European Journal of Heart Failure最新文献

{"title":"Nationwide implementation of heart failure therapies: National Heart Failure Center Accreditation Program (HF-CAP) in China.","authors":"Jingmin Zhou,Xuejuan Jin,Yamei Xu,Zhonglei Xie,Xiaotong Cui,Yanyan Wang,Hua Wang,Xinli Li,Yugang Dong,Yuhua Liao,Weimin Li,Alexandre Mebazaa,Jiefu Yang,Junbo Ge, ","doi":"10.1002/ejhf.70035","DOIUrl":"https://doi.org/10.1002/ejhf.70035","url":null,"abstract":"AIMSImplementing optimal guideline-directed medical therapy is still challenging in patients with heart failure (HF). This prospective study assessed the benefits of large-scale, nationwide, multi-annual implementation of HF therapies in China.METHODS AND RESULTSThis longitudinal, pre-post comparison design included patients in hospitals accredited by the National Heart Failure Center Accreditation Program (HF-CAP). Patients were divided into four groups: 6-12 months before accreditation (Pre); >0 -≤12 months after accreditation (Y1); >12-≤24 months after accreditation (Y2), and >24 months after accreditation (Y2+). The primary endpoint was 1-year composite HF readmission and/or cardiovascular death. Secondary endpoints included 1-year HF readmission alone, 1-year cardiovascular death alone, and association between phone calls and/or visits and outcomes. Overall, 408 073 patients with HF from 646 centres were included. After HF-CAP accreditation, more patients with HF were treated following discharge. Compared with the Pre group, risk of meeting the primary endpoint decreased in Y1 and was incrementally lower in Y2 and Y2+: fully adjusted odds ratios (OR) and 95% confidence intervals (CIs) were 0.893 (0.871-0.916), 0.855 (0.830-0.880) and 0.720 (0.695-0.745), respectively (all p < 0.0001). Risk of HF readmission alone reduced from Y1 onwards (OR 0.865 [95% CI 0.841-0.891]). Risk of cardiovascular death reduced from Y2 onwards (OR 0.942 [95% CI 0.904-0.983]). Phone calls had little association with patient outcomes; however, face-to-face visits reduced risk of cardiovascular death (OR 0.624 [95% CI 0.597-0.651]).CONCLUSIONSGuideline-directed medical therapy implementation and follow-up after HF hospitalization was achievable in ~400 000 patients and was associated with cardiovascular benefits 1-year post-initiation.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"1 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103511","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":"Dynamic tricuspid regurgitation in heart failure with preserved ejection fraction.","authors":"Tomonari Harada,Yogesh N V Reddy,Hidemi Sorimachi,Masaru Obokata,Jwan A Naser,Atsushi Tada,Shunichi Doi,Tatsuro Ibe,Mackram F Eleid,Sorin V Pislaru,Rebecca T Hahn,Barry A Borlaug","doi":"10.1002/ejhf.70050","DOIUrl":"https://doi.org/10.1002/ejhf.70050","url":null,"abstract":"AIMSThe pathophysiology of tricuspid regurgitation (TR) during exercise in heart failure with preserved ejection fraction (HFpEF) is not well understood.METHODS AND RESULTSWe investigated dynamic changes in TR severity during exercise in patients with HFpEF and associated relationships with haemodynamics, cardiopulmonary reserve, and prognosis using invasive haemodynamic exercise testing with simultaneous echocardiography and expired gas analysis. Among 169 patients with HFpEF (91 no TR, 44 mild TR, 34 ≥ moderate TR), older age and atrial fibrillation were more common in patients with greater TR severity. Right heart remodelling and dysfunction were more frequently observed with greater TR severity, particularly in the right atrium, along with stepwise increases in right atrial (RA) pressure and interventricular septal flattening, and decreases in cardiac output (CO). During exercise, TR severity frequently worsened, and over half of the patients with moderate TR at rest displayed severe TR during exercise, accompanied by profound RA dilatation, reduced RA reservoir strain, increased septal flattening, and more severely impaired CO reserve. Abnormalities in tricuspid annular motion and ventricular interaction were amplified by exercise with greater TR, but exercise pulmonary vascular pressures did not differ across groups. Patients with ≥ moderate TR during exercise displayed higher event rates (hazard ratio 2.85, 95% confidence interval 1.18-6.85), but patients with mild TR had similar prognosis as those without TR in adjusted models.CONCLUSIONSTricuspid regurgitation in HFpEF is related to advanced RA myopathy and often worsens during exercise leading to dynamic right-sided heart failure, exaggerated ventricular interaction, impaired CO reserve, and increased risk for adverse outcomes. These data emphasize the clinical importance of exercise evaluation and call for further study of novel treatments in those with significant resting and provocable TR.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"18 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103416","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":"Safety and prognostic value of left ventricular endomyocardial biopsy in dilated cardiomyopathy.","authors":"Elham Kayvanpour,Farbod Sedaghat-Hamedani,Daniel Tian Li,Ebe Amr,Ali Amr,Bernd Lahrmann,Alan Lai,Chriswh Reich,Chenyang Wang,Esther Herpel,Derliz Mereles,Lutz Frankenstein,Niels Grabe,Hugo A Katus,Norbert Frey,Benjamin Meder","doi":"10.1002/ejhf.70019","DOIUrl":"https://doi.org/10.1002/ejhf.70019","url":null,"abstract":"AIMSThe need to perform endomyocardial biopsy (EMB) in patients with non-ischaemic dilated cardiomyopathies (DCM) is debated. Here we sought to determine the extent of left ventricular collagen volume fraction (LV-CVF) in DCM patients and to evaluate it as a prognostic marker.METHODS AND RESULTSIn this retrospective longitudinal study, we included 524 patients with suspected DCM who underwent left ventricular EMB (LV-EMB) as a part of their clinical work-up. LV-CVF was quantified using automated image processing of high-resolution scans of LV-EMB. Deep phenotyping was performed including assessment of late gadolinium enhancement on cardiac magnetic resonance imaging. Endpoints were (i) composite endpoint of heart failure-related death, sudden cardiac death, aborted sudden cardiac death (appropriate implantable cardioverter-defibrillator shock, reported sustained ventricular tachycardia, or cardiopulmonary resuscitation), or cardiac transplantation, and (ii) all-cause mortality. LV-EMB was associated with 0.76% major and 2.1% minor complications. No death occurred due to EMB. LV-CVF could be reliably quantified using Bayesian classification. During a median follow-up of 43.2 months (2084 patient-years), 48 patients with LV-CVF >32% and 14 patients with LV-CVF ≤32% reached the composite endpoint (log-rank p < 0.0001). A total of 62 patients reached the endpoint all-cause mortality, from which 38 presented with LV-CVF >32% and 17 with LV-CVF ≤32% (log-rank p = 0.009). In multivariable analyses, LV-CVF and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (hazard ratio 2.03, 95% confidence interval 1.32-3.11) were independent predictors of unfavourable outcome.CONCLUSIONSLeft ventricular EMB is a safe diagnostic procedure. The extent of CVF in LV-EMB provides prognostic information in patients with DCM in addition to existing measures of left ventricular ejection fraction or NT-proBNP.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"78 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083493","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":"Atrial fibrillation in end‐stage heart failure: Cellular mechanisms behind CASTLE‐HTx","authors":"Maria Knierim, Nico Hartmann, Wiebke Maurer, Steffen Pabel, Simon Sedej, Dirk von Lewinski, Jan Gummert, Christian Sohns, Katrin Streckfuss‐Bömeke, Samuel Sossalla","doi":"10.1002/ejhf.70051","DOIUrl":"https://doi.org/10.1002/ejhf.70051","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"68 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077361","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":"Initial investigations into single nucleotide polymorphisms and their association with QTc and left ventricular function in peripartum cardiomyopathy","authors":"Gasnat Shaboodien, Charle Viljoen, Polycarp Ndibangwi, Julian Hoevelmann, Lameez Pearce, Susanna Haidari, Margherita Torchio, Federica Dagradi, Carla Spazzolini, Sarah Kraus, Ntobeko A.B. Ntusi, Peter J. Schwartz, Karen Sliwa","doi":"10.1002/ejhf.70036","DOIUrl":"https://doi.org/10.1002/ejhf.70036","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"51 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077352","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":"Glucagon‐like peptide‐1 receptor agonists across the cardiovascular‐kidney‐metabolic spectrum: One size does not fit all","authors":"João Pedro Ferreira, Pedro Marques, Bernhard Haring, João Sérgio Neves","doi":"10.1002/ejhf.70055","DOIUrl":"https://doi.org/10.1002/ejhf.70055","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"10 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077354","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":"An individual treatment effect approach to predict response to mineralocorticoid receptor antagonists in patients with heart failure and reduced ejection fraction.","authors":"Masatake Kobayashi,Kevin Duarte,João Pedro Ferreira,Guillaume Baudry,Luca Monzo,John J V McMurray,Dirk J Van Veldhuisen,Bertram Pitt,Faiez Zannad,Nicolas Girerd","doi":"10.1002/ejhf.70047","DOIUrl":"https://doi.org/10.1002/ejhf.70047","url":null,"abstract":"AIMSMineralocorticoid receptor antagonists (MRAs) are often underused in patients with heart failure (HF) and reduced ejection fraction (HFrEF). Individual treatment effect (ITE) may assist physicians in making timely decisions about which patients are the best suited for personalized therapy. We aimed at developing and validating a model to estimate ITE of MRAs in patients with HFrEF.METHODS AND RESULTSRALES and EMPHASIS-HF trials were the derivation trials used to estimate ITE of MRAs versus placebo on cardiovascular death or HF hospitalization in HFrEF over a 2-year period using counterfactual random forest method. ITE prediction models were built using linear regression and applied to the EPHESUS trial in patients with left ventricular systolic dysfunction and/or HF after myocardial infarction. In the RALES and EMPHASIS-HF trials (n = 3887), age, body weight, blood pressure, heart rate, hypertension and diabetes prevalence, stroke history, left ventricular ejection fraction, renal function, and serum sodium and potassium concentrations were identified to determine ITE scores (adjusted R2 = 0.25). As ITE scores increased, hazard ratio for treatment effect decreased from 0.82 (95% confidence interval [CI] 0.67-1.02) at ITE score 5 to 0.47 (95% CI 0.35-0.63) at ITE score 20 (p for interaction = 0.014). In the EPHESUS trial (n = 6472), a similar pattern was observed, with greater treatment effects in patients with higher ITE scores (p for interaction = 0.007).CONCLUSIONSIn HFrEF across various clinical settings, our simple ITE model predicted individual responses to MRA therapy. Although treatment effects may be attenuated at lower ITE scores, point estimates with wide CIs still generally favour benefit, suggesting that these patients still benefit.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"171 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068360","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 comorbidity burden on outcome in patients with cardiogenic shock: A Cardiogenic Shock Working Group analysis.","authors":"Jonas Sundermeyer,Song Li,Van-Khue Ton,Rachna Kataria,Elric Zweck,Kevin John,Manreet K Kanwar,Jaime Hernandez-Montfort,Shashank S Sinha,A Reshad Garan,Jacob Abraham,Vanessa Blumer,Ajar Kochar,Karthikeyan Ranganathan,Gavin W Hickey,Mohit Pahuja,Scott Lundgren,Sandeep Nathan,Esther Vorovich,Shelley Hall,Wissam Khalife,Andrew Schwartzman,Ju Kim,Oleg Alec Vishnevsky,Justin Fried,Maryjane Farr,Joseph Mishkin,I-Hui Chang,Onyedika Ilonze,Alexandra Arias,Jun Nakata,Jeffrey Marbach,Hiram Bezerra,Ann Gage,Joyce Wald,Sunu Thomas,Faisal Rahman,Amirali Masoumi,Aasim Afsal,Salman Gohar,Rachel Goodman,Karol D Walec,Peter Natov,Borui Li,Paavni Sangal,Qiuyue Kong,Peter Zazzali,Neil M Harwani,Saraschandra Vallabhajosyula,Arvind Bhimaraj,Claudius Mahr,Daniel Burkhoff,Navin K Kapur","doi":"10.1002/ejhf.70017","DOIUrl":"https://doi.org/10.1002/ejhf.70017","url":null,"abstract":"AIMSComorbidity burden is a major determinant of outcomes. Its prognostic impact on cardiogenic shock (CS) across CS subtypes remains insufficiently characterized. We aimed to characterize the prevalence and distribution of comorbidities in CS, assess their impacts on outcomes, and identify high-risk comorbidity patterns in all-cause, acute myocardial infarction-related (AMI-CS) and heart failure-related CS (HF-CS).METHODS AND RESULTSCardiogenic shock patients from the multicentre Cardiogenic Shock Working Group (CSWG) registry (2020-2024) were analysed. We used adjusted logistic regression models to assess the impact of comorbidities individually, in combination, and as a cumulative burden on in-hospital mortality. We developed the Comorbidity Risk Index for Cardiogenic Shock (COMRI-CS) to capture the association between comorbidities and CS mortality. Among 6815 patients (26.5% AMI-CS, 53.6% HF-CS), 6087 (89.3%) presented with ≥1 comorbidity, and 4390 (64.4%) with ≥3 comorbidities. In-hospital mortality increased with comorbidity burden (AMI-CS: 35.4%, 39.6%, 47.1% with 1-3, 4-6, ≥7 comorbidities, respectively; HF-CS: 19.6%, 24.9%, 27.5%, respectively). A high comorbidity burden was independently associated with a 51% higher relative mortality risk in AMI-CS (odds ratio [OR] 1.51, 95% confidence interval [CI] 1.02-2.23, p = 0.037), and a more pronounced increase of 122% in HF-CS (OR 2.22, 95% CI 1.49-3.37, p < 0.001). Distinct high-risk comorbidities and combinations were identified, varying across CS subtypes. With each COMRI-CS point, in-hospital mortality increased by ~5.5%.CONCLUSIONSIn this large real-world CS cohort, comorbidity burden was highly prevalent, varied across subtypes, and was independently associated with mortality. Integrating chronic conditions into early CS risk stratification may enhance clinical decision-making in CS management.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"24 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068359","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":"Heart failure outcomes and empagliflozin effects in patients with heart failure and reduced ejection fraction in sinus rhythm or atrial fibrillation: Data from EMPEROR-Reduced.","authors":"Michael Böhm,Javed Butler,Amr Abdin,Gerasimos Filippatos,João Pedro Ferreira,Stuart J Pocock,Martina Brueckmann,Anne Pernille Ofstad,Elke Schueler,Christoph Wanner,Faiez Zannad,Stefan D Anker,Milton Packer, ","doi":"10.1002/ejhf.70021","DOIUrl":"https://doi.org/10.1002/ejhf.70021","url":null,"abstract":"AIMSEmpagliflozin reduces cardiovascular death (CVD) or hospitalization for heart failure (HHF), slows estimated glomerular filtration rate (eGFR) decline and improves quality of life (QoL) in heart failure with reduced ejection fraction (HFrEF). Whether the effect of empagliflozin is consistent according to atrial fibrillation (AF) status is worth exploring.METHODS AND RESULTSThe impact of AF versus sinus rhythm (SR) on outcomes as well as on eGFR decline and QoL were studied post-hoc in EMPEROR-Reduced. Of patients with available rhythm analyses and after exclusion of patients with missing or paced rhythms, 2785 were included (AF, n = 928, SR, n = 1857). Differences were not significant for the primary endpoint (p = 0.66), first (p = 0.19) and recurrent HHF (p = 0.45). On placebo, alcohol consumption (interaction p = 0.32), body mass index (interaction p = 0.93), diabetes (interaction p = 0.52), hypertension (interaction p = 0.24) were not different between AF and SR. Low ejection fraction and high Kidney Disease: Improving Global Outcomes (KDIGO) class had higher event rates but without interaction between SR and AF, respectively. After a median follow-up of 20 months, empagliflozin reduced CVD or HHF compared to placebo in AF and SR (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.63-1.08; and HR 0.69, 95% CI 0.56-0.84; interaction p = 0.29). The same applied to time to first HHF (interaction p = 0.20), while there was a borderline but insignificant interaction for first and recurrent HHF (p = 0.10). The effect on annual eGFR decline and QoL scores was not different. Incident AF was numerically lower but formally not significantly different (HR 0.66, 95% CI 0.40-1.09, p = 0.11, empagliflozin vs. placebo).CONCLUSIONSIn HFrEF, AF did not significantly modify outcomes after adjustment and did not associate with eGFR slopes. Empagliflozin reduced outcomes, eGFR decline and improved QoL regardless of AF or SR and probably reduced incident AF.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"17 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068356","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":"Correction to \"Use of guideline-recommended medical therapy in patients with heart failure and chronic kidney disease: from physician's prescriptions to patient's dispensations, medication adherence and persistence\".","authors":"","doi":"10.1002/ejhf.70016","DOIUrl":"https://doi.org/10.1002/ejhf.70016","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063043","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}