nonsurgical bleeding occurred in 22.0% and 15.0% of patients, respectively (unadjusted HR 0.65, 95% CI 0.45-0.94; adjusted HR 0.82, 95% CI 0.54-1.26). Stroke (4.7% vs 2.7%) and peripheral arterial thromboembolism (4.3% vs 2.6%) were not more frequent without aspirin; pump thrombosis was rare (2 events vs 3 events).</p><p><strong>Conclusions: </strong>After ARIES-HM3 publication and the US Food and Drug Administration labeling revision, aspirin use in HM3 LVAD implantation declined substantially but persisted in approximately one-half of recipients, most often in those with established vascular disease, the population in which ARIES-HM3 showed preserved safety and a numerically greater bleeding reduction with aspirin avoidance. In this observational analysis, aspirin avoidance was not associated with a higher adjusted risk of the composite outcome, and no excess of stroke or arterial thromboembolism was observed.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165575","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":"Some Assembly Required: Treatment Burden and Readmission After Heart Transplantation.","authors":"Christine Sailer, Emma J Kirsch, Robert L Page, Prateeti Khazanie","doi":"10.1016/j.cardfail.2026.09.034","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.09.034","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166390","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":"In Case You Missed It! Key Insights from the Infiltrative Cardiomyopathy Symposium.","authors":"Anjali A Wagle, Farion Cooper, Jason Li, Irena Kuzma, Nisha A Gilotra, Farooq H Sheikh","doi":"10.1016/j.cardfail.2026.08.003","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.08.003","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172183","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":"Left Ventricular Functional Improvement is Associated With Lower Morbidity and Mortality During Long-Term Mechanical Circulatory Support: An STS Intermacs Analysis.","authors":"Eleni Maneta, Ioannis Kyriakoulis, Christos P Kyriakopoulos, Benjamin Horne, Elizabeth Dranow, Rami Alharethi, Aysha Amjad, Iosif Taleb, Konstantinos Sideris, Dai-Yin Lu, Jake Aadland, Taylor Mendenhall, Jake Goldstein, Michael Bonios, Thomas C Hanff, Craig H Selzman, Omar Wever-Pinzon, Eleni Tseliou, Stavros G Drakos","doi":"10.1016/j.cardfail.2026.09.030","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.09.030","url":null,"abstract":"<p><strong>Background: </strong>A subset of patients with advanced heart failure (HF) supported with durable left ventricular assist devices (LVADs) demonstrate significant improvement in left ventricular ejection fraction (LVEF), but the impact of such functional improvement on clinical outcomes is unclear.</p><p><strong>Methods: </strong>We analyzed adults in the STS-Intermacs registry who underwent continuous-flow LVAD implantation (2006-2017) and had echocardiographic data ≥6 months post-implant. Post-LVAD myocardial function was defined by the maximum LVEF after ≥6 months of support and categorized as <40% vs ≥40% and into finer strata. Outcomes included all-cause mortality, clinically significant sustained cardiac arrhythmia, hepatic and renal dysfunction, CVA/TIA, right HF during follow-up, and HF hospitalization. Incidence rates and incidence rate ratios were calculated during 6-month landmarked follow-up through 5 years, and associations were assessed using landmarked multivariable Cox models.</p><p><strong>Results: </strong>Among 9,518 eligible patients (age 56.6±13.2 years, 21.4% female), 1,131 (12%) achieved LVEF ≥40% over a median 27.0 months of follow-up. Compared with LVEF <40%, LVEF ≥40% was associated with lower adjusted incidence rates of death (adjusted IRR 0.85, 95% CI 0.73-0.98), arrhythmia (0.59, 0.48-0.72), hepatic dysfunction (0.58, 0.35-0.97), and HF hospitalization (0.65, 0.51-0.82), whereas adjusted differences in right HF and renal dysfunction were not significant. In adjusted time-to-event analyses, LVEF ≥40% was independently associated with lower hazards of all-cause mortality (aHR 0.82, 95% CI 0.71-0.96), HF hospitalization (0.63, 0.50-0.80), cardiac arrhythmia (0.69, 0.58-0.83), and hepatic dysfunction (0.57, 0.37-0.88). Across ordered LVEF strata, higher LVEF was associated with progressively lower risks of death and HF-related events.</p><p><strong>Conclusions: </strong>In a large multicenter LVAD cohort, LV functional response to durable support spanned a spectrum, with ∼1 in 8 (12%) durable LVAD recipients achieving a maximum post-implant LVEF ≥40% after ≥6 months of support. Higher post-implant LVEF was independently associated with improved survival and fewer HF-related events. These findings support viewing myocardial improvement during LVAD support as a clinically meaningful target that affects positively the outcomes of patients while being on mechanical support.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164852","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":"Accelerometer-Based Activity Sensing by an Insertable Cardiac Monitor In Ambulatory Patients: A Subanalysis of LUX-Dx TRENDS (LUX-Dx Heart Failure Sensors in an Insertable Cardiac Monitor System Clinical Study).","authors":"Andrew J Sauer, E Matthew Quin, Karan Bhalla, Sashi Adigopula, Bin Mi, Emily Thompson, Deepa Mahajan, Ming Duanmu, Craig M Stolen, Molly E Kupfer, Alysia Rosner, Selçuk Adabag, Scott D Solomon, Elaine Y Wan","doi":"10.1016/j.cardfail.2026.09.026","DOIUrl":"10.1016/j.cardfail.2026.09.026","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170186","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":"Cardiac resynchronization therapy outcomes by sex and QRS duration: insights from AdaptResponse and a Real-world registry.","authors":"Theofanie Mela, Wilfried Mullens, Christophe Leclercq, Michael R Gold, Ahmad S Hersi, David Birnie, Kengo Kusano, Gabriela Kaliská, Archana Rao, Kyoko Soejima, Bart Gerritse, Randy F Crossland, Gerasimos Filippatos, Carina Blomström-Lundqvist","doi":"10.1016/j.cardfail.2026.09.024","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.09.024","url":null,"abstract":"<p><strong>Background: </strong>Sex-related differences in cardiac resynchronization therapy (CRT) outcomes in heart failure (HF) patients, particularly at shorter QRS durations, remain incompletely defined. We evaluated outcomes by sex and QRS duration in AdaptResponse trial and, pooled with Medtronic product surveillance registry (PSR) data, evaluated mortality comparing CRT and no CRT.</p><p><strong>Methods and results: </strong>AdaptResponse patients (symptomatic HF, LVEF≤35%, Strauss-LBBB, and normal atrioventricular conduction; 43% women) were analyzed by sex and baseline QRS (150ms cut-off), and pooled with PSR CRT and No CRT groups meeting CRT indications. Average treatment effect on treated (ATT) propensity weighting was used to standardize the PSR groups to AdaptResponse baseline characteristics. All-cause mortality was compared between the pooled CRT patients and No CRT controls with weighted Cox models. In AdaptResponse, adjusted mortality rates did not differ significantly between women and men (HR 0.91, 95% CI: 0.72-1.15; p=0.45), and no interaction was observed between sex and QRS (p=0.31). Adjusted mortality in women with QRS<150ms was not statistically different from men with QRS≥150ms (HR 1.02, CI: 0.75-1.38). After ATT-weighting and adjustment, CRT was observed to be associated with lower mortality versus No CRT across sex and QRS subgroups (QRS 120-149ms: HR 0.50, CI: 0.31-0.82 for women and HR 0.51, CI: 0.31-0.86 for men; QRS≥150ms: HR 0.46, CI: 0.28-0.74 for women and HR 0.46, CI: 0.29-0.72 for men; all p<0.05).</p><p><strong>Conclusion: </strong>In this exploratory analysis, among patients with QRS 120-149ms, CRT was associated with a 49% and 50% relative mortality reduction in men and women, respectively, through five years of follow-up compared to No CRT controls. In AdaptResponse, mortality in women with these shorter QRS durations was similar to men with QRS≥150ms. These observational findings are hypothesis-generating and suggest a potential benefit of CRT in this patient population, particularly for women, but have not been confirmed in a randomized trial.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166796","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":"Adverse Outcomes of Transthyretin p.V142I Carriers With Non-Amyloid Heart Failure:The SCAN-MP Study.","authors":"Katie J McMenamin, Anya Sanchorawala, Shabatun Islam, Tatiana Prokaeva, Brian Spencer, Sergio Teruya, Jeremy Slivnick, Rabah Alreshq, Denise Fine, Stephen Helmke, Cesia Gallegos, Edward J Miller, Mathew S Maurer, Frederick L Ruberg","doi":"10.1016/j.cardfail.2026.08.029","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.08.029","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167379","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":"Continuous Vutrisiran Reduces Cardiovascular Events and Hospitalizations in Patients With Transthyretin Amyloidosis With Cardiomyopathy in the HELIOS-B One-Year Open Label Extension.","authors":"Sarah A M Cuddy, Jan M Griffin, W H Wilson Tang, Olivier Lairez, Caroline Morbach, Francesco Cappelli, Farooq H Sheikh, Hua Zheng, Benjamin W Lee, Alisa R Kosheleff, Ronald M Witteles","doi":"10.1016/j.cardfail.2026.09.017","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.09.017","url":null,"abstract":"<p><strong>Background: </strong>Vutrisiran significantly reduced the risk of all-cause mortality and recurrent cardiovascular (CV) events vs placebo in patients with transthyretin amyloidosis with cardiomyopathy (ATTR-CM) in the phase 3 HELIOS-B study (NCT04153149). Here, we report the long-term impact of vutrisiran on hospitalizations and urgent heart failure (HF) visits from the ongoing HELIOS-B open-label extension (OLE).</p><p><strong>Methods: </strong>In HELIOS-B, patients received vutrisiran 25 mg or placebo every 3 months over a 33-36-month double-blind period, followed by a 24-month OLE continuing with vutrisiran (continuous treatment), or if previously receiving placebo, initiating vutrisiran (delayed treatment). Hospitalizations and urgent HF visits were analyzed through 48 months (12 months of the OLE) in the overall and monotherapy (not receiving tafamidis at baseline) populations, and the baseline tafamidis subgroup.</p><p><strong>Results: </strong>Of 654 participants, 466 entered the OLE. Continuous vutrisiran reduced the risk of all-cause hospitalizations vs delayed treatment in the overall population (relative rate ratio [RRR] 0.71, 95% confidence interval [CI] 0.62-0.82, P<0.001) and the monotherapy population (RRR 0.60, 95% CI 0.50-0.72, P<0.001). Continuous vutrisiran also significantly reduced the risk of CV hospitalizations, HF hospitalizations, and non-CV hospitalizations vs delayed vutrisiran in the overall and monotherapy populations, and urgent HF visits in the overall population and baseline tafamidis subgroup.</p><p><strong>Conclusions: </strong>Continuous vutrisiran reduced the risk of CV events and hospitalizations relative to patients originally randomized to placebo in HELIOS-B. Many treatment effects were of greater magnitude at 48 months vs 36 months with continuous vutrisiran, highlighting the benefits of earlier diagnosis and treatment.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164361","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-Reported Benefits of Acoramidis Across Genotypes in Transthyretin Amyloid Cardiomyopathy: KCCQ and EQ-5D-5L Outcomes From ATTRibute-CM.","authors":"Emer Joyce, Ahmad Masri, Laura Obici, Peter VAN-DER-Meer, Jan M Griffin, Keyur Shah, Zubair Shah, Tracy Bergemann, Gillian Murtagh, Heather Falvey, Jean-François Tamby, Margot K Davis, Francesco Cappelli, Steen Hvitfeldt Poulsen, Joshua D Mitchell, Mazen Hanna, Brett W Sperry, Nitasha Sarswat","doi":"10.1016/j.cardfail.2026.09.016","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.09.016","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166233","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}