Journal of Cardiac Failure最新文献

{"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}

{"title":"Digital Walking Behaviors: Could They Be the “Gait-way” to Monitoring Heart Failure Progression in Community-based Settings?","authors":"WINDY W. ALONSO PhD, RN, FHFSA, FAHA ,&nbsp;CHRISTOPHER S. LEE PhD, RN, FHFSA, FAHA, FAAN","doi":"10.1016/j.cardfail.2024.05.010","DOIUrl":"10.1016/j.cardfail.2024.05.010","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1434-1436"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310760","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":"Skeletal Muscle Wasting: The Unmeasured “End Organ” in Advanced Heart Failure","authors":"GERIN R. STEVENS MD, PhD ,&nbsp;REBECCA COGSWELL MD","doi":"10.1016/j.cardfail.2024.08.049","DOIUrl":"10.1016/j.cardfail.2024.08.049","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1469-1471"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307845","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":"Unlocking Diversity in Cardiovascular Clinical Research: Lessons from the Screening for Cardiac Amyloidosis With Nuclear Imaging in a Minority Populations Study","authors":"Abdirahman Wardhere MD ,&nbsp;Dimitrios Bampatsias MD ,&nbsp;Elizabeth Cohn RN, PhD ,&nbsp;Denise Fine RN, BSN ,&nbsp;Cinthia de Freitas RN, BSN ,&nbsp;Cesia Gallegos MD ,&nbsp;Stephen Helmke RDCS, MPH ,&nbsp;Natalia Ionescu PA ,&nbsp;Janvier Ivrose PA ,&nbsp;Carlos Rodriguez MD ,&nbsp;Natalia Sabogal BS ,&nbsp;Sergylensky Fils RN ,&nbsp;Terrence Henry MD ,&nbsp;Sergio Teruya MS ,&nbsp;Ikram Ullah MD ,&nbsp;Damian Kurian MD ,&nbsp;Farbod Raiszadeh MD ,&nbsp;Edward J. Miller MD ,&nbsp;Frederick L. Ruberg MD ,&nbsp;Mathew S. Maurer MD","doi":"10.1016/j.cardfail.2024.04.019","DOIUrl":"10.1016/j.cardfail.2024.04.019","url":null,"abstract":"<div><h3>Background</h3><div>The Screening for Cardiac Amyloidosis<span> with Nuclear Imaging<span> in Minority Populations study seeks to determine the prevalence of transthyretin cardiac amyloidosis (ATTR-CA) among older Black or Caribbean Hispanic individuals with heart failure and an increased wall thickness. We noticed varied recruitment percentages across the recruiting sites and sought to determine the factors associated with greater percentage enrollment of eligible participants.</span></span></div></div><div><h3>Methods</h3><div>The percentage of enrolled to eligible participants was calculated across study sites. Baseline demographic and clinical characteristics, health literacy, trust in providers, perceived discrimination, area deprivation index (ADI) and English proficiency were compared by site using Kruskal-Wallis's test or one-way ANOVA for continuous variables and the Chi-Square test or Fisher's exact test for categorical variables. Wilcoxon rank sum and Chi-Square tests, with multiple comparisons correction using the false discovery rate (FDR) method, were used as post-hoc analysis when results were statistically significant.</div></div><div><h3>Results</h3><div>Among the four recruiting sites, Boston Medical Center, Columbia University Irving Medical Center, Harlem Hospital and Yale University, which employed different recruitment approaches, the percentage of participants enrolled among eligible participants differed, with the highest rate at Harlem Hospital (n=149 of 310, 48%), followed by Yale University (n=27 of 67, 40%), Boston University (n=247 of 655, 38%), and Columbia University (n=137of 442, 32%), p &lt;0.01. Direct recruitment by the primary cardiovascular care team providing clinical care was associated with higher percent enrolled across sites as were higher education levels and English proficiency. Enrollment differences across sites were not associated with the number of chronic diseases, physician trust, perceived discrimination, or health literacy.</div></div><div><h3>Conclusions</h3><div>Recruitment of eligible under-represented minorities (URMs) in SCAN-MP was associated with approaches employed in recruitment, including direct initial contact by the primary cardiovascular care team providing the potential participant's clinical care. Such data may help improve approaches to more successful recruitment of URMs in clinical research.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1507-1511"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916758","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":"Drug Development in Hypertrophic Cardiomyopathy: Should Diastology Trump Functional Capacity Assessment?","authors":"MILIND Y. DESAI MD, MBA ,&nbsp;CARLES DÍEZ-LÓPEZ MD","doi":"10.1016/j.cardfail.2024.04.022","DOIUrl":"10.1016/j.cardfail.2024.04.022","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1449-1451"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080334","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 Focus: Moving Beyond Step Count: An Explanation of Real-World Walking Behaviors Are Associated With Early-Stage Heart Failure: A Project Baseline Health Study","authors":"SPENCER CARTER MD ,&nbsp;JENNIFER T. THIBODEAU MD, MSCS","doi":"10.1016/j.cardfail.2024.04.002","DOIUrl":"10.1016/j.cardfail.2024.04.002","url":null,"abstract":"<div><div>In this issue of the <em>Journal of Cardiac Failure,</em> Dr. Sooyoon Shin and colleagues look at whether information from wearable devices, or activity trackers, could improve how a medical team monitors activity limitations for people who are at risk of developing heart failure symptoms.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1437-1438"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783712","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":"Filling the Void: How to Become a Palliative Cardiologist (and Why)","authors":"SARAH GODFREY MD, MPH ,&nbsp;SARAH CHUZI MD, MSc ,&nbsp;KATHARINE MANNING MD, MBE","doi":"10.1016/j.cardfail.2024.06.006","DOIUrl":"10.1016/j.cardfail.2024.06.006","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1535-1538"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544897","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":"HFSA Scientific Statement: Update on Device Based Therapies in Heart Failure","authors":"JERRY D. ESTEP MD ,&nbsp;HUSAM M. SALAH MD ,&nbsp;SAMIR R. KAPADIA MD ,&nbsp;DANIEL BURKHOFF MD, PhD ,&nbsp;ANURADHA LALA MD ,&nbsp;JAVED BUTLER MD, MPH, MBA ,&nbsp;SHELLEY HALL MD ,&nbsp;MARAT FUDIM MD, MHS","doi":"10.1016/j.cardfail.2024.07.007","DOIUrl":"10.1016/j.cardfail.2024.07.007","url":null,"abstract":"<div><div>Heart failure (HF) is 1 of the major challenges of our time, given its increase in prevalence and related mortality rates. Foundational pharmacological therapies, including angiotensin receptor neprilysin inhibitors (ARNIs), beta-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose co-transporter inhibitors (SGLTis), have been established for HF with reduced ejection fraction (HFrEF). Moreover, recent trials have established the role of SGLTis in patients with HF with preserved ejection fraction (HFpEF). However, even with these therapies, a substantial residual risk persists in both HFrEF and HFpEF. Alongside pharmacological advancements, device-based therapies have shown efficacy in HF management, including implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT). More recently, devices such as cardiac contractility modulation (CCM) and baroreflex activation therapy (BAT) have been approved by the FDA, although they lack comprehensive guideline recommendations. This scientific statement outlines the unmet needs in chronic HF, reviews contemporary data and provides a framework for integrating novel device-based therapies into current clinical workflows. It emphasizes the importance of early diagnosis and phenotyping, proper patient stratification and a personalized approach to combining pharmacological and device therapies. The document also highlights the need for further research into device interactions and patient selection to optimize outcomes, while recognizing the need for a more integrated approach to treatment so as to address the unmet needs and residual risks in HF management.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 11","pages":"Pages 1472-1488"},"PeriodicalIF":6.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288085","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}