European Journal of Heart Failure最新文献

{"title":"Association of patient-centred remote monitoring with clinical outcomes in patients with prior hospitalization: the TELESAT PRIOR-HF study.","authors":"Luca Monzo, Patrick Jourdain, Annabelle Jagu, Marie-France Seronde, Hélène Benchimol, Jean-Michel Tartière, Olivier Hanon, Stéphane Lafitte, Vanessa Barbet, Nicolas Pages, Sophie Nisse-Durgeat, François Picard, Nicolas Girerd","doi":"10.1093/ejhf/xuag146","DOIUrl":"https://doi.org/10.1093/ejhf/xuag146","url":null,"abstract":"<p><strong>Aims: </strong>Patients recently hospitalized for heart failure (HF) face a high risk of readmission and mortality. Remote monitoring programs (RMPs) may offer a scalable, non-invasive strategy to improve outcomes in this vulnerable population.</p><p><strong>Methods: </strong>This prespecified sub-analysis of the TELESAT-HF study included HF patients with at least one HF-related hospitalization in the year preceding study entry. Patients enrolled in the RMP and controls were identified from the French national health database. Controls were then weighted to create a group comparable to the RMP group. The primary endpoint was all-cause mortality, while secondary endpoints included HF-related rehospitalizations and cumulative days spent in hospital. Healthcare costs were also explored.</p><p><strong>Results: </strong>After weighting, ∼1258 patients managed with RMP (mean age 73 years, 33% women) and ∼2321 controls were included. Compared with SoC, RMP was associated with a lower risk of all-cause mortality (23.5% vs. 39.6%; HR 0.54, [95%CI 0.47; 0.63]; P < .001), a lower rate of HF-related hospitalizations (rate ratio: 0.85, [95%CI 0.78; 0.94]; P = .002), including fewer admissions via emergency departments (-32%), reduced need of intensive care (-35%), and fewer cumulative days spent in hospital (estimated absolute difference: -1.77, [95%CI -2.81; -0.72] days; P < .001). Mean total healthcare costs did not differ significantly between groups at 6, 12, or 24 months, despite numerically higher costs in the RMP group at later time points. Subgroup analyses showed consistent associations across age, sex, RMP modality, and the number of prior HF hospitalizations.</p><p><strong>Conclusion: </strong>Among patients recently hospitalized for HF, participation in a non-invasive RMP was associated with lower mortality, fewer HF rehospitalizations, less time spent in hospital, and a broadly cost-neutral profile. These findings support the potential role of RMP as part of routine post-discharge HF care.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855627","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":"Kidney dysfunction and pulmonary vascular disease in HFpEF: beyond association-time, congestion, and the limits of cross-sectional inference.","authors":"Guillaume Baudry, Jan Biegus, Nicolas Girerd","doi":"10.1093/ejhf/xuag158","DOIUrl":"https://doi.org/10.1093/ejhf/xuag158","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855682","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":"Takotsubo Syndrome: Comparison of data from the 2024 World literature and the 2019-2022 InterTak Registry subgroup.","authors":"John E Madias","doi":"10.1093/ejhf/xuag156","DOIUrl":"https://doi.org/10.1093/ejhf/xuag156","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831364","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":"Beyond Mean Arterial Pressure: Organ Perfusion Pressure as a Hemodynamic Target in Cardiogenic Shock.","authors":"Omar Khayat, Bahy Abofrekha, Marc-Andre Ehrenfels, Felicia Zhang, Ahmed Zayed, Hadi Itani, Martin Amor","doi":"10.1093/ejhf/xuag149","DOIUrl":"https://doi.org/10.1093/ejhf/xuag149","url":null,"abstract":"<p><strong>Background: </strong>Current cardiogenic shock (CS) management primarily targets mean arterial pressure (MAP), often overlooking the impact of venous congestion on the effective perfusion gradient. Organ Perfusion Pressure (OPP = MAP - CVP) integrates both. We investigated OPP's prognostic value for mortality, renal function, and resource utilization.</p><p><strong>Methods: </strong>This retrospective cohort study utilized MIMIC-IV database, a single-center, critical care database, to identify adult CS patients. Patients with other forms of shock were excluded. Primary outcomes were in-hospital and ICU mortality. Secondary outcomes included ICU length of stay (LOS), vasopressors/inotropes duration (VID), urine output (UO) over the initial 36 hours, renal replacement therapy (RRT) and invasive mechanical ventilation (IMV). Multivariable models adjusted for demographics (age, sex), comorbidities (Hypertension, diabetes, heart failure, atrial fibrillation, CKD), and shock severity (Cardiac arrest, Vasoactive-Inotropic Score, Maximum lactate) across standardized 12-hour landmarks.</p><p><strong>Results: </strong>Among 189 patients (mean age 65.3±14.2 years, 65.6% male), prevalent comorbidities included coronary artery disease (52.4%) and HFrEF (50.8%). Acute myocardial infarction was present in 26.5% of cases. Every 5 mmHg increase in 24-hour mean OPP was independently associated with reduced in hospital mortality (aOR 0.79, 95% CI 0.65-0.96, p=0.020). Higher OPP was associated with renal protection, with increased urine output (+0.21 mL/kg/hr, p<0.001) and reduced odds of renal replacement therapy (aOR 0.65, p<0.001).</p><p><strong>Conclusions: </strong>In CS, a higher OPP is independently associated with improved survival, renal preservation, and resource efficiency. OPP provided incremental value especially for renal outcomes. Prospective interventional trials are mandatory for validation.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831402","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":"Fragility Analysis of Cardiovascular Outcomes with Finerenone in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease.","authors":"Marco Zuin, Claudio Bilato, Pierluigi Temporelli, Fabrizio Oliva, Gianluigi Savarese, Marco Metra, Gerasimos Filippatos, Alberto Corsini, Samuel Z Goldhaber, Gregory Piazza","doi":"10.1093/ejhf/xuag150","DOIUrl":"https://doi.org/10.1093/ejhf/xuag150","url":null,"abstract":"<p><strong>Aims: </strong>Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist, has been shown to reduce cardiovascular (CV) and kidney events in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). We aimed to quantify the robustness of its CV benefits in phase 3 randomized controlled trials (RCTs) using fragility metrics coupled with conventional clinical effect measures.</p><p><strong>Methods and results: </strong>We systematically searched MEDLINE and Scopus (from inception to June 2025) for phase 3 or 4 placebo-controlled RCTs of finerenone in T2DM and CKD reporting dichotomous CV outcomes. Three trials were included: FIDELIO-DKD, FIGARO-DKD, and the pooled FIDELITY analysis. We extracted hazard ratios (HRs), absolute risk reduction (ARR), relative risk reduction (RRR), number needed to treat (NNT), fragility index (FI), reverse fragility index (RFI), fragility quotient (FQ), and reverse fragility quotient (RFQ) for the primary composite CV outcome (CV death, non-fatal myocardial infarction [MI], non-fatal stroke, heart failure hospitalization [HFH]) and individual components. The primary composite outcome was significantly reduced in FIDELIO-DKD (HR 0.86, NNT 56; FI 4, FQ 0.0007) and FIDELITY (HR 0.86, NNT 59; FI 38, FQ 0.002), but not FIGARO-DKD (HR 0.87; RFI 7, RFQ 0.0009). Among individual outcomes, HFH showed the most consistent and robust benefit (FIDELITY HR 0.78, NNT 91; FI 23, FQ 0.001). Effects on CV death, MI, and stroke were numerically favorable but statistically non-significant, with low RFIs (mostly 1-3, and up to 9).</p><p><strong>Conclusions: </strong>Finerenone significantly reduces HF hospitalization and modestly improves composite CV outcomes in T2DM with CKD, but effects on CV death, MI, and stroke are fragile. Combining fragility metrics with standard efficacy measures offers a clearer view of the reliability of trial results.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831393","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":"Update on heart transplantation: a clinical consensus statement of the Advanced Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology.","authors":"Davor Milicic, Ivo Planinc, Stamatis Adamopoulos, Tuvia Ben Gal, Marco Masetti, Steven Tsui, Bosko Skoric, Maja Cikes, Hrvoje Gasparovic, Eva Goncalvesova, Sanem Nalbantgil, Arjang Ruhparwar, Giuseppe Vergaro, Maria Generosa Crespo-Leiro, Marco Metra, Frank Ruschitzka, Finn Gustafsson","doi":"10.1093/ejhf/xuag051","DOIUrl":"https://doi.org/10.1093/ejhf/xuag051","url":null,"abstract":"<p><p>Heart transplantation (HT) remains the reference therapy for selected eligible patients with advanced heart failure (HF), recent developments in drug and device therapies notwithstanding. The majority of heart transplants are performed in Europe and the USA. However, the rate of heart transplants varies greatly among European countries, ranging from <1 to >10 per million population per annum. Due to donor organ shortage, durable mechanical circulatory support (MCS) became a practical solution for many advanced HF patients, either as a bridge to transplant or as destination therapy. The aim of the present clinical consensus statement of the European Society of Cardiology -Heart Failure Association is to provide a perspective on important issues regarding HT, in particular patient selection, pre-transplant work-up, matching of donor heart and recipient, strategies of bridging patients to transplant with temporary or durable MCS, as well as how to increase the donor organ pool. Furthermore, surgical techniques and complications are discussed, as well as immediate post-transplant, and long-term management including the main aspects of long-term follow up such as rejection surveillance, personalized immunosuppression and managing comorbidities. Cellular and antibody mediated rejection, early cardiac allograft failure, and indications for retransplantation are described. An emphasis is given on the most important post-HT complications, such as cardiac allograft vasculopathy, infections and malignancies. Finally, the need for tailored physical rehabilitation and psychosocial support, and impact of post-transplant status on reproductive health are discussed.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831384","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":"A Prehospital Decision Support Tool for the Diagnosis of Acute Heart Failure: The RAPID-CHF Score.","authors":"Jennifer Y Zhou, Jocasta Ball, Emily Nehme, David Anderson, Emily Mahony, Tegwyn McManamny, Jesslyn Wijaya, Shane Nanayakkara, David M Kaye, Ziad Nehme, Dion Stub","doi":"10.1093/ejhf/xuag138","DOIUrl":"https://doi.org/10.1093/ejhf/xuag138","url":null,"abstract":"<p><strong>Aims: </strong>Diagnostic uncertainty is a major barrier to the timely treatment of heart failure (HF) in the prehospital setting. We aimed to develop and validate a decision support tool using readily available clinical variables to predict the probability of HF among dyspnoeic patients transported by emergency medical services (EMS).</p><p><strong>Methods and results: </strong>A population-based cohort of all adults transported by EMS for dyspnoea in Victoria, Australia was chronologically split into derivation (2015-2017) and temporal validation (2018-2019) cohorts. Two models were developed: (1) a full multivariable logistic regression model using adaptive least absolute shrinkage and selection operator regression, and (2) a simplified points-based RAPID-CHF score derived from the nine most predictive variables. Among 271,204 patients with dyspnoea (176,269 derivation; 94,935 validation), 9.4% and 9.0% had HF, respectively. The full model included 19 variables and demonstrated excellent discrimination (AUC 0.861 derivation; 0.862 validation) and calibration. The RAPID-CHF score (range 0-13; comprising age, ECG rhythm, prior HF, conscious state, oxygen saturation, blood pressure, temperature, peripheral oedema, and crackles) retained strong performance (AUC 0.835 derivation; 0.836 validation) and calibration. HF prevalence increased across predefined risk categories: low (score 0-5; HF prevalence 1.7%), moderate (6-9; 13.6%) and high (10-13; 46.4%). Decision curve analysis demonstrated greater net benefit across clinically relevant thresholds than current EMS diagnosis or \"treat all\"/\"treat none\" strategies.</p><p><strong>Conclusion: </strong>A risk score derived from routinely collected prehospital variables accurately estimates HF probability among EMS-transported patients with dyspnoea. The RAPID-CHF score may facilitate earlier diagnosis and timely initiation of HF therapy in EMS workflows.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808918","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":"Predicting fast recovery in infarct-related cardiogenic shock - Insights from the ECLS-SHOCK trial.","authors":"Maria Buske, Anne Freund, Steffen Desch, Uwe Zeymer, Janine Pöss, Tharusan Thevathasan, Ibrahim Akin, Tienush Rassaf, Taoufik Ouarrak, Steffen Schneider, Holger Thiele","doi":"10.1093/ejhf/xuag151","DOIUrl":"https://doi.org/10.1093/ejhf/xuag151","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831391","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":"Letter regarding the article \"The global epidemiology of heart failure: a comprehensive and contemporary review\".","authors":"Ahmet Celik, Mehmet Birhan Yilmaz","doi":"10.1093/ejhf/xuag152","DOIUrl":"https://doi.org/10.1093/ejhf/xuag152","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831431","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":"The Dyspnea Clinic: a new emerging interdisciplinary medical concept.","authors":"Robab Breyer-Kohansal, Daniela Tomasoni, Bernhard Haring","doi":"10.1093/ejhf/xuaf005","DOIUrl":"10.1093/ejhf/xuaf005","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"141-143"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343155","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}