Journal of Cardiac Failure最新文献

{"title":"Can't patients hospitalized for acute heart failure with severe congestion expect a better prognosis?","authors":"Makiko Nakamura, Teruhiko Imamura, Koichiro Kinugawa","doi":"10.1016/j.cardfail.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.04.001","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018856","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":"NT-proBNP in the Early Convalescent Phase after High-Risk Myocardial Infarction Is Associated with Adverse Cardiovascular Outcomes: the PARADISE-MI Trial.","authors":"Karola S Jering, Brian L Claggett, Eugene Braunwald, Christopher B Granger, Lars Køber, Ulf Landmesser, Eldrin F Lewis, Aldo P Maggioni, Douglas L Mann, John Jv McMurray, Roxana Mehran, Mark C Petrie, Margaret F Prescott, Jean L Rouleau, Morten Schou, Scott D Solomon, Phillippe Gabriel Steg, Dirk von Lewinski, Marc A Pfeffer","doi":"10.1016/j.cardfail.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.03.018","url":null,"abstract":"<p><strong>Background: </strong>N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with heart failure (HF) hospitalizations and death when measured during a myocardial infarction (MI). However, NT-proBNP concentrations change following the initial ischemic insult and less is known about the prognostic importance of NT-proBNP in the early convalescent phase.</p><p><strong>Methods: </strong>PARADISE-MI randomized 5661 patients with MI complicated by LVEF ≤40% and/or pulmonary congestion to sacubitril/valsartan or ramipril. Patients with available week 2 NT-proBNP concentrations and without incident HF between randomization and week 2 (n=1062) were analyzed. Associations of week 2 NT-proBNP with subsequent clinical outcomes were evaluated in landmark analyses using Cox models adjusted for clinical characteristics including LVEF, baseline NT-proBNP and atrial fibrillation.</p><p><strong>Results: </strong>Median 2-week NT-proBNP was 1391 [676 - 2507] ng/L. Patients in the highest NT-proBNP quartile (≥2507 ng/L) were older, had lower LVEF and eGFR, higher Killip class and more atrial fibrillation. Higher NT-proBNP concentrations were independently associated with greater risk of CV death or incident HF (adjusted HR [aHR] 1.65 per doubling of NT-proBNP; 95% CI, 1.31-2.09), HF hospitalization (aHR 1.87; 95% CI, 1.38-2.54), recurrent MI (aHR 1.46; 95% CI, 1.09-1.95) and all-cause death (aHR 1.85; 95% CI, 1.35-2.53).</p><p><strong>Conclusions: </strong>Patients with elevated NT-proBNP concentrations approximately two weeks after a high-risk MI are at heightened risk of incident HF, recurrent coronary events and death, independent of baseline NT-proBNP concentrations and clinical characteristics. Elevations in NT-proBNP concentrations in the early convalescent phase may assist in risk stratification and identification of patients in need for more advanced preventive treatment approaches.</p><p><strong>Lay summary: </strong>N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a marker of ventricular wall stress and in the acute phase of a myocardial infarction (MI) is strongly associated with adverse cardiovascular outcomes. NT-proBNP concentrations change dynamically after MI but they are not routinely remeasured during follow-up. In a contemporary post-MI population enrolled in the PARADISE-MI trial, NT-proBNP measured approximately two weeks following MI was independently associated with heightened risk of death, incident heart failure and recurrent MI. NT-proBNP concentrations in the early convalescent phase may help risk stratify patients following MI and identify those in need for closer follow-up and more aggressive therapies.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001716","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 use of Left Ventricular Ejection Fraction in the Diagnosis and Management of Heart Failure. A Clinical Consensus Statement of the Heart Failure Association (HFA) of the ESC, the Heart Failure Society of America (HFSA), and the Japanese Heart Failure Society (JHFS).","authors":"Giuseppe M C Rosano, John R Teerlink, Koichiro Kinugawa, Antoni Bayes-Genis, Ovidiu Chioncel, James Fang, Barry Greenberg, Nasrien E Ibrahim, Teruhiko Imamura, Takayuki Inomata, Koichiro Kuwahara, Brenda Moura, Anekwe Onwuanyi, Naoki Sato, Gianluigi Savarese, Yasuhiko Sakata, Nancy Sweitzer, Jane Wilcox, Kazuhiro Yamamoto, Marco Metra, Andrew J S Coats","doi":"10.1016/j.cardfail.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.03.014","url":null,"abstract":"<p><p>This clinical consensus statement revisits the role of left ventricular ejection fraction (LVEF) as a measurement of cardiac function, a prognostic marker and a major criterion to classify patients with heart failure, and gives new advice for clinical practice. Heart failure is traditionally classified on the basis of LVEF thresholds and this has major implications for treatment recommendations. However, the reproducibility of LVEF measurement is poor and its prognostic and diagnostic value lessens when it is above 45%, with no relationship with the severity of either cardiac dysfunction or outcomes at higher values. These limitations dictate the need for a more comprehensive approach to classify and assess heart failure focusing more on the trajectory of LVEF rather than to its absolute value. Furthermore, the assessment of LVEF is not required for the initiation of treatments like sodium-glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists and diuretics in patients with suspected de novo heart failure and elevated N-terminal pro-B-type natriuretic peptide levels. Future research utilizing advanced imaging techniques and biomarkers which can better characterize myocardial structure, metabolism and performance may facilitate the identification of alternative therapeutic targets and better ways to monitor heart failure therapies across the entire spectrum of LVEF.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063955","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":"Acoramidis for Transthyretin Amyloid Cardiomyopathy: Open-Label Extension Study Long-Term Follow-Up.","authors":"Ahmad Masri, Mandar Aras, Martha Grogan, Daniel Jacoby, Mathew S Maurer, Sanjiv J Shah, Ronald Witteles, Paul W Wong, Alan X Ji, Jing Du, Suresh Siddhanti, Leonid Katz, Uma Sinha, Jonathan C Fox, Daniel P Judge","doi":"10.1016/j.cardfail.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.03.017","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967957","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":"Lipoprotein(a) Levels and Adverse Outcomes in Heart Failure.","authors":"Adithya K Yadalam, Apoorva Gangavelli, Alexander C Razavi, Yi-An Ko, Ayman Alkhoder, Nisreen Haroun, Rafia Lodhi, Ahmed Eldaidamouni, Mahmoud Al Kasem, Arshed A Quyyumi","doi":"10.1016/j.cardfail.2025.03.016","DOIUrl":"10.1016/j.cardfail.2025.03.016","url":null,"abstract":"<p><strong>Background: </strong>Although lipoprotein(a) [Lp(a)] level elevation is associated with new-onset heart failure (HF), it is unclear if elevated Lp(a) levels predict cardiovascular events in patients with chronic HF. Thus, we examined the association between Lp(a) levels and adverse cardiovascular outcomes in patients with HF.</p><p><strong>Methods and results: </strong>A total of 1088 patients with HF undergoing cardiac catheterization at Emory-affiliated hospitals from 2004 to 2022 were divided into low (<30 mg/dL), intermediate (30-49 mg/dL), and high (≥50 mg/dL) Lp(a) groups. The primary outcome was the composite of cardiovascular death and HF hospitalization. Outcomes were assessed by Lp(a) group with competing risk modeling accounting for noncardiovascular death after adjustment for demographics, traditional cardiovascular risk factors, ejection fraction, ischemic HF etiology, and N-terminal prohormone of brain natriuretic peptide. Sensitivity analyses were performed to explore for heterogeneity of effect. The median age was 67 years, 34% were women, 18% were Black, 74% had ischemic HF, and 60% had an ejection fraction of ≤40%. During a median follow-up time of 4.3 years, 474 composite events (44%) occurred. When compared with participants with Lp(a) <30 mg/dL after multivariable adjustment, those with Lp(a) 30-49 mg/dL (subdistribution hazard ratio [sHR] 1.35, 95% confidence interval 1.04-1.76, P = .025) and Lp(a) ≥50 mg/dL (sHR 1.38, 95% confidence interval 1.11-1.72, P = .004) had a significantly higher risk of cardiovascular death or HF hospitalization. This relationship seemed to diminish over time and was nominally stronger in those with ischemic versus nonischemic HF (P_interaction = .06), but did not meet significance after adjustment for multiple hypothesis testing.</p><p><strong>Conclusions: </strong>In patients with HF, Lp(a) ≥30 mg/dL independently predicts the risk of cardiovascular death or HF hospitalization.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795562","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":"Evolving Indications, Challenges, and Advances in Cardiac Resynchronization Therapy for Heart Failure.","authors":"Temidayo A Abe, Endurance O Evbayekha, Larry R Jackson, Sana M Al-Khatib, Sabra C Lewsey, Khadijah Breathett","doi":"10.1016/j.cardfail.2025.01.031","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.01.031","url":null,"abstract":"<p><p>Cardiac resynchronization therapy (CRT) via biventricular pacing has markedly improved heart failure outcomes over the past two decades. However, some patients show no clinical improvement or evidence of reverse remodeling following device implantation. Challenges include suboptimal patient selection, limitations in the characterization of conduction disease (especially nonspecific interventricular conduction delays), procedural constraints, inappropriate device programming, and delayed referral. Moreover, there remains no formal consensus on evaluating and characterizing CRT efficacy. Underutilization persists among women and minoritized racial and ethnic groups. Targeted research addressing unmet needs has led to evolving guideline indications. Novel electrocardiographic and imaging techniques are continually being developed to improve patient selection and alternate pacing strategies have emerged. Conduction system pacing may allow for a more physiologic approach to CRT. Observational studies and small clinical trials have shown comparable or superior efficacy of conduction system pacing over traditional biventricular pacing; however, more studies are needed. LAY SUMMARY: Cardiac resynchronization therapy via biventricular pacing has transformed heart failure management over the past two decades. This review examines persistent challenges in clinical practice and evolving guideline recommendations. Key issues, including refining patient selection, better characterizing conduction abnormalities, and optimizing device programming, were highlighted. Emerging evidence suggests conduction system pacing as a physiologic alternative to biventricular pacing, with early studies showing promising outcomes. However, rigorous clinical trials are needed to confirm these findings and guide future practice. Advancing CRT necessitates continued innovation and strategies to improve equity and access across diverse populations.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019045","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":"Clinician Insights into Effective Components, Delivery Characteristics and Implementation Strategies of Ambulatory Palliative Care for People with Heart Failure: A Qualitative Analysis","authors":"SHELLI FEDER PhD, APRN, FNP-C, ACHPN, FPCN, FAHA ,&nbsp;LYNNE IANNONE MA ,&nbsp;DORA LENDVAI PhD, RN ,&nbsp;YAN ZHAN MBA, RN ,&nbsp;KATHLEEN AKGÜN MD, MS ,&nbsp;MARY ERSEK PhD, RN, FPCN ,&nbsp;CAROL LUHRS MD ,&nbsp;LARRY A. ALLEN MD, MHS ,&nbsp;DAVID B. BEKELMAN MD, MPH ,&nbsp;NATHAN GOLDSTEIN MD ,&nbsp;DIO KAVALIERATOS PhD, FAAHPM","doi":"10.1016/j.cardfail.2024.07.009","DOIUrl":"10.1016/j.cardfail.2024.07.009","url":null,"abstract":"<div><h3>Objectives</h3><div>To elicit perspectives from specialist palliative care (SPC) and cardiology clinicians concerning the necessary components, delivery characteristics and implementation strategies of successful ambulatory SPC for people with heart failure (HF).</div></div><div><h3>Background</h3><div>Palliative care is a recommended component of guideline-directed care for people with HF. However, optimal strategies to implement SPC within ambulatory settings are unknown.</div></div><div><h3>Methods</h3><div>We conducted a qualitative descriptive study composed of semistructured interviews with SPC and cardiology clinicians at Veterans Affairs Medical Centers (VAMCs) with the highest number of ambulatory SPC consultations within the VA system among people with HF between 2021 and 2022. Clinicians were asked how they provided ambulatory SPC and what they felt were the necessary components, delivery characteristics and implementation strategies of care delivery. Interviews were analyzed using directed content analysis.</div></div><div><h3>Results</h3><div>We interviewed 14 SPC clinicians and 9 cardiology clinicians at 7 national VAMCs; 43% were physicians, and 48% were advanced-practice registered nurses/physician associates. Essential components of ambulatory SPC encompassed discussion of goals of care (eg, prognosis, advance directives) and connecting patients/caregivers to resources (eg, home care). Preferred delivery characteristics included integrated (ie, embedded) approaches to SPC delivery, standardized patient selection and referral procedures, and formalized procedures for handoffs to and from SPC. Strategies that addressed SPC implementation included deploying palliative champions, educating non-SPC clinicians on the value of ambulatory SPC for people with HF and developing ambulatory models through leadership support.</div></div><div><h3>Conclusions/Implications</h3><div>Facilitating the broader adoption of ambulatory SPC among people with HF may be achieved by prioritizing these mutually valued and necessary features of SPC delivery.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 611-620"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889346","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":"Assessment of Revascularization Preferences With Best-Worst Scaling Among Patients With Ischemic Heart Disease","authors":"AMRITA MUKHOPADHYAY MD ,&nbsp;VICTORIA VAUGHAN DICKSON PhD, RN, FAAN ,&nbsp;AISHA LANGFORD PhD, MPH ,&nbsp;JOHN A. SPERTUS MD, MPH ,&nbsp;SRIPAL BANGALORE MD, MHA ,&nbsp;YAN ZHANG MPH ,&nbsp;THADDEUS TARPEY PhD ,&nbsp;JUDITH HOCHMAN MD, MA ,&nbsp;STUART D. KATZ MD, MS","doi":"10.1016/j.cardfail.2024.10.006","DOIUrl":"10.1016/j.cardfail.2024.10.006","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 735-740"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466328","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":"Weighing the Benefits of Wearable Devices in Heart Failure Trials","authors":"JESSICA R. GOLBUS MD, MS ,&nbsp;TREJEEVE MARTYN MD, MSc","doi":"10.1016/j.cardfail.2025.03.001","DOIUrl":"10.1016/j.cardfail.2025.03.001","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 704-707"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585770","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":"Lessons Learned From 2 Research Studies Enrolling Underrepresented Patients With Ventricular Assist Devices and Their Family Caregivers","authors":"AVERY C. BECHTHOLD PhD, BSN, RN ,&nbsp;MARTHA ABSHIRESAYLOR PhD, RN ,&nbsp;RACHEL D. WELLS PhD, RN","doi":"10.1016/j.cardfail.2025.01.026","DOIUrl":"10.1016/j.cardfail.2025.01.026","url":null,"abstract":"<div><div>Given the continued challenges of and barriers to recruiting and retaining underrepresented groups in cardiovascular studies, this study aimed to describe successful recruitment strategies used by 2 related ventricular assist device (VAD) studies. The 2 exemplar studies focused on understanding how adults with a VAD and their family caregivers discuss, reflect upon and act on their personal values. To recruit a more representative and diverse sample reflective of the substantial Black population receiving care at the local academic hospital outpatient clinic, we developed multipronged recruitment strategies for a convergent mixed-methods study (Study 1) and a sequential explanatory mixed-methods study (Study 2). Two underlying principles guided recruitment strategies: (1) clinician-scientist collaboration, and (2) personalized participant interactions. This article reflects on lessons learned by an early career investigator and her mentors from 2 studies, which will support ongoing inclusive recruitment in future projects.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 748-752"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585710","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}