European Journal of Heart Failure最新文献

{"title":"The efficacy and safety of qiliqiangxin according to baseline ejection fraction in patients with heart failure and reduced ejection fraction in QUEST.","authors":"Li Shen, Liwen Shen, Iokfai Cheang, Wenming Yao, Xu Zhu, Yue Zhang, Ying Yang, Qilin Li, Haifeng Zhang, Mark C Petrie, Carolyn S P Lam, Pardeep S Jhund, John J V McMurray, Xinli Li","doi":"10.1093/ejhf/xuaf017","DOIUrl":"10.1093/ejhf/xuaf017","url":null,"abstract":"<p><strong>Aims: </strong>Qiliqiangxin (QLQX), a Chinese traditional medicine, improved outcomes in patients with heart failure and reduced ejection fraction (HFrEF) when added to guideline-directed therapy. As treatment effects in heart failure (HF) may vary with left ventricular ejection fraction (LVEF), this post hoc analysis of the QUEST (Qiliqiangxin in Heart Failure: Assessment of Reduction in Mortality) trial examined whether baseline LVEF modified the efficacy and safety of QLQX.</p><p><strong>Methods: </strong>QUEST randomized 3110 patients with symptomatic HF and LVEF ≤40%. The primary outcome was cardiovascular death or first HF hospitalization. Baseline LVEF was categorized as ≤25% (n = 482), >25-30% (n = 692), >30-35% (n = 829), and >35% (n = 1107).</p><p><strong>Results: </strong>Mean LVEF was 32% (median 33%, interquartile range 28%-37%). Patients with LVEF ≤25% had the highest rate of the primary outcome (25.4 per 100 patient-years), while rates were similar across higher LVEF groups (18.7-19.8). After multivariable adjustment, lower LVEF was independently associated with higher risks of the primary outcome and mortality. The effect of QLQX on the primary outcome was consistent across LVEF categories (hazard ratio [95% CI] from the lowest to highest: 0.91 [0.64-1.30], 0.65 [0.47-0.89], 0.94 [0.71-1.26], and 0.71 [0.55-0.91], respectively; Pinteraction = .28), and as a continuous variable (Pinteraction = .45). Similar results were observed for individual components and total HF hospitalizations (all Pinteraction > .10). The safety of QLQX was also consistent across LVEF categories.</p><p><strong>Conclusion: </strong>In patients with HFrEF, lower LVEF was associated with worse cardiovascular outcomes. QLQX reduced cardiovascular events consistently across the range of LVEF examined in QUEST, despite the limited use of sodium-glucose co-transporter 2 inhibitors.</p><p><strong>Chictr registration: </strong>ChiCTR1900021929.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"45-57"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343168","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":"Response to Letter EURJHF-25-1455.","authors":"Jörn M Schattenberg, Julian Chalabi, Yvonne Huber, Thomas Köck, Philipp Wild","doi":"10.1093/ejhf/xuaf014","DOIUrl":"10.1093/ejhf/xuaf014","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"153-154"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343257","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":"From Mechanics to Mitochondria: Dyssynchronous Heart Failure as an Energetic Disease.","authors":"Felix Hohendanner, Ajay M Shah, Sophie Van Linthout","doi":"10.1093/ejhf/xuag135","DOIUrl":"https://doi.org/10.1093/ejhf/xuag135","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808941","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":"Congestion in acute heart failure: a moving target in transition.","authors":"Amina Rakisheva, Jan Biegus, Ovidiu Chioncel","doi":"10.1093/ejhf/xuaf013","DOIUrl":"10.1093/ejhf/xuaf013","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"118-120"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343115","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":"Magnitude of and outcome associated with inappropriate prescribing in heart failure with reduced ejection fraction: an analysis of 50 348 patients from the Swedish Heart Failure Registry.","authors":"Seif El-Hadidi, Felix Lindberg, Lina Benson, Alicia Uijl, Davide Stolfo, Peter G M Mol, Raffaele Scorza, Carin Corovic Cabrera, Amr Abdin, Giuseppe M C Rosano, Gianluigi Savarese","doi":"10.1093/ejhf/xuaf026","DOIUrl":"10.1093/ejhf/xuaf026","url":null,"abstract":"<p><strong>Aims: </strong>Patients with heart failure and reduced ejection fraction (HFrEF) are frequently exposed to polypharmacy, placing them at risk of potentially inappropriate prescribing (PIP)-defined as use of drugs that may worsen HF prognosis, counteract guideline-directed medical therapies (GDMTs), or increase harmful interactions. The prevalence, predictors, and prognostic impact of PIP in HFrEF remain unclear. Therefore, the aim was to investigate the prevalence, predictors, and outcomes of PIP in a large, real-world HFrEF population.</p><p><strong>Methods: </strong>Patients with HFrEF enrolled in the Swedish HF Registry (2005-20) were included. The European Society of Cardiology position statement of PIP-HFrEF was used to retrieve PIP from the National Prescribed Drugs Register. Associations between PIP and outcomes were assessed using Cox proportional hazards and negative binomial regression for recurrent events.</p><p><strong>Results: </strong>Among 50 348 patients (median age 75 years, 29% female), 23 583 (47%) were prescribed ≥1 PIP. The most frequent agents were neuroleptics (29%), systemic steroids (10%), and NSAIDs (6%). Independent predictors included rheumatoid arthritis [odds ratio (OR) 3.39; 95% CI, 2.92-3.94], depression (OR 3.06; 95% CI, 2.74-3.42), chronic obstructive pulmonary disease (OR 1.86; 95% CI, 1.76-1.98), and gout (OR 1.48; 95% CI, 1.35-1.62). Patients on PIP were less likely to receive GDMT. Presence of ≥1 PIP was independently associated with increased 3-year risk of HF death (HR, 1.13; 95% CI, 1.04-1.23), all-cause and cardiovascular death, first and recurrent HF hospitalizations.</p><p><strong>Conclusion: </strong>Nearly half of HFrEF patients received PIP medications, particularly those with multimorbidity, which was independently associated with worse outcomes and less GDMT use. Our data underscore the need for targeted strategies to reduce inappropriate prescribing in HFrEF.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"58-69"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343086","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":"Interpreting tafamidis effectiveness within the evolving phenotype of contemporary ATTRwt cardiomyopathy.","authors":"Zhang Liu, Weiqin Huang","doi":"10.1093/ejhf/xuag020","DOIUrl":"10.1093/ejhf/xuag020","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"111-112"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343116","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 to reduce heart failure hospitalization: a systematic review and meta-analysis.","authors":"Karina V Bunting, Otilia Tica, Asgher Champsi, Madeleine Perrett, Thomas G von Lueder, Dirk J van Veldhuisen, Marcus D Flather, Dipak Kotecha","doi":"10.1093/ejhf/xuaf012","DOIUrl":"10.1093/ejhf/xuaf012","url":null,"abstract":"<p><strong>Aims: </strong>Anaemia is common in patients with chronic heart failure (CHF), worsening functional status and prognosis. The role of erythropoiesis-stimulating agents (ESAs) to reduce hospitalization remains unclear.</p><p><strong>Methods and results: </strong>A pre-registered systematic search was performed of randomized controlled trials in adults with CHF and anaemia, comparing any ESA at any dose versus placebo or no treatment.Fourteen trials were included with 3128 participants, with moderate quality of evidence for most outcomes and variable risk of bias. Meta-analysis during 5604 person-years of follow-up demonstrated no significant difference in first CHF hospitalization comparing ESAs with control: Peto odds ratio (OR) 0.93, 95% CI 0.78-1.10, P = .37; trial heterogeneity I2 = 36%. ESAs significantly reduced total CHF hospitalization with 622 events/2698 person-years, compared with 761/2914 person-years for control: incidence rate ratio 0.81, 95% CI 0.73 to 0.90, P < .001; no heterogeneity between trials, I2 = 0%. There were no significant differences between treatment groups for all-cause mortality (OR 1.01, 95% CI 0.86-1.18, P = .88; I2 = 35%) or incident adverse events. Patients randomized to ESAs increased their haemoglobin level [mean difference (MD) 1.6 g/dL compared with control, 95% CI 1.6-1.7, P < .001] and exercise tolerance (MD 69 metres, 95% CI 17-122, P = .009), with lower NYHA class on follow-up (MD -0.73 class, 95% CI -1.11 to -0.36, P < .001).</p><p><strong>Conclusion: </strong>ESA treatment in patients with CHF and mild anaemia can reduce recurrent CHF hospitalization and improve functional capacity, without any impact on adverse events. Including ESAs in CHF management could be considered in patients with anaemia at high risk of recurrent hospital admissions.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"85-95"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343093","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":"Short and long-term prognosis of hospitalization for dyspnoea based on aetiology and hospitalization ward: insights from the PARADISE cohort.","authors":"Guillaume Baudry, Claire Lacomblez, Emmanuel Bresso, Luca Monzo, Alexandre Mebazaa, Kevin Duarte, Déborah Jaeger, Adrien Bassand, Aurélien Buessler, Gaetan Giacomin, Charlène Duchanois, Torgny Wessman, Faiez Zannad, Tahar Chouihed, Nicolas Girerd","doi":"10.1093/ejhf/xuaf027","DOIUrl":"10.1093/ejhf/xuaf027","url":null,"abstract":"<p><strong>Aims: </strong>Dyspnoea accounts for nearly 5% of emergency department (ED) visits. Our aim was to describe the in-hospital and long-term outcomes of patients admitted to the ED for dyspnoea, based on their underlying aetiology, and to determine if prognosis varies according to the hospitalization setting.</p><p><strong>Methods: </strong>We analyzed 18 903 consecutive patients (48% male, average age 73 years) hospitalized after an ED visit for dyspnoea from January 2010 to December 2019, as part of the PARADISE cohort (PAthwAy of Dyspneic patIent in Emergency-NCT02800122). Dyspnoea causes were classified as acute heart failure (AHF), respiratory infection (RI), chronic obstructive pulmonary disease (COPD), pulmonary embolism (PE), or asthma.</p><p><strong>Results: </strong>RI (30%), AHF (28%), and COPD (13%) were the predominant discharge diagnoses. In-hospital mortality stood at 12% overall, ranging from 1.1% in asthma to 15% in AHF and RI. Five-year all-cause mortality for patients discharged alive was 75% in AHF, 66% in RI, 62% in COPD, 37% in PE, and 26% in asthma. Hospitalization in specialized wards was associated with significantly reduced in-hospital mortality across all aetiologies, and with a decreased long-term mortality for RI and AHF (adjusted-HR 0.90, 95% CI 0.82-0.99, P = 0.02 for RI and adjusted-HR 0.90, 95% CI 0.82-0.99, P = 0.03 for AHF).</p><p><strong>Conclusion: </strong>Patients hospitalized for dyspnoea face a high-risk of mortality both in-hospital and post-discharge. In view of the strikingly high mortality in dyspneic patients and the potential benefits of specialized management, our study calls for rapidly setting up personalized in-hospital and post-discharge dyspnoea pathways.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"130-140"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343084","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":"Comment on 'incidence of major cardiovascular events in patients with metabolic dysfunction-associated steatotic liver disease in the general population'.","authors":"Qian Zhang, Mingyue Xiao, Wendi Liu, Yue Zhao","doi":"10.1093/ejhf/xuaf006","DOIUrl":"10.1093/ejhf/xuaf006","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"151-152"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343142","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":"When a single ratio illuminates the grey zone: the prognostic value of neutrophil-to-lymphocyte ratio across the cardiovascular spectrum.","authors":"Massimo Mapelli, Elisabetta Salvioni, Jeness Campodonico, Piergiuseppe Agostoni","doi":"10.1093/ejhf/xuaf029","DOIUrl":"10.1093/ejhf/xuaf029","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"155-156"},"PeriodicalIF":10.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343174","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}