European Journal of Heart Failure最新文献

{"title":"Lower extremity lymphatic flow is associated with diuretic response in acute heart failure","authors":"Barbara Ponikowska, Robert Zymliński, Marat Fudim, Beata Ponikowska, Gracjan Iwanek, Mateusz Guzik, Jan Biegus","doi":"10.1002/ejhf.3655","DOIUrl":"https://doi.org/10.1002/ejhf.3655","url":null,"abstract":"AimsThe dysfunctional lymphatic system appears to play an important role in the development and progression of congestion in heart failure. We hypothesized that in acute heart failure (AHF), diuretic efficacy is associated with peripheral lymph flow.Methods and resultsWe prospectively studied AHF patients who received protocolized diuretics followed by assessment of lower limb flow using indocyanine green lymphangiography (a validated method for visualization of lymphatic drainage). The lymph flow was defined as ‘present’ when it reached the ankle and ‘significant’ when it reached &gt;10 cm within 10 min of dye injection, respectively. Based on diuretic efficacy (defined as cumulative diuresis and weight loss), patients were classified as diuretic responders vs. non‐responders. Overall, 65 patients (mean age: 67 ± 15 years, median [Q1–Q3] N‐terminal pro‐B‐type natriuretic peptide: 6901 [4478–12 723] pg/ml) were examined. There were 43 (66%) diuretic responders and 22 (34%) non‐responders who did not differ in baseline clinical/laboratory characteristics. Among the responders, there were more patients with lymph flow either ‘present’ or ‘significant’ (95% vs. 73% and 88% vs. 45% vs non‐responders, respectively, <jats:italic>p</jats:italic> &lt; 0.01). Responders had significantly longer median distance lymph reached within 10 min (50 [24–75] vs. 10 [3–38] cm; <jats:italic>p</jats:italic> &lt; 0.0005). There was a significant association between lymph flow and 6‐h diuresis with <jats:italic>β</jats:italic> (standard error) of 0.45 (0.13) (<jats:italic>p</jats:italic> &lt; 0.005). In the multivariable analyses, lymph flow distance (odds ratio 1.48, 95% confidence interval 1.08–2.03) independently predicted diuretic efficacy (<jats:italic>p</jats:italic> &lt; 0.05).ConclusionFor the first time, faster lower limb lymph flow was linked with better diuretic efficacy in AHF. Studies are needed to determine whether the lymphatic system can become a therapeutic target for decongestion.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"94 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797867","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":"Peroxiredoxin‐4, a marker of systemic oxidative stress, is associated with incident heart failure","authors":"Navin Suthahar, Sanne G.J. Mourmans, Anouk Achten, Joseph Pierre Aboumsallem, Wouter C. Meijers, Nils Bomer, Isabella Kardys, Ron T. Gansevoort, Stephan J.L. Bakker, Jerremy Weerts, Etto C. Eringa, Kevin Damman, Vanessa van Empel, Rudolf A. de Boer","doi":"10.1002/ejhf.3653","DOIUrl":"https://doi.org/10.1002/ejhf.3653","url":null,"abstract":"AimsOxidative stress is known to be involved in the pathophysiology of heart failure (HF). To assess oxidative stress, direct quantification of reactive oxygen species would be ideal but this is not feasible due to their short half‐lives. Antioxidant enzymes such as peroxiredoxins, produced as a direct response to oxidative stress, mirror the process and can be more easily quantified. The aim of this study was to examine whether circulating peroxiredoxin‐4 (Prx4), a marker of systemic oxidative stress, associates with incident HF and its subtypes.Methods and resultsWe included a total of 8199 individuals from the Prevention of REnal and Vascular End‐stage Disease (PREVEND) community‐based cohort (mean age: 49.8 years; 50.1% women). During a median follow‐up of 12.6 years, 349 (4.3%) HF events occurred of which 118 (33.8%) had HF with preserved ejection fraction. In a Cox proportional hazards model adjusting for age, sex, smoking, diabetes, hypertension, obesity, total and high‐density lipoprotein cholesterol, cholesterol‐lowering medication and renal disease, Prx4 was significantly associated with incident HF (hazard ratio [HR] per 1 standard deviation increase in log‐Prx4: 1.22; 95% confidence interval [CI] 1.09–1.36; <jats:italic>p</jats:italic> &lt; 0.001). Among HF subtypes, Prx4 remained associated with incident HF with preserved (HR 1.27; 95% CI 1.05–1.53) as well as reduced ejection fraction (HR 1.19; 95% CI 1.04–1.37), with no significant difference between the subtypes (<jats:italic>p</jats:italic> = 0.64).ConclusionCirculating Prx4 associates with the risk of developing HF, both with preserved and reduced ejection fraction. Future studies should examine whether Prx4 can serve as a real‐time marker of oxidative stress status.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"34 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789853","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":"Cardiac implantable electronic and other monitoring devices in continuous-flow left ventricular assist device patients. A clinical consensus statement of the Heart Failure Association and the European Heart Rhythm Association of the ESC","authors":"Offer Amir, Stamatis Adamopoulos, Haran Burri, Antoni Bayes-Genis, Christophe Leclercq, Maja Cikes, Anastasia Egorova, Petr Peichl, Marat Fudim, Archana Rao, Finn Gustafsson, Sergio Richter, Matteo Pagnesi, Giuseppe Rosano, Frank Ruschitzka, Jens Cosedis Nielsen","doi":"10.1002/ejhf.3635","DOIUrl":"https://doi.org/10.1002/ejhf.3635","url":null,"abstract":"The management of heart failure patients with continuous-flow left ventricular assist device (LVAD) patients is challenging. While one third of these patients are recipients of cardiac implantable electronic devices (CIEDs), the risk for atrial and ventricular arrhythmias may coexist.\u0000The lack of large datasets and dedicated randomized controlled trials (RCTs) focusing on LVAD and CIED implantation and management has brought medical centres to develop their own protocols and guidelines.\u0000This clinical consensus statement of the Heart Failure Association and the European Heart Rhythm Association of the ESC is a joint effort to summarize the current literature and provide advice on patient management within this field.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"75 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758151","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":"What's new in heart failure? March 2025","authors":"Julian Hoevelmann,&nbsp;Philipp Markwirth,&nbsp;Mert Tokcan,&nbsp;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":"&lt;p&gt;Resting heart rate is a strong predictor of cardiovascular (CV) mortality and morbidity in patients with heart failure (HF).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; 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.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; 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.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; 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.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; 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.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; 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.&lt;/p&gt;\u0000&lt;p&gt;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.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; 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% (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001), primarily driven by reduced hospital admissions for worsening HF (HR 0.74, 95% confidence interval [CI] 0.66–0.83; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001).&lt;/p&gt;\u0000&lt;p&gt;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.&lt;span&gt;&lt;sup&gt;5, 7&lt;/sup&gt;&lt;/span&gt; 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,&nbsp;Luca Baldetti,&nbsp;Anna Mara Scandroglio","doi":"10.1002/ejhf.3629","DOIUrl":"10.1002/ejhf.3629","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 4","pages":"656-658"},"PeriodicalIF":16.9,"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}