Journal of Cardiac Failure最新文献

{"title":"Congestion, obesity and survival in chronic heart failure.","authors":"Pierpaolo Pellicori, Joe Cuthbert, Ahmad Alsaeed, Letizia Romano, Pasquale Maffia, John Gf Cleland, Andrew L Clark","doi":"10.1016/j.cardfail.2026.04.003","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.04.003","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856455","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":"Combined Enhanced External Counterpulsation and Hyperbaric Oxygen Therapy in Ischemic Cardiomyopathy: Interim Results of a Prospective Study.","authors":"Dr Sama Akber, Dr Natrajan Sivakadaksham, Dr D Prabhakaran, Dr Ramanathan Muthiaya, Dr Ganesan Ganavelu, Dr Susheelkumar Alfred, Dr Naveen Kishore Baskar, Amir Ali, Dr Kanmani Srinivasan","doi":"10.1016/j.cardfail.2026.04.020","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.04.020","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic cardiomyopathy remains a major contributor to chronic heart failure despite optimal guideline-directed medical therapy (GDMT). HEAT HF (HBOT and EECP as Adjuvant Therapy in Heart Failure) is the first prospective study to investigate the effect of Enhanced External Counterpulsation (EECP) with adjunctive Hyperbaric Oxygen Therapy (HBOT) on enhancing cardiac function and improving clinical outcomes in patients with ischemic cardiomyopathy.</p><p><strong>Methods: </strong>This prospective interventional study was conducted on 100 adult patients with ischemic cardiomyopathy [left ventricular ejection fraction (LVEF) ≤50%] who had undergone EECP therapy with HBOT. Data on LVEF, global longitudinal strain (GLS), NYHA class, 6-minute walk test (6MWT), NT-proBNP, serum creatinine, and heart failure-related hospitalizations were collected pre- and post-intervention. This study is an ongoing clinical trial registered with the Clinical Trials Registry - India (CTRI/2024/11/076912), registered on November 18, 2024. This analysis represents interim results at 6-month follow-up.</p><p><strong>Results: </strong>There were 88% males, with a mean age of 61.5 ± 10.7 years. LVEF significantly improved from 34.17 ± 7.0 to 41.43 ± 7.0% (p<0.001). 6MWT distance increased from 243.7 ± 94.4 to 367.4 ± 72.5 m (p<0.001), and NYHA class improved from III/IV to mainly I (p<0.001). GLS, NT-proBNP, and heart failure admissions also showed significant improvements (p < 0.001). LDL levels slightly decreased (p=0.046), while serum urea and creatinine remained unchanged. Patients on more GDMT agents showed better EF improvements, suggesting a synergistic effect.</p><p><strong>Conclusion: </strong>EECP, combined with HBOT and optimal GDMT, significantly improves cardiac function, exercise capacity, symptom burden, and biochemical markers in ischemic cardiomyopathy. This non-invasive approach may offer a promising adjunct to standard heart failure management.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856411","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":"Microaxial Flow Pumps in Heart Failure Related Cardiogenic Shock - From Hemodynamic Mechanisms to Clinical Applications: A State-of-the-Art-Review.","authors":"Meagan E Prescott, Anthony P Carnicelli, William C Mostertz, Sharon L McCartney, Mason G Sanders, Jeffrey Keenan, Adam D DeVore","doi":"10.1016/j.cardfail.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.04.001","url":null,"abstract":"<p><strong>Background: </strong>Heart failure-related cardiogenic shock (HF-CS) is now the leading etiology of cardiogenic shock (CS). Advances in temporary mechanical circulatory support (tMCS), particularly microaxial flow pumps (mAFP), alongside evolving organ procurement and heart-allocation policies, have expanded opportunities for hemodynamic stabilization, recovery, and heart replacement therapy. However, prolonged support capabilities have increased the complexity of clinical decision-making in a heterogeneous population with variable candidacy for heart replacement therapies if native heart recovery (NHR) is not achieved. Optimal use of mAFP requires integration of device-specific capabilities with patient-level hemodynamics and overall clinical context.</p><p><strong>Methods and results: </strong>This state-of-the-art review synthesizes the epidemiology and pathophysiology of HF-CS, the integration of hemodynamic profiling into clinical management, and contemporary clinical evidence for mAFP use. Although DanGer Shock demonstrated mortality benefit of Impella CP™ in acute myocardial infarction-related cardiogenic shock (AMI-CS), extrapolation of these findings to HF-CS is limited by distinct pathophysiologic substrates and ongoing device evolution. Newer surgically implanted platforms, such as the axillary Impella 5.5®, provide high-capacity, sustained left ventricular unloading while preserving patient mobility, thereby extending support strategies beyond short-term stabilization, and enabling bridge-to-decision and bridge-to-replacement pathways in select patients. Observational data suggest that prompt recognition of shock severity and timely initiation of support are associated with improved outcomes, and multicenter registries that include HF-CS cohorts have refined our understanding of patient selection, device utilization, and timing of mAFP support in real-world practice. However, marked variability in patient phenotype, practice patterns, and ongoing device evolution complicates evidence interpretation. Within this context, pulmonary artery catheter (PAC)-guided hemodynamic profiling may be central to informing initial device selection and timing and enabling serial trajectory assessment to guide escalation and weaning.</p><p><strong>Conclusion: </strong>Advances in mAFP technology have broadened the therapeutic armamentarium for HF-CS, but significant opportunities for innovation in device design and implementation remain. Optimal outcomes depend on early shock recognition and frequent, comprehensive assessment of hemodynamic and clinical trajectory. Efforts to optimize patient selection and reduce device-related complications must be coupled with systems that enable rapid deployment and effective biventricular support when indicated. Future investigations should prioritize phenotype-specific trials and hemodynamic-guided algorithms to refine device selection and improve outcomes.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838250","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":"Atrial Fibrillation and Heart Failure with Preserved Ejection Fraction: One Step Closer to Therapeutic Targets?","authors":"Manoj S Ambalavanan, Nicole C Schulte, Vishal N Rao","doi":"10.1016/j.cardfail.2026.03.032","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.03.032","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838299","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 Perspectives on Cardiac Gene Therapy: A Survey of Knowledge, Attitudes, and Educational Needs.","authors":"Elizabeth Silver, Adam Taub, Vivian Bui, Greg Ruf, Christy Johnson, Cinnamon Bloss, Borsika Rabin, Marcus Urey, Barry Greenberg, Eric D Adler, Kimberly N Hong, Quan M Bui","doi":"10.1016/j.cardfail.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.04.004","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838284","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: THT 2026.","authors":"Alexander G Hajduczok, Elena Donald, Devin Stives, Joseph Toole, Anu Lala, Daniel Burkhoff","doi":"10.1016/j.cardfail.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.04.015","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815617","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 CADENCE Trial: Activin Type II Receptor Ligand Trapping With Sotatercept As First Prospective Proof-of-Concept for the Adipokine Hypothesis of Heart Failure With a Preserved Ejection Fraction.","authors":"Milton Packer","doi":"10.1016/j.cardfail.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.04.010","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815782","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-Hospital Initiation of SGLT2 Inhibitors in Patients with Acute Heart Failure: A Meta-Analysis of Randomized Controlled Trials with Trial Sequential Analysis.","authors":"Mushood Ahmed, Jamal S Rana, Laiba Sajjad, Eeshal Zulfiqar, Vineet Chandak, Qura Tul Ain, Raheel Ahmed, Robert J Mentz, Gregg C Fonarow","doi":"10.1016/j.cardfail.2026.04.018","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.04.018","url":null,"abstract":"<p><strong>Background: </strong>Acute heart failure (AHF) remains a leading cause of hospitalization and mortality despite therapeutic advances. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have shown benefits in chronic HF, but their role when initiated during hospitalization for AHF remains uncertain.</p><p><strong>Methods: </strong>A literature search was conducted across main databases through September 10, 2025 to identify randomized controlled trials (RCTs) evaluating in-hospital initiation of SGLT2 inhibitors in patients with AHF. Primary outcomes were all-cause death and worsening HF; secondary outcomes included cardiovascular death, HF rehospitalization, and safety endpoints. Random-effects model was used to estimate risk ratios (RRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Eight RCTs including 4,096 patients were analysed with a weighted median follow-up of 60 days. In-hospital initiation of SGLT2 inhibitors significantly reduced all-cause death (RR 0.61, 95% CI 0.47-0.81) and worsening HF events (RR 0.67, 95% CI 0.48-0.94) compared to control group. The risk of cardiovascular death was significantly lower with SGLT2 inhibitors (RR 0.68, 95% CI 0.47-0.99). No significant effect on HF rehospitalizations was observed (RR 0.87, 95% CI 0.70-1.09). Safety outcomes, including acute kidney injury, hypotension, hypoglycemia, urinary tract infection, and serious adverse events were comparable between groups. Trial sequential analysis confirmed firm evidence for mortality reduction, while further trials are needed for worsening HF.</p><p><strong>Conclusions: </strong>In-hospital initiation of SGLT2 inhibitors in patients with AHF lowers mortality and worsening HF without increasing adverse events. Further evidence from large scale RCTs with longer follow-ups is required to reach a definitive conclusion.</p><p><strong>Lay summary: </strong>Acute heart failure is a serious condition that often leads to repeated hospitalizations and a high risk of death. We reviewed all available clinical trials to understand whether starting a class of medications called SGLT2 inhibitors during the hospital stay can help these patients. Across eight trials involving more than 4,000 patients, in-hospital treatment with SGLT2 inhibitors lowered the chances of death and reduced episodes of worsening heart failure. Importantly, these medicines did not increase side-effects such as kidney problems, low blood pressure, or infections. Although they did not significantly reduce hospital readmissions, the overall benefits were consistent and appeared within weeks of treatment. These findings support starting SGLT2 inhibitors safely during hospitalization for acute heart failure to improve patient outcomes.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815687","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":"IL-6 and diuretic response in acute heart failure.","authors":"Daan C H Ceelen, Lukas Baumhove, Bart J van Essen, Iris E Beldhuis, Lara Zonneveld, Sietske N Zijlstra, Kevin Damman, Dirk J van Veldhuisen, Peter van der Meer, Adriaan A Voors, Jozine M Ter Maaten, Nils Bömer","doi":"10.1016/j.cardfail.2026.03.031","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.03.031","url":null,"abstract":"<p><strong>Introduction: </strong>Acute heart failure (AHF) remains a major cause of mortality and rehospitalization, with successful decongestion being the primary therapeutic goal. Plasma interleukin-6 (IL-6) levels are elevated in AHF, associated with worse outcomes, and may directly affect diuretic response. However, its relationship with natriuresis and diuresis during an AHF hospitalization remains unexplored.</p><p><strong>Methods: </strong>Plasma IL-6 was measured in 273 patients from the PUSH-AHF trial. The association between IL-6 with natriuresis and diuresis at 6, 24, 48, and 72 hours was investigated using linear mixed-effects models. Twenty-four-hour diuretic response and its association with IL-6, NT-proBNP, and bio-ADM was assessed using linear regression models. A mediation analysis was performed to evaluate whether 24-hour diuretic response mediated the association between IL-6 and clinical outcomes. Findings were externally validated in a cohort of 1591 AHF patients (PROTECT).</p><p><strong>Results: </strong>Patients with high IL-6 levels showed higher NT-proBNP levels, higher baseline heart rates and a lower ejection fraction. Patients with high IL-6 levels had significantly lower natriuresis (adjusted-p<0.001) and lower diuresis over time (adjusted-p=0.011). Furthermore, IL-6 was independently associated with poorer 24-hour diuretic response (p=0.003), unlike NT-proBNP (p=0.274) and bio-ADM (p=0.786). The relationship between elevated IL-6 and all-cause mortality or heart failure rehospitalization was for 44.6% mediated by impaired diuretic response. These findings were broadly similar in the PROTECT study.</p><p><strong>Conclusion: </strong>Higher IL-6 levels are independently associated with worse diuretic response, and decreased diuresis and natriuresis in AHF, particularly during the initial phase of hospitalization. The results indicate that IL-6 may function as a biomarker of inadequate decongestive response and could represent a potential target for therapeutic intervention.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772661","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":"Predictors of Discharge Diuretic Prescription Duration and Medication Adherence in Heart Failure.","authors":"Aradhana Verma, Neil Kalwani, Jun Fan, Megan Skye, Kylie Oakes, Paul Heidenreich, Alexander T Sandhu","doi":"10.1016/j.cardfail.2026.04.006","DOIUrl":"https://doi.org/10.1016/j.cardfail.2026.04.006","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772734","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}