European Journal of Heart Failure最新文献

{"title":"Water and electrolyte homeostasis during decongestion in heart failure","authors":"Jef Van den Eynde, Frederik H. Verbrugge","doi":"10.1002/ejhf.3727","DOIUrl":"https://doi.org/10.1002/ejhf.3727","url":null,"abstract":"In heart failure, sodium retention generally occurs out of proportion to water retention and may occur disproportionate to chloride retention, requiring excretion of other cations (i.e. potassium, magnesium, and hydrogen). Renal homeostatic mechanisms keep chloride levels in balance, making it the primary regulator of intravascular tonicity. Excess total body sodium stores and potassium depletion increase the vulnerability to dehydration, especially in the intracellular compartment. With decompensation, extracellular volume expansion with sodium and chloride overload occurs, further enhancing potassium losses. While diuretics are vital to treat fluid overload, they derange important electrolyte and water balances. Diuretic therapies in heart failure produce disproportionate electrolyte‐free water excretion, further exacerbate potassium depletion, and cause chloride losses disproportionate to natriuresis. This can be mitigated by allowing liberal electrolyte‐free water intake, providing aggressive potassium and chloride supplementation, and using upfront proximal diuretics to preserve the chloride balance.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"24 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319629","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 facilitate seamless translation from basic concepts to new heart failure drugs. A scientific statement of the Heart Failure Association of the ESC","authors":"Carlo Gabriele Tocchetti, Arantxa González, Johannes Backs, Piero Pollesello, Peter P. Rainer, Gabriele Giacomo Schiattarella, Milena Bellin, Glenn Begley, Ildiko Bock Marquette, Jean-Luc Balligand, Ines Falcao-Pires, Rick Gorczynski, Emilio Hirsch, Jean-Sebastian Hulot, Bert Klebl, Alexander R. Lyon, Christoph Maack, Tim McKinsey, Oliver J. Müller, Ida Lunde, Rusty Montgomery, Giuseppe Vergaro, Antoni Bayes-Genis, Thomas Thum, Peter van der Meer, Linda Van Laake, Franck Ruschitzka, Petar Seferovic, Andrew J. Coats, Marco Metra, Giuseppe Rosano, Sophie Van Linthout, Rudolf A. de Boer","doi":"10.1002/ejhf.3709","DOIUrl":"https://doi.org/10.1002/ejhf.3709","url":null,"abstract":"A rift has opened and is widening between basic research (bench) and clinical research and patients (bed) who need their new treatments, diagnostics and preventive strategies. This problem involving the ‘translation’ of basic scientific findings into clinical applications and potential treatments or biomarkers for a condition like heart failure is widely recognized both in academia and industry. Despite the attempts that have been made by both sides to improve this situation, the high attrition rates of drug development and the problem with reproducibility and translatability of preclinical findings to human applications still persist. As a result, the return on investment of basic research has been limited in terms of clinical impact. In this scientific statement we describe and discuss various issues with relevance to this theme and try to dissect how to move our field towards the development of more effective heart failure drugs. We zoom in on facilitating the process of heart failure drug development, the unnecessary gaps (‘valley of death’) between the critical steps in heart failure drug development, validation and de-validation of new concepts as early as possible (‘rigorous translation’). We describe forums on how to stimulate cross-talk and interaction between clinician-scientists, basic heart failure researchers, biotech and industry, and how to enable them to speak the same language, and lessons learned from successes outside the heart failure field.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"36 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312179","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":"Prognostic value of NT-proBNP in patients with primary mitral regurgitation undergoing transcatheter edge-to-edge repair.","authors":"Philipp von Stein,Jessica Weimann,Roman Pfister,Sebastian Ludwig,Benedikt Koell,Erwan Donal,Dhairya Patel,Lukas Stolz,Tetsu Tanaka,Andrea Scotti,Teresa Trenkwalder,Felix Rudolph,Daryoush Samim,Cristina Giannini,Julien Dreyfus,Jean-Michel Paradis,Marianna Adamo,Nicole Karam,Yohann Bohbot,Anne Bernard,Bruno Melica,Angelo Quagliana,Yoan Lavie Badie,Mirjam Kessler,Omar Chehab,Simon Redwood,Edith Lubos,Lars Sondergaard,Marco Metra,Chiara Primerano,Fabien Praz,Muhammed Gerçek,Erion Xhepa,Georg Nickenig,Azeem Latib,Niklas Schofer,Raj Makkar,Juan F Granada,Thomas Modine,Jörg Hausleiter,Augustin Coisne,Daniel Kalbacher,Christos Iliadis,","doi":"10.1002/ejhf.3725","DOIUrl":"https://doi.org/10.1002/ejhf.3725","url":null,"abstract":"AIMSThe prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) for primary mitral regurgitation (PMR) is unclear. This study assessed the association between NT-proBNP and outcomes and explored its additive value to the Mitral Regurgitation International Database (MIDA) score.METHODS AND RESULTSPRIME-MR, a retrospective, international, multicentre registry, includes 3083 consecutive PMR patients treated with M-TEER. This analysis focused on 1382 patients (median age 81 years, 47% female, 82% New York Heart Association [NYHA] functional class III/IV, median EuroSCORE II 4.1%) with available NT-proBNP levels and follow-up. The primary endpoint was death or heart failure hospitalization within 3 years. Median NT-proBNP level was 1991 pg/ml (T1: 578, T3: 6285), and 384 patients reached the primary endpoint (Kaplan-Meier estimate: 48.5%). Log-transformed NT-proBNP levels independently predicted the primary endpoint (adjusted hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.07-1.28; p < 0.001) after adjusting for NYHA class, haemoglobin, creatinine, and atrial fibrillation. In 1041 patients with a modified MIDA score (median 9), the score was initially associated with the primary endpoint (HR 1.10, 95% CI 1.04-1.17; p = 0.002), but lost significance when adjusting for NT-proBNP levels, which remained independently predictive (adjusted HR 1.20, 95% CI 1.07-1.34; p = 0.002).CONCLUSIONSNT-proBNP, but not the MIDA score, was independently associated with death or heart failure hospitalizations within 3 years in M-TEER-treated PMR patients. Incorporating NT-proBNP levels into clinical assessment may improve risk stratification and potentially supports earlier intervention at lower NT-proBNP levels to optimize outcomes.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"15 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320304","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 European heart failure management resources, treatment reimbursement and activities of professional and patient organizations","authors":"Petar M. Seferović, Marija Polovina, Gianluigi Savarese, Ivan Milinković, Lars Lund, Ovidiu Chioncel, Magdy Abdelhamid, Yuri Lopatin, Stefan Störk, Manuel Anguita Sanchez, Massimo Piepoli, Aldo P. Maggioni, Ewa Jankowska, Antoni Bayes‐Genis, Alain Cohen Solal, Arsen Ristić, Mariya Tokmakova, Mehmet Birhan Yilmaz, Hadi Skouri, Davor Miličić, Offer Amir, Amina Rakisheva, Gerasimos Filippatos, Giuseppe Rosano, Marco Metra, Andrew J. Coats","doi":"10.1002/ejhf.3691","DOIUrl":"https://doi.org/10.1002/ejhf.3691","url":null,"abstract":"AimsThe European Heart Failure (HF) Survey was developed by the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) to map HF management resources, reimbursement of drugs/devices for HF treatment, and structure and activities of HF professional and patient organizations.Methods and resultsThe survey encompassed 43 ESC member countries. The median number of hospitals with dedicated HF centres was 2.6 (interquartile range [IQR] 0.9–4.7) per million people. Natriuretic peptide assessment was available at a median of 6.1 (IQR 1.8–10.6) emergency departments and 8.2 (IQR 1.3–14.7) hospitals per million people, respectively, whilst cardiac magnetic resonance was available at a median of 2.0 (IQR 0.9–3.8) hospitals per million people. Short‐term and long‐term mechanical circulatory support and heart transplantation were available at a median of 1.1 (IQR 0.5–2.4), 0.4 (IQR 0.0–0.5) and 0.3 (0.2–0.5) hospitals per million people, respectively. Whilst essential HF medications were mostly available and reimbursed, gaps were observed in availability and funding of newer and advanced therapies. Density of all diagnostic and therapeutic capabilities was greater in countries with more favourable socioeconomic status. National HF societies were reported in 98% of countries, whilst HF patient organizations in 45% of countries.anaemia.ConclusionsThe European HF Survey is the result of long‐standing HFA/ESC efforts to monitor HF epidemiology, management resources, educational and awareness activities. It offers a valuable assessment of current management capabilities, highlighting challenges in providing contemporary standards of care. It also provides insights into future directions needed to address these gaps.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"18 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311242","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":"Baseline serum ferritin predicts myocardial iron uptake following intravenous iron therapy - a hypothesis-generating study.","authors":"Julio Nunez, Anna Mollar, Mayra Vera-Aviles, Syeeda Kabir, Akshay Shah, Paolo Polzella, Michael Desborough, Ingrid Cardells, Gema Miñana, Irene Del Canto, Vanessa Ferreira, Stefan Piechnik, Alicia Maceira, Samira Lakhal-Littleton","doi":"10.1002/ejhf.3730","DOIUrl":"https://doi.org/10.1002/ejhf.3730","url":null,"abstract":"<p><strong>Aims: </strong>Many patients with heart failure (HF) are iron-deficient. Intravenous (IV) iron therapy improves symptoms and reduces hospitalizations for HF. Several mechanisms have been proposed, including myocardial iron repletion. However, it is unknown if serum iron markers predict the extent of this repletion. To address this question, data from two clinical studies that evaluated changes in myocardial iron using cardiac magnetic resonance (CMR) were harnessed.</p><p><strong>Methods and results: </strong>The Myocardial-IRON trial measured change in myocardial iron, denoted by a decrease in CMR T1 and T2*, at 7 and 30 days after IV ferric carboxymaltose (FCM) in patients with iron deficiency (ID) and HF (n = 53). The STUDY trial measured myocardial and spleen iron at multiple timepoints after FCM in patients with ID without HF (n = 12). In this post-hoc analysis, we examined the association between baseline serum iron markers (transferrin saturation and ferritin) and change in myocardial iron in the weeks after FCM therapy. Changes in spleen iron were also examined, due its role as an intermediary in the redistribution of iron from iron-carbohydrate complexes such as FCM. In patients with or without HF, higher serum ferritin at baseline predicted lower rise in myocardial iron in the weeks after therapy with FCM. In contrast, higher serum ferritin at baseline predicted a greater rise in spleen iron.</p><p><strong>Conclusions: </strong>These data point towards the hypothesis that functional ID, which is characterized by elevated ferritin, could limit myocardial iron repletion after IV iron therapy, by favouring iron trapping in the spleen.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300818","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 crosstalk between immune activation and metabolism in heart failure. A scientific statement of the Heart Failure Association of the ESC.","authors":"Gabriele Fragasso,Davide Stolfo,Markus S Anker,Antoni Bayes-Genis,Ovidiu Chioncel,Stephane Heymans,Pardeep S Jhund,Basil S Lewis,Gary D Lopaschuk,Lars H Lund,Arantxa Gonzalez,Matteo Pagnesi,Gabriele Giacomo Schiattarella,Carlo Gabriele Tocchetti,Peter van der Meer,Sophie Von Linthout,Sven Wassmann,B Daan Westenbrink,Marco Metra,Giuseppe M C Rosano,Gianluigi Savarese","doi":"10.1002/ejhf.3703","DOIUrl":"https://doi.org/10.1002/ejhf.3703","url":null,"abstract":"A better understanding of additional mechanisms of heart failure (HF) progression may allow a different and more complete phenotyping of the disease and identification of novel therapeutic targets. Persistent latent myocardial inflammation/immune activation in HF may represent an attempt to restore tissue homeostasis in the failing heart, where cardiomyocytes and immune cells undergo metabolic reprogramming, which allows them to deal with decreased availability of nutrients and oxygen. This status can trigger a metabolic crosstalk between immune cells and cardiomyocytes which, depending on the outcome, can either perpetuate the maladaptive remodelling of the heart, or determine an adaptive response. Therefore, the interplay between immune activation and metabolism is gaining recognition as a potential therapeutic framework. On these premises, future studies addressing novel HF treatments should attempt to evaluate the potential therapeutic role of direct metabolic and immunological crosstalk modulation. The aim of the present scientific statement from the Heart Failure Association of the ESC is to summarize the current evidence for the connection between inflammatory and immune activation and metabolic adaptation in the onset and progression of HF, in order to promote future strategies for the development of targeted-disease preventive and therapeutic measures.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"12 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295663","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":"Liver stiffness measurement for non-invasive assessment of central venous pressure in patients with heart failure: A multicentre pilot study.","authors":"Nicolas Girerd,Jan Biegus,Adam Janas,Piotr Buszman,Marcin Suska,Ovidiu Chioncel,Julie Foucquier,Anne Llorca,Laura Cantu Sanchez,Marat Fudim,Kevin Damman,Maria Rosa Costanzo,Beth Davison,Gad Cotter,Laurent Sandrin,Victor de Lédinghen,Alexandre Mebazaa","doi":"10.1002/ejhf.3722","DOIUrl":"https://doi.org/10.1002/ejhf.3722","url":null,"abstract":"AIMSCentral venous pressure (CVP) is an important variable in assessing heart failure (HF) patients. However, invasive CVP measurement using right heart catheterization is associated with potential complications, and accurate measurement requires careful attention to technique. In this multicentre pilot study, we aimed to evaluate whether non-invasively measured liver stiffness can be used to assess CVP in patients with HF.METHODS AND RESULTSPatients aged 18 to 85 years with a history of HF (or left ventricular ejection fraction [LVEF] ≤40%) who required central venous line placement with CVP measurement were enrolled in an open-label study. Patients underwent simultaneous invasive catheter CVP measurement and non-invasive liver stiffness measurement (LSM) using vibration-controlled transient elastography (VCTE). The primary endpoint was the agreement between CVP and LSM-derived CVP (-5.9 + 6.8 × ln[LSM]) in the supine position. Among the 38 patients who completed the study, 34 (89.5%) were male, the mean age was 63.8 years, and the median LVEF was 24.5%. CVP correlated with LSM-derived CVP (Spearman r = 0.53, p < 0.001). Bland-Altman analysis demonstrated a mean difference (measured CVP minus LSM-derived CVP) of 0.11 mmHg (95% confidence interval -1.31, 1.54). LSM identified clinically significant CVP elevation (>10 mmHg) with an area under the curve of 0.83. An LSM threshold >10 kPa yielded a sensitivity of 0.73 and a specificity of 0.78, correctly classifying CVP (>10 or ≤10 mmHg) in 76% of patients.CONCLUSIONSLiver stiffness measurement is a promising non-invasive surrogate for CVP in patients with HF. Future studies are warranted to validate these findings and to assess the role of LSM for the screening, diagnosis, monitoring, and prognostic stratification of patients with HF.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"10 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295660","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 ‘Guideline-directed medical therapy for heart failure in arrhythmia-induced cardiomyopathy with improved left ventricular ejection fraction’","authors":"Philipp Bengel, Samuel Sossalla","doi":"10.1002/ejhf.3712","DOIUrl":"https://doi.org/10.1002/ejhf.3712","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"37 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260765","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 'Minimization or withdrawal of oral pharmacotherapy in chronic heart failure patients with improved myocardial function: A systematic review'.","authors":"Jiaying Ding, Jun Li, Yaling Li","doi":"10.1002/ejhf.3717","DOIUrl":"https://doi.org/10.1002/ejhf.3717","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264877","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 the letter regarding the article 'Association between liver fibrosis, plasma volume status, and cardiovascular mortality: The Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases'.","authors":"Nobuo Sasaki, Yukiko Nakano, Yukihito Higashi","doi":"10.1002/ejhf.3721","DOIUrl":"https://doi.org/10.1002/ejhf.3721","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264878","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}