European Journal of Heart Failure最新文献

{"title":"Real-life implementation of guideline-recommended medical therapy in heart failure with reduced ejection fraction: Effects on prognosis and left ventricular ejection fraction. Primary results of TITRATE-HF.","authors":"Jishnu Malgie, Mariëlle I Wilde, Stefan Koudstaal, Robert Denham, Carlos A da Fonseca, Henk P Swart, Clara E E van Ofwegen, Ayten Yilmaz, Ron Pisters, Gerard C M Linssen, Nikola Faber, Loek van Heerebeek, Julio E C van de Swaluw, Rudolf A de Boer, Hans-Peter Brunner-La Rocca, Jasper J Brugts","doi":"10.1002/ejhf.70006","DOIUrl":"https://doi.org/10.1002/ejhf.70006","url":null,"abstract":"<p><strong>Aims: </strong>Guideline-recommended medical therapy (GRMT) improves outcomes in heart failure (HF) with reduced ejection fraction (HFrEF), yet implementation remains suboptimal. TITRATE-HF prospectively evaluated GRMT implementation across different HFrEF stages, and its effect on 1-year prognosis and left ventricular ejection fraction (LVEF).</p><p><strong>Methods and results: </strong>TITRATE-HF is an observational cohort study across 48 hospitals in the Netherlands (June 2022-February 2024). A total of 4288 patients were enrolled. This primary analysis includes 12-month follow-up data of all HFrEF patients (n = 3367), stratified into de novo, chronic, and worsening HF. Longitudinal trends in GRMT prescription rates and dosages were analysed. Serial echocardiographic data assessed changes in LVEF between baseline and 12 months. Kaplan-Meier analysis assessed the composite endpoint of all-cause death or HF hospitalization. Median age was 71 years (interquartile range [IQR] 63-78), 29% were female, and 56% had non-ischaemic cardiomyopathy. In de novo HFrEF (n = 1353), quadruple therapy was 47.2% at 6 weeks, 64.7% at 3 months, 69.5% at 6 months, and 64.4% at 12 months. In chronic/worsening HFrEF (n = 1625), quadruple therapy increased from 44.6% at baseline to 54.6% at 12 months, primarily driven by greater sodium-glucose co-transporter 2 inhibitor uptake (66.0% to 78.5%). Among de novo HFrEF patients with serial echocardiograms (n = 752), median LVEF improved by 10% (IQR 3-17%) in ischaemic versus 15% (IQR 9-24%) in non-ischaemic cardiomyopathy (p < 0.001). Early quadruple GRMT initiation (within 6 weeks) and higher 6-month doses were associated with greater LVEF improvement. At 12 months, the composite endpoint occurred in 13.3%, 13.3%, and 43.8% of de novo, chronic, and worsening HFrEF patients, respectively.</p><p><strong>Conclusions: </strong>These findings highlight the importance of early and intensive GRMT implementation, and emphasize the need for continuous dose titration beyond the initial phase to improve LVEF and clinical outcomes.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843935","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":"Residual congestion defined by HFA‐ESC multiparametric criteria and 90‐day outcomes in worsening heart failure","authors":"Lucrecia María Burgos, Rocio Baro Vila, Ailin Goyeneche, Juan Pablo Costabel, Ana Spaccavento, Martín Andrés Fasan, Martin Vivas, Sebastian Ghibaudo, Marcelo Trivi, Mirta Diez","doi":"10.1002/ejhf.70004","DOIUrl":"https://doi.org/10.1002/ejhf.70004","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"39 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850916","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":"A multicentre, randomized, double-blind, active and placebo-controlled study of pecavaptan, a dual V1a/V2 vasopressin receptor antagonist, in patients with acute heart failure: The AVANTI trial.","authors":"James E Udelson,Steven R Goldsmith,Daniel Burkhoff,Pablo Colorado,Wilfried Dinh,Finn Gustafsson,Peter Kolkhof,Gerald Staedtler,Iouri Bachmakov,Adriaan A Voors,Kevin Duarte,Luca Monzo,Nicolas Girerd,Faiez Zannad","doi":"10.1002/ejhf.3801","DOIUrl":"https://doi.org/10.1002/ejhf.3801","url":null,"abstract":"AIMSBalanced dual V1a/ V2 vasopressin receptor antagonism may offer potential advantages as an adjunctive and/or a replacement therapy to loop diuretic therapy.METHODS AND RESULTSAVANTI was a double-blind, randomized trial in patients hospitalized with heart failure and residual congestion. In Part A, patients received pecavaptan or placebo as adjunctive therapy to standard of care for 30 days. In Part B, patients were randomized to continuation of furosemide or replacement by pecavaptan, as single diuretic therapies for 30 days. Co-primary endpoints were for Part A changes in weight and serum creatinine and for Part B, changes in weight and blood urea nitrogen/creatinine ratio. Among 483 patients randomized into Part A, there was no difference in weight reduction between pecavaptan and placebo (between-group difference: -0.27 kg, upper one-sided 95% confidence interval [CI] -0.29, p = 0.21) and no effect on serum creatinine (between-group difference: 0.05 mg/dl, upper one-sided 95% CI 0.12, p = 0.87). Subsequently, 286 patients were randomized into Part B. The difference in weight change between the pecavaptan and furosemide monotherapy groups over 30 days was 0.69 kg (upper one-sided 80% CI 0.95, p = 0.16), satisfying non-inferiority criteria of 1 kg. The between-group difference in log-transformed change in blood urea nitrogen/creatinine ratio was -0.22 (upper one-sided 80% CI -0.19, p < 0.0001) favouring pecavaptan. Adverse events and serious adverse events related to congestion including heart failure hospitalizations were numerically higher in the pecavaptan groups in both parts of the trial.CONCLUSIONSAdjunctive pecavaptan for 30 days in patients with residual congestion had no impact on weight loss nor on renal function. Post-discharge pecavaptan monotherapy was non-inferior to furosemide monotherapy for weight change over 30 days, but was associated with improved renal function. The increase in congestion events suggests that future trials will need optimized background diuretic dosing.CLINICAL TRIAL REGISTRATIONClinicalTrials.gov NCT03901729.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"11 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813057","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":"Rationale and design of the TRIC-I-HF-DZHK24 (TRICuspid Intervention in Heart Failure) trial.","authors":"Thomas J Stocker,Tobias Geisler,Wolfgang Rottbauer,Edith Lubos,Christian Frerker,Niklas Schofer,Johanne Frank,Ralph Stephan von Bardeleben,Tobias Kister,Rico Osteresch,Alexander Lauten,Tienush Rassaf,Jürgen Rothe,David M Leistner,Lukas Stolz,Victoria Kehl,Maria Grzeschniok,Andreas Hagendorff,Volker Rudolph,Stephan Baldus,Philipp Lurz,Steffen Massberg,Jörg Hausleiter, ","doi":"10.1002/ejhf.3795","DOIUrl":"https://doi.org/10.1002/ejhf.3795","url":null,"abstract":"AIMSTricuspid regurgitation (TR) is a detrimental disease frequently diagnosed in patients with right-sided heart failure (HF). While transcatheter tricuspid valve interventions (TTVI) effectively reduce TR and improve quality of life (QoL) in earlier stages of the disease, their effect on reducing HF hospitalizations (HFH) and improving survival remains unclear.METHODSTRIC-I-HF-DZHK24 (NCT04634266) is an investigator-initiated, prospective, randomized, open-label, multicentre strategy trial. Approximately 360 patients with severe TR and manifest right-sided HF will be enrolled. In contrast to previous trials, subjects with increased risk for HFH will be selected as facilitated by specific inclusion criteria: HFH in the previous year, or presence of cardio-renal syndrome, or evidence for cardio-hepatic syndrome. Subjects will be randomized 2:1 to TTVI and optimal medical therapy (OMT) or continuation of OMT alone. All CE-marked transcatheter repair devices including tricuspid transcatheter edge-to-edge repair (T-TEER) or transcatheter tricuspid annuloplasty can be used for TTVI. The participating 29 study sites are highly experienced and treated a mean of 176 patients in 4.5 years with T-TEER before study activation. The primary outcome will be assessed at 1 year. First, a composite of all-cause mortality, HFH, and QoL improvement will be tested hierarchically. If positive, the combination of hard clinical endpoints including all-cause mortality and HFH will be tested. Patients will be followed for a total of 3 years. The safety outcome comprises complications of TTVI, life-threatening bleeding and death.CONCLUSIONSThe TRIC-I-HF-DZHK24 trial will define the role of TTVI in patients with severe TR and right-sided HF.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"31 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813058","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":"Management of patients with heart failure at high risk of hyperkalaemia: The CARE-HK in HF registry.","authors":"Stephen J Greene,Andrew J Sauer,Michael Böhm,Biykem Bozkurt,Javed Butler,John G F Cleland,Andrew J S Coats,Nihar R Desai,Diederick E Grobbee,Ellie Kelepouris,Fausto Pinto,Giuseppe Rosano,Victoria Donachie,Solenn Fabien,Sandra Waechter,Maria G Crespo-Leiro,Martin Hülsmann,Tibor Kempf,Otmar Pfister,Anne-Catherine Pouleur,Manish Saxena,Martin Schulz,Maurizio Volterrani,Stefan D Anker,Mikhail N Kosiborod","doi":"10.1002/ejhf.3800","DOIUrl":"https://doi.org/10.1002/ejhf.3800","url":null,"abstract":"AIMSPatients with heart failure (HF) at high risk for hyperkalaemia are underrepresented in prospective HF registries. The CARE-HK in HF registry sought to characterize prospectively the clinical profile, management, and outcomes for patients with HF at high risk of hyperkalaemia.METHODS AND RESULTSCARE-HK in HF was a multinational prospective registry of outpatients with HF (regardless of left ventricular ejection fraction [LVEF]) treated with an angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker/angiotensin receptor-neprilysin inhibitor (ACEI/ARB/ARNI) and either receiving or potential candidate for a mineralocorticoid receptor antagonist (MRA). All patients were at increased risk of hyperkalaemia, defined as hyperkalaemia at baseline, prior hyperkalaemia, or estimated glomerular filtration rate (eGFR) <45 ml/min/1.73 m2. Outcomes included frequency of hyperkalaemic events (defined by clinician report with associated potassium value), achievement of renin-angiotensin system inhibitor (RASi) optimization (defined as ≥50% target doses for ACEI/ARB/ARNI and MRA), medication changes following hyperkalaemic episodes, and clinical events. Overall, 2558 patients from 111 sites across nine countries were included. Median (25th-75th) age was 73 (65-80) years, 32% were women, 61% had LVEF ≤40%, and 40% had prior laboratory evidence of hyperkalaemia. Median baseline eGFR and serum potassium were 44 (33-60) ml/min/1.73 m2 and 5.0 (4.4-5.3) mEq/L, respectively. Over a median follow-up of 12.3 (9.4-18.1) months, 29% of patients had a hyperkalaemic event, and 7% had multiple events. In characterizing treatment prescribed for most of follow-up, 29% of patients received optimal RASi/MRA therapy, 69% received suboptimal RASi/MRA therapy, and 3% received no RASi/MRA. In the 30 days following the first hyperkalaemic event, RASi/MRA was down-titrated or discontinued in 3.6% of cases. Potassium binder use was low (patiromer 9.1%, sodium zirconium cyclosilicate 5.9%). Compared with patients without a hyperkalaemic event, patients experiencing a hyperkalaemic event had similar risk of all-cause mortality (hazard ratio [HR] 1.22, 95% confidence interval [CI] 0.92-1.62, p = 0.16) and a higher risk of subsequent hospitalization (HR 1.59, 95% CI 1.35-1.86, p < 0.001).CONCLUSIONSIn this contemporary multinational prospective registry of patients with HF at high risk for hyperkalaemia, hyperkalaemic events were common but infrequently associated with RASi/MRA modification or potassium binder use. Fewer than one in three patients received optimal RASi/MRA therapy for the majority of follow-up, and hyperkalaemic events were associated with higher risk of adverse clinical outcomes.CLINICAL TRIAL REGISTRATIONClinicalTrials.gov NCT04864795.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"52 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812871","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":"Exercise haemodynamics in pulmonary hypertension - a prospective pressure-volume loop study on right ventricular adaptation and prognosis.","authors":"Bruno R Thal,Zvonimir A Rako,Nils C Kremer,Athiththan Yogeswaran,Patrick Janetzko,Selin Yildiz,Stephan Rosenkranz,Hossein Ardeschir Ghofrani,Werner Seeger,Friedrich Grimminger,Khodr Tello","doi":"10.1002/ejhf.3802","DOIUrl":"https://doi.org/10.1002/ejhf.3802","url":null,"abstract":"AIMSThe haemodynamic response to exercise is prognostic in pulmonary hypertension (PH). However, little is known about right ventricular (RV) adaptation in this context. We analysed the patterns and prognostic relevance of RV adaptation to exercise in PH.METHODS AND RESULTSWe prospectively analysed 46 patients with PH and 19 disease controls with invasive exclusion of PH. All underwent three-dimensional echocardiography, pressure-volume catheterization, and right heart catheterization at rest and during stepwise exercise on a semi-supine ergometer. Patients with PH were classified as homeometric if they had increased RV end-systolic elastance and preserved RV-pulmonary arterial coupling (end-systolic/arterial elastance) during exercise (18 patients); otherwise, they were classified as heterometric (28 patients). The mean pulmonary arterial pressure/cardiac output (mPAP/CO) slope was similar in the homeometric and heterometric groups (8.8 [6.5-13.1] vs. 8.6 [4.8-18.8] mmHg·min/L), and lower in disease controls (2.1 [1.1-4.0] mmHg/L). Multivariable logistic regression identified systolic pulmonary arterial pressure change during exercise (ΔsPAP) (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-0.99; p = 0.019) and peak exercise cardiac index (OR 0.42, 95% CI 0.18-0.97; p = 0.042) as key differentiators of homeometric/heterometric adaptation. Heterometric adaptation was significantly associated with clinical worsening and all-cause mortality (log-rank p = 0.0006 and p = 0.0246, respectively) and independently predicted clinical worsening (hazard ratio [HR] 6.52, 95% CI 2.16-19.63; p = 0.001); the HR for all-cause mortality was 6.96 (95% CI 0.87-55.66; p = 0.067).CONCLUSIONSPulmonary hypertension can present with two RV patterns under stress: homeometric with increased contractile reserve and heterometric with poorer outcome. While the mPAP/CO slope does not differentiate the two, ΔsPAP and peak cardiac index offer potential for RV adaptation pattern identification and thus prognostication.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791938","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":"Association between antecedent myocardial infarction and heart failure with preserved versus reduced ejection fraction","authors":"Mohammad A. Almesned, Bart J. van Essen, Johanna. E. Emmens, Jasper Tromp, Marcelle D. Smit, Christiane A. Geluk, Ron T. Gansevoort, Stephan. J.L. Bakker, Kevin Damman, Rudolf A. de Boer, Dirk J. van Veldhuisen, Adriaan A. Voors, Erik Lipsic","doi":"10.1002/ejhf.3788","DOIUrl":"https://doi.org/10.1002/ejhf.3788","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"6 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792299","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":"Clonal haematopoiesis of indeterminate potential is associated with progression of aortic valve stenosis","authors":"Raúl Nicolas Jamin, Jasmin Shamekhi, Tobias Zeus, Victor Mauri, Muntadher Al Zaidi, Benedikt Bartsch, Ansgar Ackerschott, Georg Nickenig, Eicke Latz, Sebastian Zimmer, Baravan Al‐Kassou","doi":"10.1002/ejhf.70000","DOIUrl":"https://doi.org/10.1002/ejhf.70000","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"31 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786534","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 and echocardiographic phenotype of cardiac wasting in patients with advanced cancer.","authors":"Markus S Anker,Muhammad Shahzeb Khan,Anja Nikolski,Jan Porthun,Muhammad Sameer Arshad,Sara Hadzibegovic,Alessia Lena,Lucie Kretzler,Jonathan L Hella,Marco Witkowski,Kathrin Rieger,Johann Ahn,Dominik P Modest,Ulrich Keller,Lars Bullinger,Matthias Totzeck,Amir A Mahabadi,Tienush Rassaf,Nikolaus Buchmann,Philipp Attanasio,Tanja Zeller,Mahir Karakas,Carlo G Tocchetti,Ursula Wilkenshoff,John G F Cleland,Stephan von Haehling,Javed Butler,Ulf Landmesser","doi":"10.1002/ejhf.3744","DOIUrl":"https://doi.org/10.1002/ejhf.3744","url":null,"abstract":"AIMSCardiac wasting-associated cardiomyopathy in patients with advanced cancer is characterized by loss of left ventricular (LV) mass and independently associated with poor prognosis. Better understanding of this very prevalent cardiomyopathy is urgently needed.METHODS AND RESULTSOverall, 398 patients with active, mostly advanced cancer without significant cardiovascular disease (mean LV ejection fraction [LVEF] 64.3 ± 0.2%) or active infection were prospectively examined (mean age 60 ± 1 years, 50% women, body mass index 25.0 ± 0.2 kg/m2, 26% cachectic). Patients were categorized and compared by quartiles of LV mass/height2. LVEF, global longitudinal strain (GLS), and anticancer therapy naive status were similar across quartiles. Patients in Q1 (lowest LV mass quartile) were younger, more likely cachectic, had lower: BMI, 10-step stair-climbing power, tricuspid annular plane systolic excursion (TAPSE), stroke volume, cardiac output, and higher heart rate. In repeat follow-up assessments after 140 ± 8 days (n = 143), LVEF, TAPSE, LV mass, left atrial volume, and GLS were found reduced (all p ≤ 0.002). Only in those with above-median LV mass at baseline, cardiac output and heart rate increased during follow-up - in those with below-median LV mass, mitral E/A decreased.CONCLUSIONSPatients with advanced cancer with low LV mass have a distinct phenotype characterized by lower cardiac chamber volumes, stroke volume, and cardiac output, but normal LVEF and GLS that may be the distinct feature of cardiac wasting-associated cardiomyopathy.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"31 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787426","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":"Atrial cardiomyopathy: From healthy atria to atrial failure. A clinical consensus statement of the Heart Failure Association of the ESC","authors":"Jerremy Weerts, Otilia Țica, Julia Aranyo, Christian Basile, Angelina Borizanova‐Petkova, Josip Andjelo Borovac, Massimiliano Camilli, Martin Eichenlaub, Emiliano Fiori, Tim Van Loon, Coenraad Withaar, Diana Zakarkaitė, Matthias D. Zink, Marianna Adamo, Alberto Aimo, Elena Arbelo, Felipe Bisbal Van Bylen, Dimitrios T. Farmakis, Dobromir Dobrev, Jelena Čelutkienė, Michael Böhm, Andrew Coats, Marco Metra, Giuseppe Rosano, Frank Ruschitzka, Antoni Bayes‐Genis, Dipak Kotecha","doi":"10.1002/ejhf.3782","DOIUrl":"https://doi.org/10.1002/ejhf.3782","url":null,"abstract":"The importance of atrial cardiomyopathy (AtCM) as a specific clinical entity is increasingly recognized. Past definitions have varied, and the lack of consistent cut‐offs for imaging parameters and biomarkers have limited clinical utility to diagnose and track AtCM progression. While research has mainly focused on AtCM in the context of atrial fibrillation, emerging evidence underscores its relevance in remodelling and development of heart failure. The aim of this consensus document was to provide a contemporary framework for AtCM, evolve the definitions of AtCM and atrial failure for more widespread clinical use, and help to direct emerging research and future clinical trials. Supporting the work of early career researchers, this consensus document evaluates diagnostic markers and summarizes the underpinning mechanisms, clinical characteristics and prognostic impact of AtCM. Our objective was to bring together new translational scientific progress, catalyse future research and enable clinical application to facilitate better management, for example in patient groups where aggressive control of risk factors or comorbidities could prevent AtCM progression. We redefined AtCM as a graded disorder that includes electrical dysfunction of the atria along with evidence of either mechanical atrial dysfunction, atrial enlargement and/or atrial fibrosis. Atrial failure is the end‐stage manifestation of AtCM, characterized by progressive structural, electrophysiological and functional changes. Earlier identification, risk stratification and ongoing research into therapeutic options have the potential to prevent the clinical consequences of AtCM and atrial failure, including adverse patient outcomes and poor quality of life associated with atrial fibrillation and heart failure.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"6 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786532","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}