Journal of Cardiac Failure最新文献

{"title":"Improving the assessment of left ventricular diastolic dysfunction by including left atrial strain in the algorithm: LA Strain and LV diastolic dysfunction assessment.","authors":"Lin Wang, Jonathan Weber, Jason Craft, Michael Passick, Omar K Khalique, Ziad A Ali, Jae K Oh, J Jane Cao","doi":"10.1016/j.cardfail.2024.08.064","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.08.064","url":null,"abstract":"<p><strong>Background: </strong>The latest guidelines on echocardiographic assessment of left ventricular diastolic dysfunction (LVDD) leave a significant proportion of patients with LVDD status undetermined. We aimed to examine the implication of an alternative algorithm incorporating left atrial (LA) strain as a tiebreaker on the indeterminate LVDD category.</p><p><strong>Methods and results: </strong>We included 823 patients who underwent echocardiography and cardiac MRI within 7 days. LVDD was assessed by echocardiography following contemporary guidelines and an alternative algorithm including LA reservoir strain as a tie-breaker. LVDD was examined for its association with LV myocardial scar burden by cardiac MRI, and a composite outcome. 275 (33%) patients had LVDD, of whom 119 had advanced grades of LVDD (grade II-III), and 117 (14%) had indeterminate LVDD grade. When LA strain was applied at cut points of 18%, 24% and 35%, subjects were reclassified as normal or LVDD dependent accordingly. Reclassification allowed a similar outcome risk-stratification as the current guidelines.</p><p><strong>Conclusions: </strong>LA reservoir strain improved LVDD assessment by eliminating indeterminate status/grade while maintaining the same effective outcome stratification as current guidelines.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564523","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":"Right Ventricular Mass Oversizing Is Associated With Improved Post-transplant Survival in Heart Transplant Recipients With Elevated Transpulmonary Gradient.","authors":"Yeahwa Hong, Nicholas R Hess, Luke A Ziegler, Ander Dorken-Gallastegi, Nidhi Iyanna, Mohamed Abdullah, Edward T Horn, Michael A Mathier, Mary E Keebler, Gavin W Hickey, David J Kaczorowski","doi":"10.1016/j.cardfail.2024.09.018","DOIUrl":"10.1016/j.cardfail.2024.09.018","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the effects of pre-transplant transpulmonary gradient (TPG) and donor right ventricular mass (RVM) on outcomes following heart transplantation.</p><p><strong>Methods: </strong>UNOS registry was queried to analyze adult recipients who underwent primary isolated heart transplantation from 1/1/2010 to 12/31/2018. The recipients were dichotomized into 2 groups based on their TPG at the time of transplantation, < 12 and ≥ 12 mmHg. The outcomes included 5-year survival and post-transplant complications. Propensity score-matching was performed. Subanalysis was performed to evaluate the effects of donor-recipient RVM matching, where a ratio < 0.85 was classified as undersized, 0.85-1.15 as size-matched, and > 1.15 as oversized.</p><p><strong>Results: </strong>We analyzed 17,898 isolated heart transplant recipients, and 5129 (28.7%) recipients had TPG ≥ 12 mmHg at the time of transplantation. The recipients with TPG ≥ 12 mmHg experienced significantly lower 5-year survival rates (78.4% vs 81.2%; P < 0.001) compared to the recipients with TPG < 12 mmHg, and this finding persisted in the propensity score-matched comparison. The recipients with TPG ≥ 12 mmHg experienced a higher rate of post-transplant dialysis and a longer duration of hospitalization. Oversizing the donor RVM considerably improved the 5-year survival among the recipients with TPG ≥ 12 mmHg, comparable to those with TPG < 12 mmHg.</p><p><strong>Conclusion: </strong>Elevated pre-transplant TPG is associated with significantly reduced post-transplant survival. However, oversizing the donor RVM is associated with improved survival rates in recipients with elevated TPG, resulting in improved survival that is comparable to that of recipients with normal TPG. Therefore, careful risk stratification and donor matching among recipients with elevated TPG is essential to improve outcomes in this vulnerable population.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545716","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 Rise of Patient-Reported Outcome Measures: Trends in Heart Failure Clinical Trials.","authors":"Mirza S Khan, Mohammad Abdel Jawad, Nobuhiro Ikemura, Charles F Sherrod, Evan L O'Keefe, Paul S Chan, John A Spertus, Timothy J Fendler","doi":"10.1016/j.cardfail.2024.09.019","DOIUrl":"10.1016/j.cardfail.2024.09.019","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545717","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":"Effects of a Web-based Multiple Component Mindfulness Meditation for Pulmonary Hypertension Program on Symptoms and Health-related Quality of Life: A Pilot Randomized Controlled Trial.","authors":"Tania T VON Visger, Vishal Parikh, Denise Gabrielle Sese, William J Gibbons, Alan Hunt, Chin-Shang Li, Yu-Ping Chang","doi":"10.1016/j.cardfail.2024.09.017","DOIUrl":"10.1016/j.cardfail.2024.09.017","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501084","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":"Kidney Replacement Therapies in Advanced Heart Failure - Timing, Modalities, and Clinical Considerations.","authors":"Ramzi Ibrahim, Chelsea Takamatsu, Abdulla Alabagi, Hoang Nhat Pham, Bijin Thajudeen, Sevag Demirjian, W H Wilson Tang, Preethi William","doi":"10.1016/j.cardfail.2024.09.014","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.09.014","url":null,"abstract":"<p><p>Acute kidney dysfunction is commonly encountered in advanced heart failure and carries significant prognostic implications, often leading to poorer outcomes and increased mortality. It can alter the course of decision making for left ventricular assist device (LVAD) and cardiac transplantation candidacy. Kidney replacement therapies (KRT) offer a critical intervention in this context but require careful consideration of timing, various types of KRT modalities, individual patient preferences and circumstances. This review discusses the intricacies of KRT in advanced heart failure, examining how to optimize timing and choose among the various KRT modalities. It also provides a detailed discussion on the unique clinical scenarios that clinicians may face when treating this vulnerable patient group.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501087","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":"Genetic Testing Practices and Pathological Assessments in End Stage Heart Failure Patients Undergoing Heart Transplantation and Left Ventricular Assist Device.","authors":"Elizabeth Silver, Alessia Argiro, Sarah S Murray, Lauren Korty, Grace Lin, Victor Pretorius, Marcus Urey, Kimberly N Hong, Eric D Adler, Quan M Bui","doi":"10.1016/j.cardfail.2024.09.015","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.09.015","url":null,"abstract":"<p><strong>Background: </strong>Genetic cardiomyopathies (CM) are increasingly recognized as causes of end-stage heart failure (ESHF). Identification of a genetic etiology in ESHF has important prognostic and family implications. However, genetic testing practices are understudied in ESHF patients.</p><p><strong>Methods: </strong>This single-center, retrospective study included consecutive ESHF patients who underwent heart transplantation (HT) or left ventricular assist device (LVAD) from 2018 to 2023. Data, including genetic testing and pathology reports, were collected from the electronic medical record. Analyses of demographic and clinical characteristics were stratified by genetic testing completion and presence of clinically actionable variant. Logistic regression was performed to evaluate for associations between histology findings and genetic variants.</p><p><strong>Results: </strong>A total of 529 adult patients (mean age 57 years) were included in the study and were predominantly male (79%, 422/529) and non-white (61%, 322/529). Genetic testing was performed in 54% (196/360) of patients with either non-ischemic or mixed CM. A clinically actionable result was identified in 36% (70/196) of patients, of which, only 43% (30/70) had a genetic counselor referral. The most common genetic variants were TTN (32%, 24/75), MYBPC3 (13%, 10/75), and TTR (11%, 8/75). Clinically actionable variants were identified in patients with known heart failure precipitators, such as alcohol use. In multivariable analysis, presence of interstitial fibrosis, specifically diffuse, on pathology was significantly associated with a clinically actionable variant (aOR 2.29, 95% CI [1.08-4.86], p = 0.03).</p><p><strong>Conclusion: </strong>ESHF patients with non-ischemic or mixed CM undergoing advanced therapies had a low uptake of genetic services, including testing and counselors, despite a high burden of genetic disease. Pathology findings, such as interstitial fibrosis, may provide insight into genetic etiology. The underutilization of services suggests a need for implementation strategies to improve uptake.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501086","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 Noninferiority in Terms of 6-month Morbidity and Mortality Rates of a Hospital-at-home Care Pathway for Patients With Acute Heart Failure: FIL-EAS-ic Study Protocol.","authors":"Jean-Michel Tartière, Jocelyne Candel, Mathilde LE Caignec, Lolita Jaunay, Charlotte Patin, Lamia Kesri-Tartière, Marjorie Esteveny, Mélanie Harel, Hannah Derksen, Gonzalo Quaino, Isabelle Lecardonnel, Farid Challal, Pauline Armangaud, Caroline Birgy","doi":"10.1016/j.cardfail.2024.09.016","DOIUrl":"10.1016/j.cardfail.2024.09.016","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a common cause of hospitalization and is associated with high mortality rates, long hospital stays and high economic costs worldwide. Novel care pathways are increasingly being considered to address these burdens. In France, a mixed conventional hospitalization and hospital-at-home (HaH) care pathway (named FIL-EAS-ic) has been designed to reduce hospital lengths of stay without impairing HF outcomes. This protocol describes the study design, which evaluate the noninferiority of the FIL-EAS-ic pathway compared to conventional hospitalization in terms of 6-month all-cause mortality and/or unscheduled HF-related hospitalization.</p><p><strong>Methods and results: </strong>A randomized, prospective multicenter trial (NCT04878263) will be conducted involving 2 groups of patients in a 1:2 ratio: (1) a control group following the conventional hospitalization pathway; and (2) the experimental group following the FIL-EAS-ic pathway. We aim to include 454 patients from the Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer and the Hôpital d'Instruction des Armées Sainte-Anne in France from June 2021-June 2023. The noninferiority of the FIL-EAS-ic pathway compared to conventional hospitalization, in terms of 6-month all-cause mortality and/or unscheduled HF-related hospitalization, will be tested by the Farrington-Manning method. Impact on treatment adherence, HF rehospitalizations and cumulative time spent in the hospital will also be compared between the 2 groups.</p><p><strong>Conclusions: </strong>This clinical trial will provide evidence concerning a novel HF care pathway in France as well as its potential to improve follow-up care, quality of life, and patient satisfaction and its potential to reduce costs.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501083","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":"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, David E Lanfear, Michael P Dorsch, Bin Liu, Jasmine A Luzum","doi":"10.1016/j.cardfail.2024.09.012","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.09.012","url":null,"abstract":"<p><strong>Background: </strong>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 RAAS inhibitors 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 RAAS inhibitor 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 RAAS inhibitor associated reductions in HFrEF hospitalizations.</p><p><strong>Methods: </strong>The primary outcome was time to first heart failure hospitalization. A (de-identified) heart failure patient registry and data from 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 RAAS inhibitor exposure. The proportion of Yoruba African ancestry was quantified.. Analysis of self - identified race were performed in both the registry and GUIDE-IT. Analysis of genomic ancestry was only performed in the registry since this information was not available in GUIDE-IT. A fixed effect meta-analysis combined results of both the registry and GUIDE-IT for race.</p><p><strong>Results: </strong>The registry had 1010 total HFrEF patients (Black = 509 and White = 501) with 852 having ancestry quantification (>80% Yoruba African Ancestry = 381 and <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 RAAS inhibitor exposure with heart failure hospitalization by race (meta-analysis p-value for race*RAAS inhibitor exposure interaction = 0.49; Black patients HR [95% CI] for RAAS inhibitor exposure = 0.89 [0.64-1.23)] P = 0.47; White patients = 1.20 (0.83-1.75) P = 0.34). Results were similar when analyzed by ancestry (p-value for ancestry*RAAS inhibitor exposure interaction = 0.57; >80% Yoruba African Ancestry = 0.93 [0.51-1.69] P = 0.80; <5% Yoruba African Ancestry = 1.29 [0.57-2.92] P = 0.54).</p><p><strong>Conclusions: </strong>In contrast to a previous meta-analysis, this more contemporary analysis of 2 HFrEF patient datasets demonstrates the absence of a racial disparity in RAAS inhibitor 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 healthcare usage, and the use of more advanced statistical approaches.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-21","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":"Affairs of the Heart: Exploring Sexual QOL in the LVAD Population.","authors":"Richa Agarwal","doi":"10.1016/j.cardfail.2024.10.003","DOIUrl":"10.1016/j.cardfail.2024.10.003","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466327","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":"Palliative Care Is at the Heart of Cardiology.","authors":"Nicolas Burry, Shunichi Nakagawa","doi":"10.1016/j.cardfail.2024.10.002","DOIUrl":"10.1016/j.cardfail.2024.10.002","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466335","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}