Journal of Cardiac Failure最新文献

{"title":"Building and Growing a Multi-Disciplinary Program as Early Career Faculty: Lessons Learned and Practical Strategies.","authors":"Spencer J Carter","doi":"10.1016/j.cardfail.2025.09.014","DOIUrl":"10.1016/j.cardfail.2025.09.014","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191863","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":"Hemodynamic Profiles during Pulmonary Artery Pressure Sensor Implantation: Risk Stratification in Chronic HFrEF.","authors":"Daniel Jabr, Rachel Pedersen, Amogha Dahal, Manuel Paredes-Flores, Ali A Valika, Nasir Z Sulemanjee, Sunil Pauwaa, Muhyaldeen Dia, Gregory P Macaluso, Jessica Pillarella, Anjali Joshi, Christopher Sciamanna, Mark Dela Cruz, William G Cotts, Azmey A Matarieh, Hetal A Gandhi, Shoeb M Hussain, Afoma P Ezidinma, Nikhil Narang, Vinh Q Chau","doi":"10.1016/j.cardfail.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.09.002","url":null,"abstract":"<p><strong>Background: </strong>Invasive hemodynamics may facilitate outpatient identification of ambulatory advanced HF. We analyzed cardiac failure risk stratified by four hemodynamic profiles recorded during implantation of the pulmonary artery pressure (PAP) sensor, CardioMEMS™ HF system.</p><p><strong>Methods: </strong>This multicenter, retrospective cohort study included HFrEF patients who underwent PAP sensor implantation from 2015 to 2022. Hemodynamic profiles were categorized using the Stevenson HF classification, defining \"cold\" (impaired systemic perfusion) as cardiac index <2.2L/min/m2; and \"wet\" (hemodynamic congestion) as pulmonary capillary wedge pressure ≥18mmHg. The primary endpoint was 1-year cardiac failure, including all-cause mortality, inotrope dependence, need for durable VAD or heart transplantation.</p><p><strong>Results: </strong>Among 512 patients (median age 71 years, 28% female, 77% NYHA class III, median NT-proBNP 2554 pg/mL), the hemodynamic profiles were as follows: 30% Warm-Dry, 22% Warm-Wet, 21% Cold-Dry, and 27% Cold-Wet. Overall, 118 patients (23%) experienced cardiac failure, of which 57 required chronic inotrope, durable VAD implantation, or heart transplantation and 61 died with medical therapy. One-year event-free survival differed across the profiles: Warm-Dry (90%), Warm-Wet (74%), Cold-Dry (80%), and Cold-Wet (61%) (P<0.001). Multivariable analysis (reference: Warm-Dry) showed increased cardiac failure risk in Cold-Wet (adjusted HR [95%CI]: 4.4 [2.4-7.8], P<0.001), Cold-Dry (adjusted HR [95%CI]: 2.2 [1.1-4.2], P=0.019), and Warm-Wet (adjusted HR [95%CI]: 2.8 [1.5-5.4], P=0.001).</p><p><strong>Conclusion: </strong>At time of PAP sensor placement, an abnormal hemodynamic profile - especially Cold-Wet - was associated with increased cardiac failure risk, indicating subgroups who might have already progressed to ambulatory advanced heart failure.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191821","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":"Between Two Signals: The Intersection of Electrophysiology and Heart Failure.","authors":"Jose Lopez","doi":"10.1016/j.cardfail.2025.09.015","DOIUrl":"10.1016/j.cardfail.2025.09.015","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191740","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":"Recovery in Cardiogenic Shock: Why Terminology Matters.","authors":"Vanessa Blumer","doi":"10.1016/j.cardfail.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.09.027","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191780","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":"Heart Failure Devices: Treatment Options, Underutilization, and a Proposed Trigger System for Patient Referral and Evaluation.","authors":"Marat Fudim, Dmitry M Yaranov, Richa Gupta, Laurie Letarte, Samuel Sears, Brian G Howard, Nir Uriel, Vikram Raje, Kiran Mahmood, Sean P Pinney, Amin Yehya, Amit Alam, Pujan Patel, Albert Hicks, Amarinder Bindra, Steve M Antoine, Jason Feliberti, Allman Rollins, Vishal N Rao, Patrick McCann, Nirav Raval, Rachel Garcia, Ahmed Sayed","doi":"10.1016/j.cardfail.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.08.019","url":null,"abstract":"<p><p>The use of guideline-directed medical therapy (GDMT) has substantially prolonged and improved the livelihoods of patients with heart failure (HF). Nevertheless, adherence rates remain suboptimal. Even when successfully maximized and adhered to, there is a substantial residual risk of recurrent HF hospitalization and death. In light of this, there is a strong need for effective interventions that can reduce the high residual risk seen in patients with HF. Several device options exist which are approved by the FDA and which have been shown to reduce morbidity and/or mortality in patients among whom GDMT was maximized. These include valvular interventions (aortic valve replacement, mitral valve repair, and tricuspid valve repair/replacement), cardiac resynchronization, cardiac contractility modulation, remote hemodynamic monitoring, and baroreceptor activation therapy. The pivotal trials for each of these interventions, and the patient populations for which they have been approved, are discussed. Current rates of device use in clinical practice remain very low. For many device classes, the vast majority of eligible patients are not offered or prescribed the device. Several reasons may explain this mismatch, foremost of which is a lack of clinical awareness about when to escalate therapy, identify patients requiring more than GDMT, and access to centers with sufficient experience. To aid the appropriate uptake of device therapy in clinical practice, we propose a simple mnemonic for use by clinicians that can prompt the early identification and prompt referral of patients with HF who likely merit consideration of additional device-based therapy in addition to GDMT.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185855","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":"Match Decline Forecasts Slowing Advanced Heart Failure Cardiology Workforce Growth Toward 2030.","authors":"Eiran Z Gorodeski, Shashank Shekhar, Robert A Montgomery","doi":"10.1016/j.cardfail.2025.08.022","DOIUrl":"10.1016/j.cardfail.2025.08.022","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185883","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 Transplant We Trust? Perspectives on the Erosion of Trust in the United States Transplant System.","authors":"Jenna Skowronski, Kurt Sweat, Maryjane Farr","doi":"10.1016/j.cardfail.2025.09.025","DOIUrl":"10.1016/j.cardfail.2025.09.025","url":null,"abstract":"<p><p>The US national organ transplant program was established more than 50 years ago, founded on the tenets of fairness, equity, and safety. Public trust is paramount to the success of every aspect of organ transplantation, including donor registration, organ procurement organization practices, donor hospital partnerships, and allocation policy. This perspective evaluates the status of public trust in organ transplants in the context of new and concerning developments in US practices and government responses. Our focus is on the potential impacts on heart transplantation, specifically on waitlist mortality, especially for patients without an alternative option of durable mechanical circulatory support.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149093","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":"JCF In Case You Missed It! ESC Congress 2025.","authors":"Paula Rambarat, Elena M Donald, Jesus Alvarez-Garcia, Jozine M Ter Maaten","doi":"10.1016/j.cardfail.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.09.026","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137796","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":"Qualitative Analysis of Patient-Physician Discussions About the Benefits and Tradeoffs of Heart Failure Medications.","authors":"Henry D Biermann, Candace D Speight, Sarah C Montembeau, Andrea R Mitchell, Emily F Lowe, Advaita Krishnan, Laura D Scherer, Daniel D Matlock, Peter A Ubel, Larry A Allen, Neal W Dickert","doi":"10.1016/j.cardfail.2025.07.025","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.07.025","url":null,"abstract":"<p><strong>Background: </strong>How physicians frame medication benefits and tradeoffs while engaging in shared decision making with patients is not well described in the management of heart failure with reduced ejection fraction (HFrEF).</p><p><strong>Methods: </strong>This qualitative, secondary analysis of recorded encounters between clinicians and patients with HFrEF sought to identify major themes regarding communication of medication benefits and tradeoffs. Encounters occurred in six clinics within two academic health systems. English-speaking adult patients with a diagnosis of HFrEF (ejection fraction ≤40%) were enrolled.</p><p><strong>Results: </strong>A total of 247 patient encounters were analyzed. Patients' mean (SD) age was 62.9 (13.9); 70.5% were male; 64.0% were White, 26.3% Black, and 3.2% Hispanic/Latinx. Overall, 70% of encounters contained a discussion involving medication benefits. Substantial variability was observed, and four main themes emerged. 1) Primary benefits (increased survival, reduced hospitalizations, better quality of life) were commonly discussed, but clinicians described the magnitude in only two cases; 2) Adjunctive drug benefits (improved physiology, tolerability, affordability) were described nonspecifically; 3) Persuasive forms of communication were common, including direct appeals to authority/guidelines, references to pharmaceutical advertisements, and emotive language; 4) Significant heterogeneity was present in the content and character of benefit tradeoff discussions.</p><p><strong>Conclusions: </strong>Rare inclusion of medication benefit magnitude, variability in the presentation of benefits, and use of persuasive and emotive communication all challenge traditional notions of shared decision-making but are commonly encountered in clinical interactions for heart failure. Recognizing these contextual factors and evaluating which are consistent with effective decision-making in HFrEF and other chronic conditions is important and needed.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137719","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":"Antibody-independent microvascular inflammation impacts long-term risk in heart transplantation.","authors":"Shi Huang, Nelson Chow, Kyle Saysana, Eric Farber-Eger, Quinn S Wells, David W Bearl, JoAnn Lindenfeld, Kelly H Schlendorf, Kaushik Amancherla","doi":"10.1016/j.cardfail.2025.08.021","DOIUrl":"10.1016/j.cardfail.2025.08.021","url":null,"abstract":"<p><strong>Background: </strong>Microvascular inflammation (MVI) following heart transplantation can occur with or without circulating anti-HLA donor-specific antibodies (DSAs). We sought to characterize the relationship between MVI, with or without accompanying DSA, and post-transplant outcomes.</p><p><strong>Methods: </strong>We analyzed 8,305 endomyocardial biopsies (EMB) from 832 adult and pediatric HT recipients between July 1, 2013 and October 31, 2023. EMBs were graded by consensus guidelines, with MVI defined as pAMR grade ≥1. Rejection phenotypes were classified as no rejection, isolated cellular rejection (ACR), DSA-negative MVI, and DSA-positive MVI. Cox models with time-varying covariates were constructed to evaluate associations with incident CAV and mortality, adjusting for donor and recipient age.</p><p><strong>Results: </strong>Among 832 HT recipients, 238 developed CAV and 121 died over a median follow-up of 4 years (IQR 2.3-6.4 years). Compared with individuals who never experienced biopsy-proven rejection, DSA-negative MVI was independently associated with CAV (HR, 1.47; 95% CI 1.00-2.16; P-value = 0.047). DSA-positive MVI was associated with mortality (HR 1.97; 95% CI 1.07-3.64) with DSA-negative MVI demonstrating directional-concordance (HR 1.50, 95% CI 0.87-2.57), independent of CAV (HR 1.71, 95% CI 1.13-2.58). These associations remained consistent when stratified by adult and pediatric subgroups and in a six-month landmark sensitivity analysis.</p><p><strong>Conclusions: </strong>MVI, with or without DSA, may be harmful in HT, extending recent renal findings to thoracic transplantation. Understanding the mechanistic basis for these results will be essential for identifying novel targets for therapeutic modulation and prolonging graft survival.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113209","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}