European Journal of Heart Failure最新文献

{"title":"Kidney function decline, heart failure hospitalization, and the effect of empagliflozin in heart failure: an EMPEROR-pooled analysis","authors":"Masatake Kobayashi,Kevin Duarte,Guillaume Baudry,João Pedro Ferreira,Luca Monzo,Javed Butler,Faiez Zannad,Nicolas Girerd","doi":"10.1093/ejhf/xuag295","DOIUrl":"https://doi.org/10.1093/ejhf/xuag295","url":null,"abstract":"Abstract Background Kidney function decline in heart failure (HF) may accelerate during periods surrounding HF-related events, while sodium-glucose cotransporter 2 inhibitors slow kidney function decline. However, the temporal relationship between kidney function changes, HF-related events, and treatment effects has not been well characterized. Aims We aimed to explore kidney function trajectories around HF-related events and to assess whether empagliflozin modifies these changes. Methods and results In a pooled analysis of the EMPEROR-Reduced and EMPEROR-Preserved trials, we examined longitudinal changes in estimated glomerular filtration rate (eGFR) before and after HF-related events, defined as HF hospitalization or HF-related death. In the EMPEROR-Pooled analysis, HF-related events occurred in 12.7% of 9554 patients during a median follow-up of 20.9 months (14.7–28.6). Patients who experienced HF-related events had a steeper eGFR decline during the 12 months before the event than those without HF-related events: average −5.01 ml/min/1.73 m2/year vs −1.93 ml/min/1.73 m2/year; P < .001. During the 12 months after HF-related events, eGFR decline persisted at an average rate of −4.73 ml/min/1.73 m2/year. These trajectories were not materially altered after adjustment for concurrent NYHA class or natriuretic peptide levels. Compared with placebo, empagliflozin slowed eGFR decline in patients without events (between-group difference, 0.94 ml/min/1.73 m2/year) and before events (1.09 ml/min/1.73 m2/year). The post-event difference was smaller (0.29 ml/min/1.73 m2/year), without significant heterogeneity across periods (P > .10). Findings were consistent across trials and irrespective of prior HF hospitalization. Conclusion Across the LVEF spectrum, kidney function decline accelerated before HF-related events and remained rapid thereafter. Empagliflozin attenuated eGFR decline without evidence of heterogeneity across periods.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"2020 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087908","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":"SAFE-EXIT HF Study: Integrating Ultrasound Congestion Assessment with Clinical Variables to Predict Outcomes After Heart Failure Hospitalization","authors":"Abel Torrelles,Mar Domingo,Elisabet Zamora,Josep Lupón,Meritxell Soler,Gregorio Romero-González,Elena Barceló,Blanca Ochoa,Ángel Caballero,Manel Maymí-Ballesteros,Rosa Vila,Guillem Guix,Xavier García-Calvo,Cristina Pacho,Cristina Tural,Júlio Núñez,Antoni Bayés-Genís","doi":"10.1093/ejhf/xuag300","DOIUrl":"https://doi.org/10.1093/ejhf/xuag300","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"26 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087912","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":"Urinary Sodium Thresholds Require a Defined Diuretic Challenge","authors":"Xiang Zhou,Hongyan Liu,Zhengdong Hua","doi":"10.1093/ejhf/xuag305","DOIUrl":"https://doi.org/10.1093/ejhf/xuag305","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"12 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149092266","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":"Revisiting dry weight in heart failure: a treatment-defined target in the era of foundational medical therapy?","authors":"Guillaume Baudry","doi":"10.1093/ejhf/xuag304","DOIUrl":"https://doi.org/10.1093/ejhf/xuag304","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"10 18 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087910","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":"Pharmacological treatment strategies to prevent heart failure across the cardiovascular-kidney-metabolic spectrum: an EJHF Expert Consensus Statement","authors":"Riccardo M Inciardi,Amr Abdin,Magdy Abdelhamid,Giuseppe Ambrosio,Michael Böhm,Antonio Cannata,Ovidiu Chioncel,Francesco Cosentino,Alberto Esteban-Fernandez,Ahmed Elsanhoury,Nicolas Girerd,Pardeep S Jhund,Felix Lindberg,Sophie Van Linthout,Carlo M Lombardi,Brendon L Neuen,John W Ostrominski,Davide Stolfo,Muthiah Vaduganathan,Scott D Solomon,Wilfried Mullens,Marco Metra,Gianluigi Savarese","doi":"10.1093/ejhf/xuag301","DOIUrl":"https://doi.org/10.1093/ejhf/xuag301","url":null,"abstract":"Abstract Heart failure (HF) remains a major cause of morbidity, mortality, and increased healthcare costs worldwide, and is recognized as the result of progressive cardiovascular–kidney–metabolic (CKM) syndrome. Obesity, type 2 diabetes, chronic kidney disease, hypertension, and atherosclerotic cardiovascular disease frequently coexist and interact through shared pathophysiological mechanisms that promote HF onset, especially with preserved ejection fraction (HFpEF). This European Journal of Heart Failure (EJHF) Expert Consensus Statement synthesizes contemporary evidence supporting pharmacological strategies to prevent HF across the CKM spectrum. Foundational therapies, including renin–angiotensin system inhibitors, sodium–glucose cotransporter 2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and incretin-based agents, demonstrate complementary benefits in reducing HF events, cardiovascular death, and chronic kidney disease (CKD) progression in high-risk populations. Early, parallel initiation of these therapies may modify disease trajectory and attenuate progression from at-risk and pre-HF stages to overt clinical HF. This document further emphasizes the need for an up-front, accelerated implementation strategy supported by structured monitoring, multidisciplinary CKM care pathways, and proactive management of laboratory abnormalities. Overcoming barriers such as clinical inertia, safety misperceptions, polypharmacy, cost constraints, and inequities in access is essential to translate evidence into population-level impact. Harmonization of prevention frameworks across cardiology, nephrology, endocrinology, and primary care societies is urgently required. Integrated, cross-disciplinary implementation of evidence-based CKM management offers a realistic opportunity to reduce incident HF and mitigate its growing global burden.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"36 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087994","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":"Determinants and associations of health-related quality of life with mortality in acute and chronic heart failure: findings from the ESC HF III Registry","authors":"Marjan Walli-Attaei,Lars H Lund,Ramon Luengo-Fernandez,Alastair Gray,Aleksandra Torbica,Radu Huculeci,Victor Aboyans,Adam D Timmis,Panos Vardas,Aldo P Maggioni,José Leal","doi":"10.1093/ejhf/xuag236","DOIUrl":"https://doi.org/10.1093/ejhf/xuag236","url":null,"abstract":"Abstract Aims To assess the demographic, clinical, behavioural, and treatment factors associated with health-related quality of life (HRQoL) in heart failure (HF), examine the association between HRQoL and mortality, and evaluate changes in HRQoL over 1-year. Methods We analysed the ESC EORP Heart Failure III Registry, including patients hospitalized with acute HF or outpatient HF visits. HRQoL was assessed using the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) questionnaire. Generalized linear models examined associations between demographic, clinical, behavioural, and treatment characteristics with baseline HRQoL. Cox proportional hazards models assessed the relationship between baseline HRQoL and 1-year mortality. Changes in HRQoL were classified as improvement, deterioration, or mixed change across EQ-5D dimensions, and determinants of change were assessed using fixed-effects models. Results Among 10 130 patients (acute HF: 38.6%; outpatient HF: 61.4%), those with acute HF had worse baseline HRQoL than outpatients. Older age, female sex, eGFR ≤29, NYHA class III/IV, and dyspnoea at rest were strongly associated with lower HRQoL in both acute and outpatient HF. Lower baseline HRQoL was associated with a higher risk of death at 1 year, with a 0.1-unit decrease in HRQoL on a scale of −0.59 to 1.00 (equivalent to 37 days of full health lost annually) associated with a 9% higher risk of death; a finding consistent across ejection fraction categories and sex. At 1-year, 45% of patients reported improved HRQoL, and improvements were more common in those with acute HF, mildly reduced ejection fraction, and women. Use of ACEi/ARBs/ARNIs was associated with a modest improvement in HRQoL at 1 year. Conclusions HRQoL provides important clinical information and may provide additional insight into patients’ health status and disease progression beyond conventional clinical measures.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"9 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149092167","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? September 2026","authors":"Renzo Laborante,Gianluigi Savarese,Carlo M Lombardi,Riccardo M Inciardi","doi":"10.1093/ejhf/xuag302","DOIUrl":"https://doi.org/10.1093/ejhf/xuag302","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"15 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087996","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":"Effectiveness of Finerenone in Slowing Chronic Kidney Disease Progression After Hospitalization for Heart Failure: A FIDELITY Subgroup Analysis.","authors":"Tariq Shafi, Stefan D Anker, Bertram Pitt, Luis M Ruilope, Peter Rossing, Meike Brinker, Katja Rohwedder, Charlie Scott, Youssef M K Farag, Gerasimos Filippatos","doi":"10.1093/ejhf/xuag299","DOIUrl":"https://doi.org/10.1093/ejhf/xuag299","url":null,"abstract":"<p><strong>Background: </strong>Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, reduces risk of heart and kidney outcomes in people with chronic kidney disease (CKD) and type 2 diabetes (T2D). Heart failure is the leading cause of hospitalization in patients with CKD. Here we evaluated whether the reduction in estimated glomerular filtration rate (eGFR) decline (CKD progression) with finerenone persists after hospitalization for heart failure (HHF).</p><p><strong>Methods and results: </strong>This post hoc analysis utilized the FIDELITY dataset pooled from the phase 3 FIDELIO-DKD (NCT02540993) and FIGARO-DKD (NCT02545049) trials, comprising adults with CKD and T2D on optimized renin-angiotensin system inhibitor treatment, randomized 1:1 to finerenone or placebo. Participants included experienced HHF between 4 months post randomization and study end. The key outcome was change in chronic eGFR slope (eGFR estimated from serum creatinine) before and after HHF. To avoid confounding from serum creatinine changes preceding and following HHF, eGFR values ±90 (primary analysis), ±120, and ±150 days from HHF were excluded. Baseline characteristics, medications, and mean hospital stay length were generally balanced between treatment groups. For the primary analysis, both the pre-HHF and post-HHF mean change in eGFR declined slower with finerenone versus placebo (between-group difference 2.68 mL/min/1.73 m2/year [95% confidence interval [CI], 0.87 to 4.49] pre-HHF and 0.96 mL/min/1.73 m2/year [95% CI, -0.99 to 2.91] post-HHF).</p><p><strong>Conclusion: </strong>Treatment with finerenone is associated with clinically meaningful attenuation of CKD progression in people with CKD and T2D before HHF, and persists post-HHF, suggesting that maintaining finerenone after HHF may continue to confer benefits in attenuating CKD progression.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068776","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":"Longitudinal proteomic organ-specific aging in heart failure","authors":"Kaiyong Qu,Ernest Diez Benavente,Ezgi Hatip Ünlü,Anne-Mar L N van Ommen,M Louis Handoko,Arco J Teske,Maarten Jan Cramer,Folkert W Asselbergs,Frans H Rutten,Eric Boersma,Hester M den Ruijter,N Charlotte Onland-Moret,Isabella Kardys,Elisa Dal Canto","doi":"10.1093/ejhf/xuag298","DOIUrl":"https://doi.org/10.1093/ejhf/xuag298","url":null,"abstract":"Abstract Background Heart failure (HF) is a systemic syndrome affecting multiple organs. Organ age gaps (OAGs), quantifying organ-level aging from plasma proteomics, are linked to organ-specific disease including HF but have been studied exclusively cross-sectionally. We examined how organ-specific aging evolves within individuals over the course of HF and whether it carries prognostic information beyond established HF markers. Methods We studied two complementary cohorts with repeated plasma proteomic profiling: 557 individuals including those at risk for HF, pre-HF, and newly diagnosed HF (HELPFul, mainly HFpEF)and 382 patients with established HF (Bio-SHiFT, all LVEF &amp;lt; 50%). OAGs for five organs plus a conventional clock were z-scored. Within each cohort, we modelled longitudinal OAG trajectories using linear mixed-effects models, and, in Bio-SHiFT, related OAGs to the primary endpoint using Cox models with progressive adjustment up to NT-proBNP and troponin T. Results Baseline OAGs differed across HF severity in both cohorts. Longitudinally, 50 HELPFul individuals with LVDD showed increasing artery and immune OAGs over 4.6 years. In Bio-SHiFT, event-free patients had stable trajectories, whereas those with adverse events showed sharply accelerating multi-organ aging over 2.1 years (immune β = 0.36 z-score per year, 95% CI 0.26 to 0.47; heart β = 0.29, 95% CI 0.17 to 0.40). Higher OAGs predicted the primary endpoint, and the kidney, lung, and immune OAGs remained prognostic after full adjustment including NT-proBNP and troponin T. Conclusion In this exploratory study, multi-organ aging accelerated before adverse events, and the kidney, lung, and immune OAGs predicted outcome independently of conventional severity markers, supporting a dynamic, organ-level view of HF risk that warrants confirmation in larger cohorts.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"7 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149049130","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":"Non-steroidal mineralocorticoid receptor antagonists in HFpEF/HFmrEF: does resistant hypertension matter?","authors":"Takahiro Komori,Lucas Lauder,Kazuomi Kario","doi":"10.1093/ejhf/xuag273","DOIUrl":"https://doi.org/10.1093/ejhf/xuag273","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"92 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020317","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}