Journal of Cardiac Failure最新文献

{"title":"Transplantation Outcomes in Hepatitis C Virus-Positive Donor Hearts After Circulatory Death","authors":"FRANCESCO CASTAGNA MD, MSc,&nbsp;CHARLOTTE ANDERSSON MD, PhD,&nbsp;MANDEEP R. MEHRA MD, MSc","doi":"10.1016/j.cardfail.2024.08.056","DOIUrl":"10.1016/j.cardfail.2024.08.056","url":null,"abstract":"<div><div>Although the use of hepatitis C virus (HCV)-positive hearts has been shown to be safe and effective among donors with donation after brain death (DBD), it remains unknown whether such organs recovered after circulatory death (DCD) have similar outcomes. In contradistinction to recovery from DBD using cold static organ storage, DCD procurement processes typically use normothermic-perfusion transport strategies that necessitate the use of a large volume of donor blood and involve exposure to temperatures oscillating between cold to dominantly normothermic conditions. We performed a retrospective analysis of United Network for Organ Sharing (UNOS) registry data in the United States and found that clinical outcomes do not differ with respect to rates of treated allograft rejection, early and 1-year survival. Ideally, the organ-recovery source should not result in a bias in organ-offer acceptance from HCV-positive donors, although long-term outcome data are yet unavailable.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 477-480"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288089","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 IV MS, MSc ,&nbsp;JOHN A. SPERTUS MD, MPH ,&nbsp;KENSEY L. GOSCH MS ,&nbsp;ANDREW WANG MD ,&nbsp;PERRY M. ELLIOTT MD ,&nbsp;NEAL K. LAKDAWALA MD ,&nbsp;MATTHEW REANEY PHD, MSC ,&nbsp;YUE ZHONG PHD ,&nbsp;JENNY LAM MD, PhD ,&nbsp;KATHLEEN W. WYRWICH PhD ,&nbsp;ANDREW J. SAUER MD","doi":"10.1016/j.cardfail.2024.08.061","DOIUrl":"10.1016/j.cardfail.2024.08.061","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 481-484"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Sweat Rate for In-Hospital and Home-Based Decongestive Therapy.","authors":"Doron Aronson, Yaacov Nitzan, Sirouch Petcherski, Aviv Shaul, William T Abraham, Daniel Burkhoff, Tuvia Ben Gal","doi":"10.1016/j.cardfail.2025.01.010","DOIUrl":"10.1016/j.cardfail.2025.01.010","url":null,"abstract":"<p><strong>Background: </strong>The interstitial fluid compartment is disproportionally expanded in heart failure (HF). Enhancing sweat rate removes fluids and sodium directly from the interstitial compartment.</p><p><strong>Objectives: </strong>To study the feasibility and efficacy of direct interstitial decongestion in hospitalized HF patients.</p><p><strong>Methods: </strong>We used a device designed to enhance fluid and salt expulsion via the eccrine sweat glands. Patients were treated for 1 to 6 days in the hospital. Following discharge, home therapy continued for 30 to 60 days (1-4 treatments/week). The primary efficacy endpoint for the in-hospital phase was a fluid loss of ≥500 mL per ≥4 hours per treatment. Secondary performance endpoints included changes in congestion score and N-terminal pro b-type natriuretic peptide (NT-proBNP) levels, evaluated for each phase separately.</p><p><strong>Results: </strong>We studied 15 patients, 12 completing both the hospital and home phases. During the in-hospital phase, median weight change due to device therapy was 2.4 kg (interquartile range [IQR] 2.20-3.77), and the primary endpoint was met in 86% of treatment sessions. During the home treatment, median weight loss was 3.1 kg (IQR 0.6 to 7.4 Kg). Congestion score declined from 6 (IQR 6-7) to 1 (IQR 1-1.5) at the end of home therapy (P = 0.002). Median NT-proBNP levels decreased from 7732 (IQR 4694-9746) to 4984 pg/mL (IQR 3559-8950, P = 0.01) during the hospital phase and to 3596 ng/mL (IQR 1640-5742, P = 0.02) at the end of home therapy.</p><p><strong>Conclusion: </strong>Fluid removal via the skin is an effective strategy for enhancing decongestion in hospitalized patients with acute decompensated heart failure. Following hospital discharge, device therapy was associated with additional improvement in decongestion.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074551","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":"Prediction and Longer-Term Outcomes of All-cause and Cardiovascular Mortality in the HEART-FID Trial.","authors":"Justin A Ezekowitz, Hillary Mulder, Robert J Mentz, Javed Butler, Carmine G De Pasquale, Gregory D Lewis, Eileen O'Meara, Piotr Ponikowski, Richard W Troughton, Yee Weng Wong, Robert Adamczyk, Syed Numan, Nicole Blackman, Frank W Rockhold, Adrian F Hernandez","doi":"10.1016/j.cardfail.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.01.009","url":null,"abstract":"<p><strong>Background: </strong>The HEART-FID trial is the largest trial to test intravenous iron (ferric carboxymaltose [FCM]) versus placebo in patients with heart failure and iron deficiency. The results showed a modest but non-statistically significant reduction in important clinical outcomes, including all-cause mortality.</p><p><strong>Objectives: </strong>We sought to understand the factors associated with all-cause mortality.</p><p><strong>Methods: </strong>Data on patients enrolled in HEART-FID were used to determine factors associated with all-cause mortality via multivariable models. The models included key clinical characteristics, including treatment interactions identified in the primary analysis (age by sex and country of enrollment). All-cause mortality at 12 months and over the full duration of follow-up (median 23.1 months) was evaluated using Cox proportional hazard regression.</p><p><strong>Results: </strong>A total of 3065 patients had 737 all-cause mortality events over the duration of the trial, with 289 events occurring in the first 12 months. Fewer patients randomized to FCM died by 12 months compared with the placebo group (131 receiving FCM vs. 158 receiving placebo; hazard ratio 0.82 [95% confidence interval: 0.65-1.04]). Patients who died were more likely to be older with diabetes, atrial fibrillation, lower ejection fraction and estimated glomerular filtration rate, and a higher N-terminal pro b-type natriuretic peptide (NT-proBNP) level. The 3 multivariable factors most strongly associated with all-cause mortality at 12 months were NT-proBNP level, country of enrollment, and 6-minute walk test distance. Similar results were seen for predicting all-cause mortality over the entire follow-up; the addition of an age × sex × FCM interaction yielded statistically significant results, with greater association of benefit from FCM found for older women than for other patient subgroups.</p><p><strong>Conclusion: </strong>FCM, compared with placebo, was associated with a potentially clinically meaningful (but not statistically significant) reduction in all-cause mortality, with key predictors of mortality being natriuretic peptide level, country of enrollment, and 6-minute walk test distance.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074560","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 Role of Lactate Metabolism in Heart Failure and Cardiogenic Shock: Clinical Insights and Therapeutic Implications.","authors":"Melana Yuzefpolskaya, Sarah Schwartz, Annamaria Ladanyi, Jacob Abraham, Chris P Gale, Jonathan Grinstein, Liviu Klein, David T Majure, Anita Phancao, Farooq H Sheikh, Paolo C Colombo, James L Januzzi, Ezequiel J Molina","doi":"10.1016/j.cardfail.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.01.011","url":null,"abstract":"<p><p>Heart failure (HF) is associated with poor prognosis, especially when it progresses to cardiogenic shock (CS), where survival rates substantially decline. A key area of interest is the role of blood lactate as a biomarker in these conditions. Lactate is produced under normal physiological conditions but increases with impaired tissue perfusion, a hallmark of HF and CS. Elevated lactate levels result from increased production, reduced clearance, or both, and are often associated with worse outcomes. Traditionally considered a byproduct of anaerobic metabolism, lactate is now recognized as an important energy substrate, particularly in myocardial tissue during periods of metabolic stress. Recent studies suggest that dynamic lactate monitoring, including lactate clearance (LC), may provide critical insights into patient prognosis and response to therapy. Serial measurements of lactate have been shown to predict survival in critically ill patients, including those with HF and CS. In CS, elevated lactate levels correlate with increased mortality risk, and LC is emerging as an important parameter in treatment protocols. Despite growing evidence of lactate's clinical relevance, research is needed to establish standardized thresholds and optimal monitoring timelines. Understanding the complexities of lactate metabolism and its role in HF and CS could lead to improved risk stratification and more personalized treatment approaches.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074636","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":"Intra-aortic entrainment pump for LV unloading: What phase of the cardiac cycle does the device unload?","authors":"Samta Veera, Kenji Watanabe, Kiyotake Ishikawa","doi":"10.1016/j.cardfail.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.01.006","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065751","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":"\"Ok to discharge to the street\": Housing insecurity and heart failure outcomes.","authors":"Thomas M Cascino, Monica Colvin","doi":"10.1016/j.cardfail.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.01.005","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065750","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":"Without Known Cause: Contextualizing the Body.","authors":"Darlene Anita Scott","doi":"10.1016/j.cardfail.2024.12.014","DOIUrl":"10.1016/j.cardfail.2024.12.014","url":null,"abstract":"<p><p>The author describes her personal experience with a cardiac diagnosis to demonstrate how wellness disparities are often rooted in historical constructions of \"ideal\" physical presentation that are both racialized and gendered. Her experiential analysis contends that failure to contextualize patients and divorce them from these historically problematic constructions is used to justify their profound disability and death.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065757","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":"Balancing Fat Loss and Muscle Loss in the Quest to Reduce Obesity in Patients with Heart Failure.","authors":"Sheldon E Litwin","doi":"10.1016/j.cardfail.2025.01.004","DOIUrl":"10.1016/j.cardfail.2025.01.004","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038872","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":"Reassessing the need for primary prevention implantable cardioverter-defibrillators in contemporary patients with heart failure.","authors":"Ilan Goldenberg, Justin Ezekowitz, Christine Albert, Jeffrey D Alexis, Lisa Anderson, Elijah R Behr, James Daubert, Katherine E Di Palo, Kenneth A Ellenbogen, Dillon J Dzikowicz, Eileen Hsich, David T Huang, James L Januzzi, Valentina Kutyifa, Anuradha Lala, Anekwe Onwuanyi, Ileana L Piña, Roopinder K Sandhu, Samuel Sears, Jakub Sroubek, Robert Strawderman, Wojciech Zareba, Javed Butler","doi":"10.1016/j.cardfail.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.12.001","url":null,"abstract":"<p><p>The main function of the implantable cardioverter-defibrillator (ICD) is to protect against sudden cardiac death (SCD) due to ventricular tachyarrhythmia (VTA). Current guidelines provide a recommendation to implant a prophylactic ICD for the primary prevention of SCD in individuals having heart failure with reduced ejection fraction (HFrEF) who never experienced a previous sustained VTA. However, these recommendations are based on clinical trials conducted more than 20 years ago and may not be applicable to contemporary patients with HFrEF who have a lower arrhythmic risk as a result of advances in heart failure medical therapies. Thus, there is an unmet need for more appropriate selection of contemporary patients with HFrEF for a primary prevention ICD. In this article, we review data underlying the current clinical equipoise on the need for routine implantation of a primary prevention ICD in patients with HFrEF and the rationale for conducting clinical trials that aim to reassess the role of the ICD in this population.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364761","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}