European Journal of Heart Failure最新文献

{"title":"AI-echocardiography: an eagle eye for the prognostic staging of ATTR cardiomyopathy.","authors":"Beat A Kaufmann, Evangelos Giannitsis, Gabriela M Kuster","doi":"10.1093/ejhf/xuag006","DOIUrl":"10.1093/ejhf/xuag006","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"115-117"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343157","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":"Efficacy of finerenone in patients with heart failure and mildly reduced or preserved ejection fraction: a prespecified analysis of heart rate and heart rhythm in the FINEARTS-HF trial.","authors":"Misato Chimura, Pardeep S Jhund, Alasdair D Henderson, Brian L Claggett, Akshay S Desai, James Lay-Flurrie, Andrea Scalise, Katja Rohwedder, Carolyn S P Lam, Michele Senni, Faiez Zannad, Bertram Pitt, Muthiah Vaduganathan, Scott D Solomon, John J V McMurray","doi":"10.1093/ejhf/xuag008","DOIUrl":"10.1093/ejhf/xuag008","url":null,"abstract":"<p><strong>Aims: </strong>The association between heart rate (HR) and clinical outcomes is well understood in patients with heart failure with reduced ejection fraction (HFrEF) but less clear in those with HFmrEF/HFpEF, especially among individuals with atrial fibrillation (AF). In a prespecified analysis of the FINEARTS-HF trial, we examined the association between baseline HR and clinical outcomes by heart rhythm and evaluated finerenone's effect across the spectrum of HR.</p><p><strong>Methods: </strong>The primary outcome was a composite of cardiovascular death and total (first and recurrent) HF events. Heart rhythm (sinus rhythm or AF) was determined from the baseline ECG. Patients with pacemaker rhythm or missing HR/rhythm data were excluded.</p><p><strong>Results: </strong>Among patients with sinus rhythm (SR n = 3497; 62%), higher baseline HR was associated with a higher incidence rate for the primary outcome. In patients with AF (n = 2190; 38%), no association between HR and outcomes was observed. The effect of finerenone on the primary outcome was consistent across the HR spectrum, regardless of rhythm (P for interaction = 0.96 in SR; 0.49 in AF). In patients with SR, there was no significant HR change with finerenone versus placebo. In AF patients, finerenone led to a small but statistically significant HR reduction: a placebo-corrected decrease of 1.35 bpm (95% CI: 0.41-2.29) from baseline to 12 months.</p><p><strong>Conclusions: </strong>Among patients with HFpEF/HFmrEF in FINEARTS-HF, higher baseline HR was associated with a higher risk of the primary outcome in patients with SR but not in those with AF. Finerenone's effect on the primary outcome was consistent across the HR spectrum, irrespective of rhythm.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04435626.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"26-38"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343113","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":"SUBCUT HF II: rationale and design of a multicentre randomized controlled trial of SUBCUTaneous furosemide to support early discharge in patients admitted to hospital due to Heart Failure.","authors":"Ross T Campbell, Joanna Osmanska, Kieran F Docherty, Fozia Z Ahmed, Andrew L Clark, Louise Clayton, John G F Cleland, Chris Critoph, Matthew Dewhurst, Nick Hartshorne-Evans, Roy S Gardner, Kate V Gatenby, Kaushik Guha, Paul R Kalra, Andrea Lees, Alex McConnachie, Pieter Muntendam, Kirstie Mowat, Joanne O'Donnell, Anna Placzek, Robin Ray, Henry Oluwasefunmi Savage, Rebeka Schiff, Iain Squire, Kirsty Wetherall, Ken Wong, Chih Wong, John J V McMurray, Mark C Petrie","doi":"10.1093/ejhf/xuaf018","DOIUrl":"10.1093/ejhf/xuaf018","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) hospitalizations are frequent and lengthy, and usually involve treatment with intravenous diuretics to relieve congestion. SUBCUT HF II is evaluating the safety and efficacy of an alternative ambulatory care strategy using a novel subcutaneous formulation of furosemide delivered via a wearable pump.</p><p><strong>Methods: </strong>The SUBCUT HF II trial is a multicentre, randomized, active comparator trial involving 20 hospitals in the UK. Eligible participants are patients with HF receiving inpatient treatment with intravenous loop diuretic. Patients are randomized to either early supported discharge, using a novel formulation of subcutaneous furosemide (SQIN-Furosemide) administered by a wearable pump (SQIN-Infusor), or continued inpatient treatment using intravenous furosemide.</p><p><strong>Results: </strong>The primary endpoint is days spent alive and out of hospital at 30 days. As of October 2025, 168 of 170 patients have been randomized.</p><p><strong>Conclusion: </strong>The SUBCUT HF II trial is testing the safety and efficacy of an ambulatory care approach to managing patients presenting to the hospital with HF.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT05419115.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"121-129"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343101","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":"Contemporary heart failure evidence in 2025: a joint summary of key trials from the European Journal of Heart Failure and ESC Heart Failure Journal.","authors":"Jan Biegus, Antoni Bayes-Genis, Stephan von Haehling, Wojciech Kosmala, Philipp Markwirth, Zoltán Papp, Piotr Ponikowski, Gianluigi Savarese, Michał Tkaczyszyn, Mert Tokcan, Michael Böhm","doi":"10.1093/ejhf/xuag015","DOIUrl":"10.1093/ejhf/xuag015","url":null,"abstract":"<p><p>Heart failure (HF) remains a major global health challenge, characterized by high morbidity, mortality, and healthcare costs despite substantial advances in pharmacological, device-based, and structural therapies. Its increasing prevalence reflects population ageing, improved survival after myocardial infarction, and the rising burden of cardiometabolic disease, while growing clinical heterogeneity across the ejection fraction spectrum demands more precise diagnostic and therapeutic strategies. This state-of-the-art review summarizes contemporary HF evidence published in the European Journal of Heart Failure and ESC Heart Failure Journal, integrating recent advances in epidemiology, aetiology, diagnostics, and treatment. Emerging data underscore the role of multi-parametric biomarkers, advanced imaging, and artificial intelligence-based tools in enabling earlier diagnosis, refined risk stratification, and personalized management. Aetiology-specific insights-including hypertensive and ischaemic heart disease, cardiomyopathies, amyloidosis, and pregnancy-related HF-are reshaping clinical pathways and therapeutic decision-making. Major developments in guideline-directed medical therapy are reviewed, including early and intensive initiation strategies, expanding evidence for sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists across the spectrum of ejection fraction, and persistent gaps between trial evidence and real-world implementation. Advances in decongestion, cardio-renal interactions, structural valve interventions, and device-based monitoring further illustrate the evolving complexity of HF care. Despite an expanding therapeutic armamentarium, delayed diagnosis, underuse of evidence-based therapies, and organizational barriers continue to limit clinical impact. Bridging this implementation gap through earlier prevention, precision phenotyping, and integrated multidisciplinary care is essential to improving outcomes for HF patients.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"1-21"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343099","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":"Mineralocorticoid receptor antagonists reduce new-onset atrial fibrillation across the cardio-kidney-metabolic spectrum: a meta-analysis of randomized clinical trials.","authors":"Pedro Marques, Francisco Vasques-Nóvoa, Faiez Zannad, Patrick Rossignol, João Pedro Ferreira","doi":"10.1093/ejhf/xuaf009","DOIUrl":"10.1093/ejhf/xuaf009","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"41-44"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343119","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":"Erythropoiesis-stimulating agents in anaemic patients with HF-a lost cause?","authors":"Markus S Anker, Muhammad Shahzeb Khan, Tim Friede, John G F Cleland","doi":"10.1093/ejhf/xuag010","DOIUrl":"10.1093/ejhf/xuag010","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"96-98"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343123","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":"Reply to commentary on 'effect of glucagon-like peptide-1 receptor agonists on heart failure outcomes and cardiovascular death across varying cardiovascular kidney-metabolic comorbidity'.","authors":"Tariq Jamal Siddiqi, Muhammad Shahzeb Khan, Gregg C Fonarow, Javed Butler, Stephen J Greene","doi":"10.1093/ejhf/xuaf004","DOIUrl":"10.1093/ejhf/xuaf004","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"149-150"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343236","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":"Clinical impact of early changes in guideline-directed medical therapy after mitral valve transcatheter edge-to-edge repair.","authors":"Ayano Yoshida, Masanori Yamamoto, Gaku Nakazawa, Kazuki Mizutani, Nobuhiro Yamada, Naoko Soejima, Takayuki Kawamura, Hiroki Matsuzoe, Tatsuya Miyoshi, Mike Saji, Shunsuke Kubo, Masahiko Asami, Yusuke Enta, Shinichi Shirai, Masaki Izumo, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Hisao Otsuki, Toru Naganuma, Hiroki Bota, Yohei Ohno, Masahiro Yamawaki, Hiroshi Ueno, Daisuke Hachinohe, Yuki Izumi, Tetsuro Shimura, Atsushi Sugiura, Toshiaki Otsuka, Kentaro Hayashida","doi":"10.1093/ejhf/xuag005","DOIUrl":"10.1093/ejhf/xuag005","url":null,"abstract":"<p><strong>Background and aims: </strong>Mitral transcatheter edge-to-edge repair (M-TEER) is an established therapy for functional mitral regurgitation (FMR) and reduced left ventricular ejection fraction (LVEF). Although guideline-directed medical therapy (GDMT) is ideally optimized before M-TEER, this procedure may facilitate early post-procedural GDMT changes. However, the clinical impact of early in-hospital GDMT modifications remains unclear.</p><p><strong>Methods: </strong>We analysed 1638 patients with FMR and LVEF <50% enrolled in a multicentre Japanese registry. The patients were stratified according to the number of GDMT classes prescribed at discharge (single [n = 183]; double [n = 505]; triple [n = 630]; quadruple [n = 320]). Changes from before M-TEER to discharge were categorized as increased (n = 271), unchanged (n = 1219), or decreased (n = 148). Associations between GDMT patterns and subsequent outcomes were evaluated. The primary endpoint was a composite of all-cause mortality and heart failure rehospitalization at 1 year.</p><p><strong>Results: </strong>Primary endpoints were achieved in 357 patients (22%). Event rates decreased across groups (single, 32%; double, 24%; triple, 21%; quadruple, 14%; P < 0.001). After adjusting for confounders, a greater number of GDMT classes at discharge independently predicted better prognosis (hazard ratio [HR]: 0.83; 95% confidence interval [CI]: 0.73-0.95), whereas pre-M-TEER GDMT was not significant. Compared with decreased GDMT, an unchanged status was not associated with improved outcomes, while an increased status significantly improved prognosis (HR 0.62, 95% CI 0.39-0.99).</p><p><strong>Conclusion: </strong>In patients with FMR and LVEF <50%, a higher number of GDMT classes at discharge and in-hospital uptitration of the GDMT class were associated with better outcomes, suggesting that early post-procedural GDMT optimization warrants further investigation.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"70-81"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343145","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":"Effect of the cardiac myosin activator omecamtiv mecarbil on ventricular arrhythmias, cardiac arrest, and sudden death in heart failure with reduced ejection fraction: the GALACTIC-HF trial.","authors":"Alberto Foà, Muthiah Vaduganathan, Brian L Claggett, Rafael Diaz, Fady I Malik, Stephen B Heitner, Stuart Kupfer, Punag H Divanji, G Michael Felker, Marco Metra, John J V McMurray, John R Teerlink, Scott D Solomon","doi":"10.1093/ejhf/xuag023","DOIUrl":"10.1093/ejhf/xuag023","url":null,"abstract":"<p><strong>Aims: </strong>Omecamtiv mecarbil (OM) has been shown to benefit individuals with heart failure and reduced ejection fraction but the clinical experience of cardiac myosin activators and risk of life-threatening ventricular arrhythmias (VA) is limited. We investigated the effects of OM on incidence of VA, cardiac arrest, and sudden death (SD) in the GALACTIC-HF trial.</p><p><strong>Methods: </strong>GALACTIC-HF was a placebo-controlled randomized trial testing the efficacy and safety of OM in participants with symptomatic chronic HF and LVEF ≤35%. Ventricular arrhythmias and cardiac arrest were investigator-reported adverse events while SD was centrally adjudicated. Severe HF was defined according to the ESC-HFA criteria. The effect of OM on the composite of the first occurrence of serious VA, cardiac arrest, or SD was examined using Cox proportional hazards models.</p><p><strong>Results: </strong>Over a median follow-up of 21.8 months, 706 out of the 8232 participants randomized in the GALACTIC-HF trial experienced serious VA, cardiac arrest, or SD. Randomization to OM led to a trend towards reduced risk for the composite arrhythmic outcome (377 events in the placebo group vs. 329 in the OM study arm; HR 0.86; 95% CI 0.75-1.00; P = .054). The strength of the association between OM and lower risk of composite events was stronger in participants with an LVEF ≤the median level of 28% (HR 0.77; 95% CI 0.63-0.94; P = .009) and appeared consistent in participants with severe HF.</p><p><strong>Conclusion: </strong>In this post hoc analysis of the GALACTIC-HF trial, we observed a potential reduction in life-threatening arrhythmia, cardiac arrest, and SD with OM treatment, especially in patients with severely reduced LVEF. These findings require prospective validation in the ongoing COMET-HF trial.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"99-107"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343158","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 'evaluating early cardiology involvement and survival outcomes across NT-proBNP levels: an island-wide retrospective cohort study'.","authors":"Hui-Chin Chang, Shuo-Yan Gau","doi":"10.1093/ejhf/xuaf007","DOIUrl":"10.1093/ejhf/xuaf007","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"144-145"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343108","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}