Journal of Cardiac Failure最新文献

{"title":"Navigating High-Risk Percutaneous Coronary Interventions: Predicting Loss of Pulse Pressure and the Role of Mechanical Circulatory Support","authors":"Jason Grady NRP , Allison Dupont MD, FACC, FSCAI","doi":"10.1016/j.cardfail.2024.08.035","DOIUrl":"10.1016/j.cardfail.2024.08.035","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 10","pages":"Pages 1300-1301"},"PeriodicalIF":6.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400394","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":"Dual Training in Interventional Cardiology: The Next Frontier","authors":"WILLARD N. APPLEFELD MD ,&nbsp;ANN GAGE MD ,&nbsp;SARASCHANDRA VALLABHAJOSYULA MD, MSc ,&nbsp;M. IMRAN ASLAM MD","doi":"10.1016/j.cardfail.2024.05.018","DOIUrl":"10.1016/j.cardfail.2024.05.018","url":null,"abstract":"<div><div>Dual training in Interventional Cardiology (IC) with other cardiac subspecialties such as Advanced Heart Failure and Transplant Cardiology (AHFTC) and Critical Care Cardiology (CCC) is becoming a pathway for trainees to acquire a needed skill set to deliver comprehensive care for increasingly complex patients in the intensive care unit and catheterization laboratory settings. The makeup of these training pathways varies depending on several factors, with the resultant role of the specialist reflecting this reality. Herein, we review the merits to combined fellowship training for the Interventional Cardiologist, the ideal structure of programs to facilitate this, and how the faculty position for such a unique specialist can enhance a program.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 10","pages":"Pages 1395-1398"},"PeriodicalIF":6.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400383","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":"Impact of Right Ventricular Dysfunction on Outcomes in Acute Myocardial Infarction and Cardiogenic Shock: Insights from the National Cardiogenic Shock Initiative","authors":"SARAH GORGIS MD ,&nbsp;KARTIK GUPTA MD ,&nbsp;ALEJANDRO LEMOR MD ,&nbsp;DANA BENTLEY MWC ,&nbsp;CHRISTIAN MOYER PhD ,&nbsp;THOMAS McRAE MD ,&nbsp;MATHEEN KHUDDUS MD ,&nbsp;RAHUL SHARMA MD ,&nbsp;MICHAEL LIM MD ,&nbsp;ALI NSAIR MD ,&nbsp;DAVID WOHNS MD ,&nbsp;ADITYA MEHRA MD ,&nbsp;LANG LIN MD ,&nbsp;ADITYA BHARADWAJ MD ,&nbsp;RYAN TEDFORD MD ,&nbsp;NAVIN KAPUR MD ,&nbsp;JENNIFER COWGER MD ,&nbsp;WILLIAM O'NEILL MD ,&nbsp;MIR B. BASIR DO","doi":"10.1016/j.cardfail.2024.07.015","DOIUrl":"10.1016/j.cardfail.2024.07.015","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricular dysfunction (RVD) complicates 30%–40% of cases in acute myocardial infarction (AMI) and cardiogenic shock (CS). There are sparse data on the effects of RVD on outcomes and the impact of providing early left ventricular (LV) mechanical circulatory support (MCS) on RV function and hemodynamics.</div></div><div><h3>Methods and Results</h3><div>Between July 2016 and December 2020, 80 sites participated in the study. All centers agreed to treat patients with AMI-CS using a standard protocol emphasizing invasive hemodynamic monitoring and rapid initiation of LV-MCS. RVD was defined as a right atrial (RA) pressure of &gt;12 mm Hg and a pulmonary artery pulsatility index (PAPI) of &lt;1 within 24 hours of the index procedure. The primary outcome was survival to discharge. In a subgroup analysis, data available from the Automated Impella Controller console was used to analyze diastolic suction alarms from LV placement signal and its relation to RVD. A total of 361 patients were included in the analysis, of whom 28% had RVD. The median age was 64 years (interquartile range 55–72 years), 22.7% were female and 75.7% were White. There was no difference in age, sex, or comorbidities between those with or without RVD. Patients with RVD had a higher probability of active CPR during LV-MCS implant (14.7% vs 6.3%), Society for Cardiovascular Angiography and Interventions stage E shock (39.2% vs 23.2%), and higher admission lactate levels (5.1 mg/dL vs 3.0 mg/dL). Survival to discharge was significantly lower among those with RVD (61.8% vs 73.4%, odds ratio 0.89, 95% confidence interval 0.36–0.95, <em>P</em> = .031). This association remained significant in the multivariate analysis. There was no significant difference in hemodynamic variables within 24 hours of LV-MCS support among those with or without RVD. At 24 hours, patients with a CPO of &gt;0.6 W and a PAPi of &gt;1 had a trend toward better survival to discharge compared with those with a CPO of ≤0.6 W and a PAPi of ≤1 (77.1% vs 54.6%, <em>P</em> = .092). Patients with RVD were significantly more likely to have diastolic suction alarms within 24 hours of LV-MCS initiation.</div></div><div><h3>Conclusions</h3><div>RVD in AMI-CS is common and associated with worse survival to discharge. Early LV-MCS decreases filling pressures rapidly within the first 24 hours and decreases the rate of RVD. Achieving a CPO of &gt;0.6 W and a PAPi of &gt;1 within 24 hours is associated with high survival. Diastolic suction alarms may have usefulness as an early marker of RVD.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 10","pages":"Pages 1275-1284"},"PeriodicalIF":6.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400389","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":"Secondary Mitral Regurgitation: Updated Review with Focus on Percutaneous Interventional Management","authors":"Manish Vinayak MD ,&nbsp;Francesca R. Prandi MD ,&nbsp;Lucy Safi DO ,&nbsp;Anupam Sharma MD ,&nbsp;Gilbert H.L. Tang MD, MSc, MBA ,&nbsp;Stamatios Lerakis MD PhD ,&nbsp;Annapoorna S. Kini MD ,&nbsp;Samin K. Sharma MD ,&nbsp;Sean Pinney MD ,&nbsp;Anuradha Lala MD ,&nbsp;Sahil Khera MD, MPH","doi":"10.1016/j.cardfail.2024.06.018","DOIUrl":"10.1016/j.cardfail.2024.06.018","url":null,"abstract":"<div><div>Secondary mitral regurgitation (SMR) is associated with increased mortality and heart failure hospitalizations. The management of heart failure patients with SMR is complex and requires a multidisciplinary Heart Team approach. Guideline-directed medical therapies remain fundamental, yet in a proportion of patients SMR persists. In the past decade, transcatheter edge-to-edge repair (TEER) has been shown to improve survival in patients with SMR who remain symptomatic despite medical therapy. Technical advancements across newer generations of devices, improved imaging, and greater operator expertise have collectively contributed to the increased safety and efficacy of this procedure over time. Various emerging transcatheter mitral valve repair and replacement devices are currently under investigation and may offer superior, complementary or synergistic treatment options in patients ineligible for TEER. This review provides a state-of-the-art overview regarding the diagnosis of SMR, and currently available transcatheter mitral valve interventions and describes a contemporary approach to the management of SMR.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 10","pages":"Pages 1302-1318"},"PeriodicalIF":6.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400400","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":"Reduction of Cardiac Allograft Vasculopathy by PCI: Quantification and Correlation With Outcome After Heart Transplantation","authors":"MADELEINE ORBAN MD ,&nbsp;ANNE KUEHL CandMed ,&nbsp;LOUIS PECHMAJOU MD ,&nbsp;CHRISTOPH MÜLLER MD ,&nbsp;MAROUN SFEIR MD ,&nbsp;STEFAN BRUNNER MD ,&nbsp;DANIEL BRAUN MD ,&nbsp;JOERG HAUSLEITER MD ,&nbsp;MARIE-CÉCILE BORIES MD ,&nbsp;ANNE-CÉLINE MARTIN MD, PhD ,&nbsp;SARAH ULRICH MD ,&nbsp;ROBERT DALLA POZZA MD ,&nbsp;JULINDA MEHILLI MD ,&nbsp;XAVIER JOUVEN MD, PhD ,&nbsp;CHRISTIAN HAGL MD ,&nbsp;NICOLE KARAM MD, PhD ,&nbsp;STEFFEN MASSBERG MD","doi":"10.1016/j.cardfail.2024.07.011","DOIUrl":"10.1016/j.cardfail.2024.07.011","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous coronary intervention (PCI) might improve outcome at severe stages of cardiac allograft vasculopathy (CAV) among patients after heart transplantation (HTx). Yet, risk stratification of HTx patients after PCI remains challenging.</div></div><div><h3>Aims</h3><div>To assess whether the International Society for Heart and Lung Transplantation (ISHLT) CAV classification remains prognostic after PCI and whether risk-stratification models of non-transplanted patients extend to HTx patients with CAV.</div></div><div><h3>Methods</h3><div>At 2 European academic centers, 203 patients were stratified in cohort 1 (ISHLT CAV1, without PCI, n = 126) or cohort 2 (ISHLT CAV2 and 3, with PCI). At first diagnosis of CAV or first PCI, respectively, ISHLT CAV grades, SYNTAX scores I and II (SXS-I, SXS-II) were used to quantify baseline and residual CAV (rISHLT, rSXS-I, rSXS-II). RSXS-I &gt; 0 defined incomplete revascularization (IR).</div></div><div><h3>Results</h3><div>SXS-II predicted mortality in cohort 1 (<em>P</em> = 0.004), whereas SXS-I (<em>P</em> = 0.009) and SXS-II (<em>P</em> = 0.002) predicted mortality in cohort 2. Post-PCI, IR (<em>P</em> = 0.004), high rISHLT (<em>P</em> = 0.02) and highest tertile of rSXS-II (<em>P</em> = 0.006) were associated with higher 5-year mortality. In bivariable Cox analysis, baseline SXS-II, IR and rSXS-II remained predictors of 5-year mortality post-PCI. There was a strong inverse relationship between baseline and rSXS-I (r = -0.55; <em>P</em> &lt; 0.001 and r = -0.50; <em>P</em> = 0.003, respectively) regarding the interval to first reintervention.</div></div><div><h3>Conclusion</h3><div>People with ISHLT CAV classification could apply for risk stratification after PCI. SYNTAX scores could be complemental for risk stratification and individualization of invasive follow-up of HTx patients with CAV.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 10","pages":"Pages 1222-1230"},"PeriodicalIF":6.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400398","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":"In Memoriam: Aslan Turer, MD, MHS, MBA (1974–2024)","authors":"Jennifer T. Thibodeau MD, MSCS ,&nbsp;Sarah K. Gualano MD, MBA ,&nbsp;Lanny Hall MD","doi":"10.1016/j.cardfail.2024.07.018","DOIUrl":"10.1016/j.cardfail.2024.07.018","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 10","pages":"Pages 1399-1400"},"PeriodicalIF":6.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400390","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":"Myocardial Revascularization in Heart Failure: A State-of-the-Art Review","authors":"MANASI TANNU ,&nbsp;ADAM J. NELSON ,&nbsp;JENNIFER A. RYMER ,&nbsp;W. SCHUYLER JONES MD","doi":"10.1016/j.cardfail.2024.08.002","DOIUrl":"10.1016/j.cardfail.2024.08.002","url":null,"abstract":"<div><div>Patients with heart failure (HF) and underlying coronary artery disease (CAD) have a substantially higher risk of mortality compared with those with HF from other causes. However, identifying individuals with HF for whom revascularization is likely to improve prognosis is a complex clinical decision. Revascularization is likely beneficial for patients with CAD-predominant symptoms, such as those with acute myocardial infarction or stable ischemic heart disease with refractory angina. However, for patients with HF-predominant symptoms, characterized by dyspnea without acute myocardial infarction or refractory angina, the benefits of revascularization are less clear. This state-of-the-art review summarizes the outcomes, clinical trials, and therapeutic approaches for patients with both CAD and HF, and proposes a therapeutic algorithm to guide the diagnosis and comprehensive workup of these complex patients.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 10","pages":"Pages 1330-1342"},"PeriodicalIF":6.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400393","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":"Sex-Based Survival Outcomes in Cardiogenic Shock","authors":"ASHLEY M. DARLINGTON MD ,&nbsp;KIRSTEN M. LIPPS MD ,&nbsp;BENJAMIN HIBBERT MD, PhD ,&nbsp;SHANNON M. DUNLAY MD, MS ,&nbsp;GARIMA DAHIYA MD ,&nbsp;JACOB C. JENTZER MD","doi":"10.1016/j.cardfail.2024.06.016","DOIUrl":"10.1016/j.cardfail.2024.06.016","url":null,"abstract":"<div><h3>Background</h3><div>Sex-based disparities have been demonstrated in care delivery for females with cardiogenic shock (CS), including lower use of coronary angiography (CAG), percutaneous intervention (PCI) and mechanical circulatory support (MCS). We evaluated whether sex-based disparities exist and are associated with worse CS outcomes in females.</div></div><div><h3>Methods</h3><div>We studied a retrospective cohort of 1498 consecutive, unique adult cardiovascular intensive care unit (CICU) admissions with CS from 2007–2018.</div></div><div><h3>Results</h3><div>Compared to males, females (n = 566, 37.1%) were older (71.7 vs 67.8 years; <em>P</em> &lt; 0.001) but had similar burdens of medical comorbidities. Acute myocardial infarction (AMI) was present in 54.1% of females and 59.1% of males (<em>P</em> = 0.06). There were no sex-based differences in the use of CAG and PCI, but females received temporary MCS less commonly. Specifically, females with non-AMI CS received MCS devices less commonly (17.6% vs 24.4%; <em>P</em> = 0.04). There was no difference in in-hospital or 1-year mortality rates between the sexes. Compared to males, females who received PCI had lower risks of 1-year mortality (unadjusted HR 0.72; <em>P</em> = 0.03), whereas females who received CAG without PCI had higher risks of 1-year mortality (unadjusted HR 1.41; <em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>No sex-based disparities in mortality due to CS were demonstrated in this large, diverse cohort of patients with CICU admissions. Females who underwent PCI demonstrated lower risks of 1-year mortality, whereas females who underwent CAG without PCI demonstrated higher risks of 1-year mortality compared to males. This may reflect underuse of PCI as a mortality-reducing therapy in females.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"30 10","pages":"Pages 1211-1219"},"PeriodicalIF":6.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400401","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":"Differential Prognostic Impact of Clinical Congestion between Preserved versus Reduced Ejection Fraction in Patients Hospitalized for Acute Decompensated Heart Failure: Findings from the Japanese Kyoto Congestive Heart Failure Registry.","authors":"Kazuya Nagao, Takao Kato, Hidenori Yaku, Takeshi Morimoto, Kenji Aida, Shiori Kawakami Maruichi, Yasutaka Inuzuka, Yodo Tamaki, Erika Yamamoto, Yusuke Yoshikawa, Takeshi Kitai, Ryoji Taniguchi, Moritake Iguchi, Masashi Kato, Mamoru Takahashi, Toshikazu Jinnai, Takafumi Kawai, Akihiro Komasa, Ryusuke Nishikawa, Yuichi Kawase, Takashi Morinaga, Kanae Su, Mitsunori Kawato, Yuta Seko, Tsukasa Inada, Moriaki Inoko, Mamoru Toyofuku, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Satoshi Shizuta, Yukihito Sato, Koichiro Kuwahara, Neiko Ozasa, Koh Ono, Takeshi Kimura","doi":"10.1016/j.cardfail.2024.08.060","DOIUrl":"10.1016/j.cardfail.2024.08.060","url":null,"abstract":"<p><strong>Background: </strong>Most patients hospitalized for heart failure (HF) present with signs of congestion. Prognostic significance of clinical congestion may vary depending on left ventricular ejection fraction (LVEF). This study aims to investigate the prognostic impact of congestion across different LVEF categories.</p><p><strong>Methods and results: </strong>Composite congestion scores (CCSs; 0-9) derived from the severity of edema, jugular venous pressure, and orthopnea, were analyzed on admission and at discharge in 3787 patients hospitalized for HF (LVEF ≥ 40%: n = 2347, LVEF < 40%: n = 1440). The median admission CCS was 4 in both LVEF strata (P = .64). Adjusted hazard ratios (HRs; 95% confidence interval [CI]) of the moderate (CCS 4-6) and severe congestion [7-9] groups relative to the mild congestion [0-3] group on admission for a composite of all-cause death or HF rehospitalization were 1.20 (1.04-1.39, P = .01) and 1.54 (1.27-1.86, P < .001) in the LVEF ≥ 40% stratum, and 1.20 (1.01-1.44, P = .04) and 0.82 (0.61-1.07, P = .14) in the LVEF < 40% stratum, respectively (P_interaction< .001). A total of 16% of the patients with LVEF ≥40% and 14% with LVEF <40% had residual congestion (CCS ≥ 1) at discharge, which was associated with a respective adjusted HR of 1.40 (1.18-1.65, P < .001) and 1.25 (0.98-1.58, P = .07) for postdischarge death or HF rehospitalization (P_interaction = 0.63).</p><p><strong>Conclusion: </strong>The severity of clinical congestion on admission was associated with adverse clinical outcomes in patients with LVEF ≥ 40%, but not in those with LVEF < 40%. These findings warrant further studies to better understand the detailed profile of congestion across the LVEF spectrum.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365361","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":"Validating the Association Between Composite Metrics of Guideline-Directed Medical Therapy and Clinical Outcomes for Patients With Heart Failure With Reduced Ejection Fraction.","authors":"Alexandra Steverson, Jamie Calma, Stephanie Hsiao, Karim Sallam, Anubodh S Varshney, Jessica R Golbus, Paul A Heidenreich, Alexander T Sandhu","doi":"10.1016/j.cardfail.2024.08.054","DOIUrl":"10.1016/j.cardfail.2024.08.054","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365363","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}