Journal of Cardiac Failure最新文献

{"title":"Equal Treatment, Unequal Outcomes? Debunking the Racial Disparity in Renin Angiotensin Aldosterone System Inhibitor–Associated Reduction in Heart Failure Hospitalizations","authors":"SHANA D.R. LITTLETON BS ,&nbsp;DAVID E. LANFEAR MD, MS ,&nbsp;MICHAEL P. DORSCH PharmD, MS ,&nbsp;BIN LIU PhD, MPH ,&nbsp;JASMINE A. LUZUM PharmD, PhD","doi":"10.1016/j.cardfail.2024.09.012","DOIUrl":"10.1016/j.cardfail.2024.09.012","url":null,"abstract":"<div><h3>Background</h3><div>Renin angiotensin aldosterone system inhibitors (RAASi) are a mainstay treatment in patients with heart failure with reduced ejection fraction (HFrEF) in part to prevent hospitalizations. However, whether RAASi reduce the risk of hospitalization in Black patients is not entirely clear because enrollment of Black patients in previous clinical trials was low and a previous meta-analysis showed a significant racial disparity: reduction in hospitalizations with an RAASi in White patients but not Black patients. Previous studies relied on the use of self-identified race instead of genomic ancestry. Therefore, this study aimed to investigate the role of self-identified race and genomic ancestry in the racial disparity in RAASi–associated reductions in HFrEF hospitalizations.</div></div><div><h3>Methods</h3><div>The primary outcome was time to first heart failure hospitalization. Data from the Henry Ford Heart Failure Pharmacogenomic Registry (HFPGR) and the GUIDE-IT multi-center randomized control trial were analyzed with Cox proportional hazards models un/adjusted for clinical risk factors, death as a competing risk, and time-varying RAASi exposure. The proportion of Yoruba African ancestry was quantified. Analyses of self-identified race were performed in both the HFPGR and GUIDE-IT. Analysis of genomic ancestry was only performed in the HFPGR since this information was not available in GUIDE-IT. A fixed effect meta-analysis combined results of both the HFPGR and GUIDE-IT for race.</div></div><div><h3>Results</h3><div>The HFPGR had 1010 total HFrEF patients (Black = 509 and White = 501) with 852 having ancestry quantification (&gt;80% Yoruba African Ancestry = 381 and &lt;5% Yoruba African Ancestry = 471). GUIDE-IT had 810 HFrEF patients (Black = 322 and White = 488). There was no significant difference in the association of RAASi exposure with heart failure hospitalization by race (meta-analysis <em>P</em> value for race*RAASi exposure interaction = .49; Black patients hazard ratio [HR, 95% confidence interval] for RAASi exposure = 0.89 [0.64–1.23)], <em>P</em> = .47; White patients = 1.20 [0.83–1.75], <em>P</em> = .34). Results were similar when analyzed by ancestry (<em>P</em> value for ancestry*RAASi exposure interaction = 0.57; &gt;80% Yoruba African Ancestry = 0.93 [0.51–1.69], <em>P</em> = .80; &lt;5% Yoruba African Ancestry = 1.29 [0.57–2.92], <em>P</em> = .54).</div></div><div><h3>Conclusions</h3><div>In contrast to a previous meta-analysis, this more contemporary analysis of 2 HFrEF patient datasets demonstrates the absence of a racial disparity in RAASi–associated reductions in heart failure hospitalizations. The difference in this racial disparity over time may be due to improvements in background heart failure therapies, racial differences in health care usage, and the use of more advanced statistical approaches.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 5","pages":"Pages 800-809"},"PeriodicalIF":6.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501085","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":"ExCITe: A Narrative Review of Motivating Factors for Residency and Fellowship Selection to Provide Insights Regarding the Waning Interest in Advanced Heart Failure and Transplant Cardiology Training","authors":"EDAN ZITELNY MD ,&nbsp;MARK H. DRAZNER MD, MSc ,&nbsp;JONATHAN DAVIS MD ,&nbsp;NOSHEEN REZA MD ,&nbsp;ERSILIA M. DEFILIPPIS MD ,&nbsp;PRATEETI KHAZANIE MD, MPH ,&nbsp;JOHN R. TEERLINK MD ,&nbsp;RACHNA KATARIA MD","doi":"10.1016/j.cardfail.2024.10.443","DOIUrl":"10.1016/j.cardfail.2024.10.443","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 5","pages":"Pages 853-857"},"PeriodicalIF":6.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692970","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":"A Novel Predictive Score Model for Successful Weaning From Mechanical Circulatory Support in Patients With Cardiogenic Shock","authors":"SHO SUZUKI MD ,&nbsp;NAMI TERAOKA MD ,&nbsp;KII ITO MD ,&nbsp;YUKARI OKUMA MD ,&nbsp;KAZUHIRO KIMURA MD ,&nbsp;MASATOSHI MINAMISAWA MD ,&nbsp;SOICHIRO EBISAWA MD ,&nbsp;HIROHIKO MOTOKI MD ,&nbsp;HIROSHI IMAMURA MD ,&nbsp;TATSUICHIRO SETO MD ,&nbsp;KOICHIRO KUWAHARA MD","doi":"10.1016/j.cardfail.2024.07.023","DOIUrl":"10.1016/j.cardfail.2024.07.023","url":null,"abstract":"<div><h3>Background</h3><div>Clinical evidence regarding predictors of successful weaning from mechanical circulatory support (MCS) is lacking. This study aimed to create a simple risk score to predict successful weaning from MCS in patients with cardiogenic shock.</div></div><div><h3>Methods and Results</h3><div>This retrospective single-center cohort study included 114 consecutive patients with cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation or IMPELLA between January 2013 and June 2023. Patients with out-of-hospital cardiac arrest were excluded. The primary end point was successful weaning from MCS, defined as successful decannulation without the need for MCS reimplantation and survival to discharge. Multivariable logistic regression with a stepwise variable selection was performed to generate the prediction model. We first developed a general weaning score model, and then created a simple version of the score model using the same variables. Fifty-five patients were weaned from MCS successfully. The following variables measured during weaning evaluation were selected as the components of the weaning score model: acute myocardial infarction (AMI), mean blood pressure, left ventricular ejection fraction (LVEF), lactate level, and QRS duration. According to the results, we conducted a novel weaning score model to predict successful weaning from MCS: 1.774 – 2.090 × (AMI) + 0.062 × [mean blood pressure (mm Hg)] + 0.139 × [LVEF (%)] – 0.322 × [Lactate (mg/dL)] – 0.066 × [QRS (ms)]. The following variables were selected as the components of the simple version of the weaning score model: AMI, mean blood pressure of ≥80 mm Hg, lactate of &lt;10 mg/dL, QRS duration of ≤95 ms, and LVEF of &gt;35%.</div></div><div><h3>Conclusions</h3><div>We developed a simple model to predict successful weaning from MCS in patients with cardiogenic shock.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 5","pages":"Pages 791-799"},"PeriodicalIF":6.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988069","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":"Dynamic Tricuspid Regurgitation in Acute Heart Failure: A Prognostic Challenge and Therapeutic Opportunity","authors":"BHAVANADHAR PENTA MD, DM,&nbsp;GILBERT H.L. TANG MD, MSc, MBA","doi":"10.1016/j.cardfail.2025.03.010","DOIUrl":"10.1016/j.cardfail.2025.03.010","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 5","pages":"Pages 789-790"},"PeriodicalIF":6.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700449","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":"Prevalence and Prognostic Implications of Changes in Tricuspid Regurgitation Severity in Acute Heart Failure","authors":"TETSUYA KOBAYASHI MD ,&nbsp;YUYA MATSUE MD, PhD ,&nbsp;YUDAI FUJIMOTO MD ,&nbsp;DAICHI MAEDA MD, PhD ,&nbsp;KEISUKE KIDA MD, PhD ,&nbsp;TAKESHI KITAI MD, PhD ,&nbsp;NOBUYUKI KAGIYAMA MD, PhD ,&nbsp;TETSUO YAMAGUCHI MD, PhD ,&nbsp;TAKAHIRO OKUMURA MD, PhD ,&nbsp;ATSUSHI MIZUNO MD ,&nbsp;SHOGO OISHI MD ,&nbsp;YASUTAKA INUZUKA MD, PhD ,&nbsp;EIICHI AKIYAMA MD ,&nbsp;SATOSHI SUZUKI MD, PhD ,&nbsp;MASAYOSHI YAMAMOTO MD, PhD ,&nbsp;YUICHI TAMURA MD, PhD ,&nbsp;TOHRU MINAMINO MD, PhD","doi":"10.1016/j.cardfail.2024.08.043","DOIUrl":"10.1016/j.cardfail.2024.08.043","url":null,"abstract":"<div><h3>Background</h3><div>Tricuspid regurgitation (TR), prevalent in acute heart failure (AHF), has a poor prognosis; however, the dynamics of TR severity during hospitalization and its prognostic implications remain unclear. We investigated TR dynamism during hospitalization and its prognostic impact in AHF.</div></div><div><h3>Methods and Results</h3><div>This is a post hoc analysis of a prospective multicenter study of patients with AHF who underwent echocardiographic TR severity evaluation at admission and before discharge. The primary end point was a combined of 1-year all-cause mortality and HF rehospitalization after discharge. Among 1079 participants, TR severity changed dynamically, with 60.3% of those with moderate TR and 29.6% of those with severe TR at admission being diagnosed as no or mild TR at discharge. In 3 groups stratified by changes in TR severity, the persistent TR groups had a higher incidence of the primary end point than the resolution and absence groups. In adjusted analyses, the persistent group (hazard ratio, 1.37; 95% confidence interval, 1.04–1.80), but not the resolution group (hazard ratio, 1.07; 95% confidence interval, 0.79–1.44), had a higher primary end point incidence than the absence group.</div></div><div><h3>Conclusions</h3><div>TR severity at admission in patients with AHF can change dynamically and is associated with subsequent prognosis. Significant TR that remains even after decongestive therapy might be a target for further treatment in hospitalized patients with AHF.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 5","pages":"Pages 781-788"},"PeriodicalIF":6.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125841","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":"Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry","authors":"DAISUKE SAKAMOTO MD ,&nbsp;YOHEI SOTOMI MD, PhD ,&nbsp;YUKI MATSUOKA MD ,&nbsp;DAISAKU NAKATANI MD, PhD ,&nbsp;KATSUKI OKADA MD, PhD ,&nbsp;AKIHIRO SUNAGA MD ,&nbsp;HIROTA KIDA MAS ,&nbsp;TAIKI SATO MD ,&nbsp;TETSUHISA KITAMURA MD, MSc, DrPH ,&nbsp;MASAHIRO SEO MD ,&nbsp;MASAMICHI YANO MD, PhD ,&nbsp;TAKAHARU HAYASHI MD, PhD ,&nbsp;AKITO NAKAGAWA MD, PhD ,&nbsp;YUSUKE NAKAGAWA MD, PhD ,&nbsp;SHUNSUKE TAMAKI MD, PhD ,&nbsp;YOSHIO YASUMURA MD, PhD ,&nbsp;TAKAHISA YAMADA MD, PhD ,&nbsp;SHUNGO HIKOSO MD, PhD ,&nbsp;YASUSHI SAKATA MD, PhD ,&nbsp;OCVC-Heart Failure Investigators","doi":"10.1016/j.cardfail.2024.10.440","DOIUrl":"10.1016/j.cardfail.2024.10.440","url":null,"abstract":"<div><h3>Objectives</h3><div>N-terminal pro brain natriuretic peptide (NT-proBNP) is a biomarker for myocardial stress that is used in diagnosing and prognosticating heart failure (HF). However, its interpretation is complicated by clinical factors. This study aims to clarify the prognostic value of NT-proBNP in patients with heart failure with preserved ejection fraction (HFpEF), and risk-prediction cutoffs considering various clinical factors.</div></div><div><h3>Methods</h3><div>The study used data from the prospective, multicenter, observational Asian HFpEF registry. Patients with acute decompensated HF and left ventricular ejection fraction ≥ 50% were included. NT-proBNP levels were measured at discharge. The primary endpoint was a composite of all-cause death and hospitalization due to HF within 1 year after discharge.</div></div><div><h3>Results</h3><div>A total of 1231 patients (83 [77–87] years old, 551 [45%] male) were enrolled, and 916 eligible patients were analyzed. The median NT-proBNP level was 1060 pg/m. In a multivariable logistic regression model, NT-proBNP was significantly associated with the primary endpoint (adjusted OR for log-transformed NT-proBNP: 2.71, 95% CI: 1.78–4.18; <em>P</em> &lt; 0.001). Subgroup analysis revealed varying NT-proBNP distributions and differential safety cutoffs (329–929 pg/mL) at sensitivity of 0.8 based on factors such as atrial fibrillation and chronic kidney disease, maintaining its discriminatory performance (area under the curve: 0.587–0.734).</div></div><div><h3>Conclusions</h3><div>NT-proBNP levels at discharge are a significant prognostic marker for HFpEF. Although NT-proBNP levels showed different distributions in various subgroups, and cutoff values were distinctive for each, the prognostic utility was found to be equivalent in almost all subgroups and had similar moderate discriminative performance. The study highlights the necessity of personalized NT-proBNP cutoffs for better management of and prognostication for patients with HFpEF.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 5","pages":"Pages 771-780"},"PeriodicalIF":6.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668067","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":"Artificial Intelligence in the Management of Heart Failure.","authors":"Baljash Cheema, Jonathan Hourmozdi, Adrienne Kline, Faraz Ahmad, Rohan Khera","doi":"10.1016/j.cardfail.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.02.020","url":null,"abstract":"<p><p>Artificial intelligence has the potential to revolutionize the management of heart failure. Artificial intelligence-based tools can guide the diagnosis and treatment of known risk factors, identify asymptomatic structural heart disease, improve cardiomyopathy diagnosis and symptomatic heart failure treatment, and uncover patients transitioning to advanced disease. By integrating multimodal data, including omics, imaging, signals, and electronic health records, state-of-the-art algorithms allow for a more tailored approach to patient care, addressing the unique needs of the individual. The last decade has led to the development of numerous artificial intelligence solutions targeting each aspect of the heart failure syndrome. However, significant barriers to implementation remain and have limited clinical uptake. Data privacy concerns, real-world model performance, integration challenges, trust in artificial intelligence, model governance, and concerns over fairness and bias are some of the topics requiring additional research and development of best practices. This review highlights progress in the use of artificial intelligence to guide the diagnosis and management of heart failure while underscoring the importance of overcoming key implementation challenges that are currently slowing progress.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970493","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":"Reimagining Heart Failure Care: Highlights from ACC 2025.","authors":"Alexander G Hajduczok, Elena Donald, Merna Hussien, Matteo Fabbri, Devin Stives, Patricia Campbell, Ersilia M DeFilippis","doi":"10.1016/j.cardfail.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.04.005","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010870","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":"Guideline-Directed medical therapy in Heart Failure in a developing country- A real world physician survey from India.","authors":"Shantanu P Sengupta, Abraham Oomman, Harikrishnan Sivadasanpillai, Uday Jadhav, Raghuraman Bagirath, Sundar T, Sanjay Mittal, Jaigopal Pb, Vijay Chopra","doi":"10.1016/j.cardfail.2025.03.020","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.03.020","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012648","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":"NSAIDs use, kidney outcomes and the effect of empagliflozin: an analysis from EMPEROR-Preserved.","authors":"João Pedro Ferreira, Faiez Zannad, Francisco Vasques-Nóvoa, Pedro Marques, Gerasimos Filippatos, Stuart J Pocock, Javed Butler, Milton Packer, Stefan D Anker","doi":"10.1016/j.cardfail.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.03.019","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968252","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}