Journal of Cardiac Failure最新文献

{"title":"The Effects of Burst Steroid Therapy on Short-term Decongestion in Acute Heart Failure Patients With Pro-inflammatory Activation: A Post Hoc Analysis of the CORTAHF Randomized, Open-label, Pilot Trial.","authors":"Jan Biegus, Gad Cotter, Beth A Davison, Yonathan Freund, Adriaan A Voors, Christopher Edwards, Maria Novosadova, Koji Takagi, Hamlet Hayrapetyan, Andranik Mshetsyan, Drambyan Mayranush, Alain Cohen-Solal, Jozine M ter Maaten, Gerasimos Filippatos, Ovidiu Chioncel, Malha Sadoune, Matteo Pagnesi, Tabassome Simon, Marco Metra, Douglas L Mann, Alexandre Mebazaa, Piotr Ponikowski","doi":"10.1016/j.cardfail.2024.09.002","DOIUrl":"10.1016/j.cardfail.2024.09.002","url":null,"abstract":"<p><strong>Background: </strong>The effect of steroids on congestion in patients with acute heart failure (AHF) is not known.</p><p><strong>Methods and results: </strong>Patients with AHF, NT-proBNP levels > 1500 pg/mL and high-sensitivity C-reactive protein (hsCRP) levels > 20 mg/L were randomized to once-daily oral 40 mg prednisone for 7 days or usual care. In this post hoc analysis, congestion score was calculated on the basis of orthopnea, edema and rales (0 reflecting lack of congestion, and 9 maximal congestion) at each time point. Among 100 eligible patients randomized, those assigned to prednisone had a greater improvement in congestion score at day 31 (win odds for the prednisone group compared to usual care at day 31 was 1.77 (95% CI 1.17-2.84; P = 0.0066) in all patients and 2.41 (95% CI 1.37-5.05; P = 0.0016) in patients with IL-6 > 13 pg/mL at baseline. In patients with congestion scores ≥ 7 at baseline, the effects of prednisone therapy on the EQ-5D visual analog scale score were 4.30 (95% CI 0.77-7.83) points at day 7 and 5.40 (0.51-10.29) points at day 31, accompanied by lower heart rate and respiratory rate and higher oxygen saturation compared to usual care.</p><p><strong>Conclusions: </strong>In patients with AHF and inflammatory activation, 7-day steroid therapy was associated with reduction in signs of congestion up to day 31. These results need confirmation in larger studies examining potential effects of steroids on congestion, diuresis, fluid redistribution and vascular permeability as well as clinical effects in AHF.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365362","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 Feasibility of an Implanted Inferior Vena Cava Sensor for Accurate Volume Assessment: FUTURE-HF2 Trial.","authors":"Nir Uriel, Kunjan Bhatt, Rami Kahwash, Thomas R McMinn, Manesh R Patel, Scott Lilly, John R Britton, Louise Corcoran, Barry R Greene, Robyn M Kealy, Annette Kent, William S Sheridan, Ajay J Kirtane, Sanjum S Sethi, Jeremiah P Depta, Scott C Feitell, Gabriel Sayer, Marat Fudim","doi":"10.1016/j.cardfail.2024.09.003","DOIUrl":"10.1016/j.cardfail.2024.09.003","url":null,"abstract":"<p><strong>Background: </strong>A novel implantable sensor has been designed to measure the inferior vena cava (IVC) area accurately so as to allow daily monitoring of the IVC area and collapse to predict congestion in heart failure (HF).</p><p><strong>Methods: </strong>A prospective, multicenter, single-arm, Early Feasibility Study enrolled 15 patients with HF (irrespective of ejection fraction) and with an HF event in the previous 12 months, an elevated NT-proBNP level, and receiving ≥ 40 mg of furosemide equivalent. Primary endpoints included successful deployment without procedure-related (30 days) or sensor-related complications (3 months) and successful data transmission to a secure database (3 months). Accuracy of sensor-derived IVC area, patient adherence, NYHA classification, and KCCQ were assessed from baseline to 3 months. Patient-specific signal alterations were correlated with clinical presentation to guide interventions.</p><p><strong>Results: </strong>Fifteen patients underwent implantation: 66 ± 12 years; 47% female; 27% with HFpEF, NT-ProBNP levels 2569 (median, IQR: 1674-5187, ng/L; 87% NYHA class III). All patients met the primary safety and effectiveness endpoints. Sensor-derived IVC areas showed excellent agreement with concurrent computed tomography (R² = 0.99, mean absolute error = 11.15 mm²). Median adherence to daily readings was 98% (IQR: 86%-100%) per patient-month. A significant improvement was seen in NYHA class and a nonsignificant improvement was observed in KCCQ.</p><p><strong>Conclusions: </strong>Implantation of a novel IVC sensor (FIRE1) was feasible, uncomplicated and safe. Sensor outputs aligned with clinical presentations and improvements in clinical outcomes. Future investigation to establish the IVC sensor remote management of HF is strongly warranted.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347365","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 Psychometric Performance of the Kansas City Cardiomyopathy Questionnaire-12 in Symptomatic Obstructive Hypertrophic Cardiomyopathy.","authors":"Andrew J Sauer, Charles F Sherrod, Kensey L Gosch, Suzanne V Arnold, Matthew Reaney, Yue Zhong, Jenny Lam, Kathleen W Wyrwich, John A Spertus","doi":"10.1016/j.cardfail.2024.09.010","DOIUrl":"10.1016/j.cardfail.2024.09.010","url":null,"abstract":"<p><strong>Background: </strong>A primary goal of treating patients with obstructive hypertrophic cardiomyopathy (oHCM) is to improve their symptoms, function and quality of life. Although the psychometric properties of the 23-item Kansas City Cardiomyopathy Questionnaire (KCCQ-23) have been described in oHCM, they have not been assessed for the shorter 12-item version (KCCQ-12), which is used increasingly in clinical practice.</p><p><strong>Methods and results: </strong>Using data from the EXPLORER-HCM trial, the psychometric properties of the KCCQ-12 were evaluated. The KCCQ-12 domain and summary scores had moderate correlations with the most relevant clinical (New York Heart Association class, exercise duration, peak oxygen consumption) and patient-reported measures (EQ-5D-5L visual analog scale, Work Productivity and Activity Impairment [WPAI] questionnaire, and Hypertrophic Cardiomyopathy Symptom Questionnaire [HCMSQ]). KCCQ-12 domain scores had strong internal consistency, and test-retest reliability, demonstrated significant and proportional changes with differing magnitudes of clinical change (assessed by the patients' global impressions of change and the patients' impressions of severity), and they demonstrated close equivalence to the KCCQ-23 scores.</p><p><strong>Conclusions: </strong>The KCCQ-12 demonstrated good psychometric performance for patients with oHCM, comparable to that of the KCCQ-23, supporting its use in clinical practice to care for patients with oHCM.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347367","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 Kansas City Cardiomyopathy Questionnaire in Relation to New York Heart Association Class.","authors":"Charles F Sherrod, John A Spertus, Kensey L Gosch, Andrew Wang, Perry M Elliott, Neal K Lakdawala, Matthew Reaney, Yue Zhong, Jenny Lam, Kathleen W Wyrwich, Andrew J Sauer","doi":"10.1016/j.cardfail.2024.08.061","DOIUrl":"10.1016/j.cardfail.2024.08.061","url":null,"abstract":"<p><strong>Background: </strong>In order to identify candidacy and treatment response for patients with obstructive hypertrophic cardiomyopathy (oHCM), clinicians need an accurate means of assessing symptoms, function, and quality of life. While the New York Heart Association (NYHA) Classification is most often used for this purpose, the Kansas City Cardiomyopathy Questionnaire (KCCQ-23) is more accurate and sensitive to change, although less familiar to practicing clinicians. To support interpreting the KCCQ-23, we describe cross-sectional and longitudinal changes in KCCQ scores in the context of the NYHA.</p><p><strong>Methods: </strong>Participants from the EXPLORER-HCM trial (NCT03470545) completed the KCCQ-23 and clinicians assigned NYHA classes at study visits. Participants were included if they had baseline and week 30 data for cross-sectional and longitudinal changes. Median KCCQ-23 scores were compared by NYHA class at baseline and week 30 and by change in NYHA class from baseline to week 30.</p><p><strong>Results: </strong>Cross-sectionally, the KCCQ-23 Overall Summary Scores (KCCQ-23 OSS) and Clinical Summary Scores (KCCQ-23 CSS) had an inverse relationship with the NYHA class at baseline and 30 weeks, with marked variations in KCCQ-23 scores among patients assigned to the same NYHA class. When improving from NYHA class II to I, the median changes in KCCQ-23 OSS and KCCQ-23 CSS were 10 (IQR 4, 22) and 8 (IQR 2, 20), respectively. The changes were larger when improving from NYHA class III to II and from NYHA class III to I.</p><p><strong>Conclusion: </strong>KCCQ-23 scores are inversely related to NYHA classes, with significant variability within classes. Changes in scores are not linear, suggesting greater differences when patients move between NYHA Classes II and III than when moving between Classes I and II. These insights may help clinicians better understand cross-sectional and longitudinal changes in KCCQ scores.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347366","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":"Baroreflex Function in Cardiovascular Disease.","authors":"Husam M Salah, Richa Gupta, Albert J Hicks, Kiran Mahmood, Nicholas A Haglund, Amarinder S Bindra, Steve M Antoine, Rachel Garcia, Amin Yehya, Dmitry M Yaranov, Pujan P Patel, Jason P Feliberti, Allman T Rollins, Vishal N Rao, Laurie Letarte, Vikram Raje, Amit H Alam, Patrick McCANN, Nirav Y Raval, Brian Howard, Marat Fudim","doi":"10.1016/j.cardfail.2024.08.062","DOIUrl":"10.1016/j.cardfail.2024.08.062","url":null,"abstract":"<p><p>The baroreflex system is involved in modulating several physiological functions of the cardiovascular system and can modulate cardiac output, blood pressure, and cardiac electrophysiology directly and indirectly. In addition, it is involved in regulating neurohormonal pathways involved in the cardiovascular function, such as the renin-angiotensin-aldosterone system and vasopressin release. Baroreflex dysfunction is characterized by sympathetic overactivation and parasympathetic withdrawal and is associated with several cardiovascular diseases, such as hypertension, heart failure, and coronary artery disease. Targeting the baroreflex system via invasive (eg, baroreflex activation therapy and endovascular baroreceptor amplification) and noninvasive approaches (eg, slow breathing exercises and exercise training) has emerged as a novel pathway to manage cardiovascular diseases. Studies examining the long-term safety and efficacy of such interventions in various cardiovascular diseases are needed.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347280","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":"Highlights for the Heart Failure Cardiologist from the Seventh World Symposium on Pulmonary Hypertension: Are We Out of the Woods Yet?","authors":"Thomas M Cascino, Bradley A Maron, Jean-Luc Vachiéry, Vallerie V McLAUGHLIN, Ryan J Tedford","doi":"10.1016/j.cardfail.2024.09.009","DOIUrl":"10.1016/j.cardfail.2024.09.009","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347284","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: Rates of Heart Failure Medicines and Hospital Readmission: An explanation of \"Prescription Patterns in the Management of Heart Failure and its Association with Readmissions: A Retrospective Analysis\".","authors":"Spencer Carter, Jennifer T Thibodeau","doi":"10.1016/j.cardfail.2024.09.008","DOIUrl":"10.1016/j.cardfail.2024.09.008","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347363","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":"Prescription Patterns in Management of Heart Failure and Its Association With Readmissions: A Retrospective Analysis.","authors":"Simran Agrawal, Zayd Alhaddad, Sarah Nabia, Obaid Ur Rehman, Madiha Kiyani, Ajay Kumar, Nripesh Regmi, Adhvithi Pingili, Rakesh Allamaneni, Amrit Paudel, Greg C Fonarow, Anup Agarwal","doi":"10.1016/j.cardfail.2024.08.059","DOIUrl":"10.1016/j.cardfail.2024.08.059","url":null,"abstract":"<p><strong>Background: </strong>The American Heart Association/American College of Cardiology/Heart Failure Society of America recently added sodium-glucose cotransporter-2 inhibitors in addition to renin-angiotensin-aldosterone system inhibitors, beta-blockers, and mineralocorticoid receptor antagonists to form the 4 pillars of guideline-directed medical therapy (GDMT) for the management of heart failure with reduced ejection fraction (HFrEF). Despite strong evidence suggesting improved outcomes with inpatient initiation of GDMT at target doses, significant lag has been noted in prescription practices. We sought to study GDMT prescription rates in patients with HFrEF at the time of hospital discharge and evaluate its association with various patient characteristics and all-cause readmission rates.</p><p><strong>Methods and results: </strong>We used a modified version of Heart Failure Collaboratory (HFC) score to characterize patients into 2 groups (those with an HFC score of <3 and an HFC score of ≥3) and to examine various socioeconomic and biomedical factors affecting GDMT prescription practices. Out of the eligible patients, the prescription rates for beta-blockers was 77.9%, renin-angiotensin-aldosterone system inhibitor was 70.3%, and mineralocorticoid receptor antagonists was 41%. Furthermore, prescription rates for sacubitril/valsartan was 27.7% and sodium-glucose cotransporter-2 inhibitors was 17%. Only 1% of patients had an HFC score of 9 (drugs from all 4 classes at target doses). Patients of black ethnicity, those admitted on teaching service and those with HFrEF as the primary cause of admission were more likely to have an HFC of ≥3 at discharge. An HFC of ≥3 was associated with lower rates of 1-month all-cause readmissions.</p><p><strong>Conclusions: </strong>Consistent with the prior research, our data show significant gaps in prescription of GDMT in HFrEF. Further implementation research should be done to improve GDMT prescription during inpatient stay.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347364","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":"Statistical Non-Significance, Likelihood Ratio, and The Interpretation of Clinical Trial Evidence: Insights from Heart Failure Randomized Trials.","authors":"Muhammad Shahzeb Khan, Adeena Jamil, James L Januzzi, Muteia Shakoor, Monica M Bennett, Johanna S Van Zyl, Harriette G C Van Spall, Javed Butler","doi":"10.1016/j.cardfail.2024.07.026","DOIUrl":"10.1016/j.cardfail.2024.07.026","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375456","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":"Denial for Advanced Heart Failure Therapies Due to Psychosocial Stressors: Who Comes Back?","authors":"Kayla Buttafuoco, Daniel Daunis, Tandra Carter, Jolaunda Hoye, Maura Webb, Shi Huang, Marshall Brinkley, Joann Lindenfeld, Jonathan Menachem, Dawn Pedrotty, Aniket Rali, Suzanne Sacks, Kelly Schlendorf, Hasan Siddiqi, Lynne Stevenson, Sandip Zalawadiya, Lynn Punnoose","doi":"10.1016/j.cardfail.2024.08.057","DOIUrl":"10.1016/j.cardfail.2024.08.057","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial evaluations to assess candidacy for advanced heart failure therapies are not standardized across institutions, potentially contributing to disparities in approval for advanced therapies. Remediation rates of psychosocial stressors among patients with advanced HF and reconsideration for advanced therapies have not been well-described.</p><p><strong>Methods and results: </strong>We performed a retrospective, single-center study of 647 adults evaluated for heart transplant and ventricular assist device implantation between 2014 and 2020, of whom 89 (14%) were denied for psychosocial stressors, including caregiver, substance use, housing, financial, or mental health concerns. Later reevaluation occurred in 32 patients (36%), of whom 23 were then approved. Patients initially declined were mostly male (76%), White (74%), and urban (79%). Reevaluation occurred in more women than men (43% vs 34%), Black patients than White (43% vs 37%), and urban patients than rural (39% vs 28%). Patients had fewer psychosocial stressors at reevaluation (median 0.5) than at initial denial (median 2.0). Caregiver and substance use concerns were the most prevalent stressors in patients never returning for or subsequently denied at reevaluation.</p><p><strong>Conclusions: </strong>Caregiver and substance use concerns were common in patients denied for psychosocial reasons. Future efforts should focus on early screening for these stressors and the implementation of a systematic reevaluation process.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347282","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}