European Journal of Heart Failure最新文献

{"title":"What's new in heart failure? March 2025","authors":"Julian Hoevelmann, Philipp Markwirth, Mert Tokcan, Bernhard Haring","doi":"10.1002/ejhf.3639","DOIUrl":"10.1002/ejhf.3639","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 3","pages":"409-411"},"PeriodicalIF":16.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ivabradine improves win ratios of heart failure outcomes in patients with reduced ejection fraction – insights from the SHIFT trial","authors":"Amr Abdin, Saarraaken Kulenthiran, Michel Komajda, Jeffrey S. Borer, Ian Ford, Luigi Tavazzi, Cécile Batailler, Karl Swedberg, Michael Böhm","doi":"10.1002/ejhf.3648","DOIUrl":"https://doi.org/10.1002/ejhf.3648","url":null,"abstract":"<p>Resting heart rate is a strong predictor of cardiovascular (CV) mortality and morbidity in patients with heart failure (HF).<span><sup>1</sup></span> The results of the SHIFT trial showed that heart rate reduction with ivabradine significantly reduced adverse clinical outcomes in a population with symptomatic HF and heart rates of 70 bpm or more.<span><sup>2, 3</sup></span> In CV outcome trials, treatment efficacy is often assessed with a composite endpoint that includes both fatal and non-fatal events, using a Cox proportional hazards model focused on the time to the first event. This method has limitations, such as giving equal statistical weight to each component, regardless of its clinical significance.<span><sup>4</sup></span> This is especially relevant as recent HF composites may include milder, non-hospitalization events. Furthermore, the model overlooks fatal events that occur after non-fatal ones and ignores recurrent non-fatal episodes, which may lower the treatment's perceived impact by focusing only on the first event. Alternatively, the win ratio (WR) approach uses a composite outcome that aligns with clinical priorities and patient preferences.<span><sup>5</sup></span> It enables a hierarchical structure based on the clinical importance of each component and can include recurrent events along with continuous or categorical measures, like patient-reported outcomes or biomarkers.<span><sup>6</sup></span> These advantages have recently drawn significant attention to the WR method. To understand how the WR compares to conventional time-to-first-event and total events analyses, we conducted this study to evaluate WR alongside hazard ratios (HRs) within the SHIFT trial.</p>\u0000<p>The SHIFT trial enrolled 6505 patients with left ventricular ejection fraction (LVEF) ≤35% and a resting heart rate ≥70 bpm. Patients were randomized to receive ivabradine or placebo in addition to guideline-based standard care.<span><sup>2</sup></span> The starting dose was 5 mg ivabradine twice daily; doses were adjusted upward or downward (2.5, 5, or 7.5 mg twice daily) at every visit according to heart rate and tolerability. Ivabradine reduced CV deaths or HF hospitalizations (HFH) (the study primary endpoint) by 18% (<i>p</i> < 0.0001), primarily driven by reduced hospital admissions for worsening HF (HR 0.74, 95% confidence interval [CI] 0.66–0.83; <i>p</i> < 0.0001).</p>\u0000<p>In the present analysis, the clinical benefit was assessed using the WR with a hierarchical endpoint of CV death and number of HFH. For this analysis, we used both matched and unmatched methods.<span><sup>5, 7</sup></span> In the matched pairs approach, patients receiving the new treatment were paired with those on standard treatment based on individual risk scores. In SHIFT, these scores were calculated using a Cox model adjusted for key prognostic factors: beta-blocker use, New York Heart Association class, LVEF, age, ischaemia, systolic blood pressure, and baseline creatinine ","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"58 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time for a new perspective on polypharmacy in heart failure","authors":"Ulrich Laufs, Stephen J. Greene, Martin Schulz","doi":"10.1002/ejhf.3650","DOIUrl":"https://doi.org/10.1002/ejhf.3650","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"16 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of mineralocorticoid receptor antagonists on the risk of sudden cardiac death across cardio-kidney-metabolic diseases: A meta-analysis of randomized clinical trials","authors":"Pedro Marques, Faiez Zannad, João Pedro Ferreira","doi":"10.1002/ejhf.3647","DOIUrl":"https://doi.org/10.1002/ejhf.3647","url":null,"abstract":"Sudden cardiac death (SCD) is a prevalent cause of mortality among patients with cardio-kidney-metabolic (CKM) diseases. Mineralocorticoid receptor antagonists (MRAs) reduce the risk of SCD in patients with left ventricular dysfunction, but it is unclear if similar effects are expected across different CKM risk populations irrespective of ejection fraction.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143678247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardioprotective effects of semaglutide on isolated human ventricular myocardium","authors":"Thomas Krammer, Maria J. Baier, Philipp Hegner, Tilman Zschiedrich, David Lukas, Matthias Wolf, Christian Le Phu, Vanessa Lutz, Katja Evert, Kostiantyn Kozakov, Jing Li, Andreas Holzamer, Lars S. Maier, Zdenek Provaznik, Donald M. Bers, Stefan Wagner, Julian Mustroph","doi":"10.1002/ejhf.3644","DOIUrl":"https://doi.org/10.1002/ejhf.3644","url":null,"abstract":"Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has shown promising effects in reducing cardiovascular events in patients with obesity and heart failure (HF) with preserved ejection fraction (HFpEF) irrespective of concomitant diabetes. However, the exact mechanisms underlying its cardioprotective actions remain unclear. Our study investigates the direct effects of semaglutide on human cardiomyocytes, focusing on calcium (Ca) and sodium (Na) handling and its potential to improve myocardial contractility.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"45 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular arrhythmias in acute heart failure. A clinical consensus statement of the Association for Acute CardioVascular Care (ACVC), the European Heart Rhythm Association (EHRA) and the Heart Failure Association (HFA) of the ESC","authors":"Bulent Gorenek, Adrianus P. Wijnmaalen, Andreas Goette, Gurbet Ozge Mert, Bradley Porter, Finn Gustafsson, Gheorghe Andrei Dan, Joris Ector, Markus Stuehlinger, Michael Spartalis, Nils Gosau, Offer Amir, Ovidiu Chioncel","doi":"10.1002/ejhf.3645","DOIUrl":"https://doi.org/10.1002/ejhf.3645","url":null,"abstract":"Patients presenting with or alerting emergency networks due to acute heart failure (AHF) form a diverse group with a plethora of symptoms, risks, comorbidities, and aetiologies. During AHF, there is an increased risk of destabilizing the functional substrate and modulatory adding to the risk of ventricular arrhythmias (VAs) already created by the structural substrate. New VAs during AHF have previously identified patients with higher in-hospital and 60-day morbidity and mortality. Risk stratification and criteria/best time point for coronary intervention and implantable cardioverter-defibrillator implantation, however, are still controversial topics in this difficult clinical setting. The characteristics and logistics of pre-hospital emergency medicine, as well as the density of centres capable of treating AHF and VAs, differ massively throughout Europe. Scientific guidelines provide clear recommendations for the management of arrhythmias in chronic heart failure patients. However, the incidence, significance, and management of arrhythmias in patients with AHF have been less studied. This consensus paper aimed to address the identification and treatment of VAs that complicate the course of patients who have AHF, including cardiogenic shock.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"124 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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 patients with left ventricular assist device: Don't forget the native heart","authors":"Matteo Pagnesi, Luca Baldetti, Anna Mara Scandroglio","doi":"10.1002/ejhf.3629","DOIUrl":"https://doi.org/10.1002/ejhf.3629","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"17 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with the use of guideline-directed medical therapy in patients with left ventricular assist device","authors":"Michel Chedid El Helou, Phoo Pwint Nandar, Larisa G. Tereshchenko, Miriam Jacob, Pavan Bhat, Amanda R. Vest, Sanjeeb Bhattacharya, Eileen Hsich, Patrick Collier, W.H. Wilson Tang, Edward Soltesz, Michael Z. Tong, Randall C. Starling, Trejeeve Martyn","doi":"10.1002/ejhf.3591","DOIUrl":"https://doi.org/10.1002/ejhf.3591","url":null,"abstract":"Societal guidelines have recently supported the use of guideline-directed medical therapy (GDMT) in patients with left ventricular assist device (LVAD) to promote ventricular recovery. We sought to characterize patient factors associated with use of GDMT in durable LVAD recipients.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"124 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC","authors":"Davide Stolfo, Massimo Iacoviello, Ovidiu Chioncel, Markus S. Anker, Antoni Bayes-Genis, Frieder Braunschweig, Antonio Cannata, Seif El Hadidi, Gerasimos Filippatos, Pardeep Jhund, Alexandre Mebazaa, Brenda Moura, Massimo Piepoli, Robin Ray, Arsen D. Ristic, Petar Seferovic, Maggie Simpson, Hadi Skouri, Carlo Gabriele Tocchetti, Sophie Van Linthout, Cristiana Vitale, Maurizio Volterrani, Kalliopi Keramida, Sven Wassmann, Basil S. Lewis, Marco Metra, Giuseppe M.C. Rosano, Gianluigi Savarese","doi":"10.1002/ejhf.3642","DOIUrl":"https://doi.org/10.1002/ejhf.3642","url":null,"abstract":"The multiplicity of coexisting comorbidities affecting patients with heart failure (HF), together with the availability of multiple treatments improving prognosis in HF with reduced ejection fraction, has led to an increase in the number of prescribed medications to each patient. Polypharmacy is defined as the regular use of multiple medications, and over the last years has become an emerging aspect of HF care, particularly in older and frailer patients who are more frequently on multiple treatments, and are therefore more likely exposed to tolerability issues, drug–drug interactions and practical difficulties in management. Polypharmacy negatively affects adherence to treatment, and is associated with a higher risk of adverse drug reactions, impaired quality of life, more hospitalizations and worse prognosis. It is important to adopt and implement strategies for the management of polypharmacy from other medical disciplines, including medication reconciliation, therapeutic revision and treatment prioritization. It is also essential to develop new HF-specific strategies, with the primary goal of avoiding the use of redundant treatments, minimizing adverse drug reactions and interactions, and finally improving adherence. This clinical consensus statement document from the Heart Failure Association of the European Society of Cardiology proposes a rationale, pragmatic and multidisciplinary approach to drug prescription in the current era of multimorbidity and ‘multi-medication’ in HF.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"16 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of Cardiology","authors":"Maurizio Volterrani, Geza Halasz, Stamatis Adamopoulos, Pier Giuseppe Agostoni, Javed Butler, Andrew J.S. Coats, Alan Cohen-Solal, Wolfram Doehner, Gerasimos Filippatos, Ewa Jankowska, Carolyn S.P. Lam, Ekaterini Lambrinou, Lars H. Lund, Giuseppe Rosano, Marco Metra, Stefania Paolillo, Pasquale Perrone Filardi, Amina Rakisheva, Gianluigi Savarese, Petar Seferovic, Carlo Gabriele Tocchetti, Massimo Piepoli","doi":"10.1002/ejhf.3440","DOIUrl":"https://doi.org/10.1002/ejhf.3440","url":null,"abstract":"For most patients with chronic, progressive illnesses, maintaining good quality of life (QoL), with preserved functional capacity, is just as crucial as prolonging survival. Patients with heart failure (HF) experience much worse QoL and effort intolerance than both the general population and people with other chronic conditions, since they present a range of physical and psychological symptoms, including shortness of breath, chest discomfort, fatigue, fluid congestion, trouble with sleeping, and depression. These symptoms reduce patients' capacity for daily social and physical activity. Usual endpoints of large-scale trials in chronic HF have mostly been defined to evaluate treatments regarding hospitalizations and mortality, but more recently, patients' priorities and needs expressed with QoL are gaining more awareness and are being more extensively evaluated. This scientific statement aims at discussing the importance of QoL in HF, summarizing the most largely adopted questionnaires in HF care, and providing an overview on their application in trials and the potential for their transition to clinical practice. Finally, by discussing the reasons limiting their application in daily clinical routine and the strategies that may promote their implementation, this statement aims at fostering the systematic integration of the patient's standpoint in HF care.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"87 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}