European Journal of Heart Failure最新文献

{"title":"Cost-effectiveness of digitoxin in heart failure with reduced ejection fraction in the European Union and the United States.","authors":"Priyanka Boettger, Anika Großhennig, Stefan Störk, Dominik Berliner, Johannes Schwab, Andreas Rieth, Lars Maier, Martin Huelsmann, Heiko von der Leyen, Christian Veltmann, Michael Böhm, Armin Koch, Samuel Sossalla, Johann Bauersachs, Udo Bavendiek","doi":"10.1093/ejhf/xuag270","DOIUrl":"https://doi.org/10.1093/ejhf/xuag270","url":null,"abstract":"<p><strong>Aims: </strong>Digitoxin reduced the composite of death or worsening heart failure in DIGIT-HF, but whether these benefits translate into economic value remains unknown. We assessed its cost-effectiveness as add-on therapy for heart failure with reduced ejection fraction (HFrEF) across all 27 European Union Member States (EU-27) and the United States (US).</p><p><strong>Methods: </strong>We developed a DIGIT-HF-informed, multi-jurisdictional three-state Markov cost-utility model projecting 10-year and lifetime outcomes. Clinical risks and intention-to-treat effects were held constant; hospitalization costs, EQ-5D-5L utilities, digitoxin costs, discounting, and willingness-to-pay (WTP) thresholds varied by jurisdiction. Uncertainty was assessed using 10 000 probabilistic simulations.</p><p><strong>Results: </strong>Across the EU-27, digitoxin was cost-effective at 10 years, with incremental costs of -€338 to +€25 per patient, incremental quality-adjusted life-years (QALYs) of 0.188-0.231, and a maximum incremental cost-effectiveness ratio (ICER) of €120/QALY. Over lifetime, corresponding ranges were -€79 to +€72, 0.373-0.453 QALYs, and a maximum ICER of €174/QALY. At €50 000/QALY, cost-effectiveness probability was 92%. Digitoxin was cost-saving in 24 of 27 Member States at 10 years and 10 of 27 over lifetime. In the USA, it was cost-saving (lifetime savings US$405 per patient; 0.43 QALYs; 93.4% probability of cost-effectiveness).</p><p><strong>Conclusion: </strong>Digitoxin generated clinically meaningful health benefits at negligible incremental cost and remained cost-effective across every evaluated EU-27 healthcare system and the USA. Economic value emerged earliest within the first decade and in higher-cost hospital systems, while lifetime analysis captured larger cumulative gains in quality-adjusted survival.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856772","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":"Artificial Intelligence predicted ESC 2026 Heart Failure Guidelines.","authors":"Guillaume Baudry, Javed Butler, Faiez Zannad","doi":"10.1093/ejhf/xuag281","DOIUrl":"https://doi.org/10.1093/ejhf/xuag281","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838500","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":"History of worsening heart failure and outcomes with vericiguat in ambulatory HFrEF: an exploratory post-hoc analysis of VICTOR.","authors":"Stefan Störk, Javed Butler, Caroline Morbach, Fabian Kerwagen, Johann Bauersachs, Ephraim B Winzer, Justin Ezekowitz, Carolyn S P Lam, Inga Bayh, Stefan Herrmann, Irina Barash, Faiez Zannad","doi":"10.1093/ejhf/xuag262","DOIUrl":"https://doi.org/10.1093/ejhf/xuag262","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838552","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":"Workup and management of rhythm disorders in myocarditis and inflammatory cardiomyopathy: a clinical consensus statement of the European Heart Rhythm Association and the Heart Failure Association of the ESC, the ESC Working Group on Myocardial & Pericardial Diseases, the European Association of Preventive Cardiology of the ESC, the Heart Rhythm Society, the Asian Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society.","authors":"Giovanni Peretto, Cristina Basso, Antonio Berruezo, Entela Bollano, Alida Linda Patrizia Caforio, Michela Casella, Christian De Chillou, Micaela Ebert, Sabiha Gati, Massimo Imazio, Koshiro Kanaoka, Petr Kuchynka, Enrique Asensio-Lafuente, Jose Luis Merino, Alexander Álvarez Ortiz, Antonis Pantazis, Jayasree Pillarisetti, Giuseppe Rosano, Petar M Seferović, Jacob Tfelt-Hansen, Roderick Tung, Katja Zeppenfeld, Carsten Tschöpe","doi":"10.1093/ejhf/xuag271","DOIUrl":"https://doi.org/10.1093/ejhf/xuag271","url":null,"abstract":"<p><p>Myocarditis is an important and frequently underrecognized cause of atrioventricular conduction disease and ventricular arrhythmias and may also be associated with atrial arrhythmias and sinus node dysfunction. Arrhythmic risk evolves over time as a result of the interplay between myocardial inflammation, fibrosis, and genetic predisposition. Despite its clinical relevance, guidance for the diagnosis, treatment, and follow-up of arrhythmias in myocarditis has remained limited. This consensus statement provides a structured framework for the management of arrhythmias in myocarditis and inflammatory cardiomyopathy (Infl-CMP), integrating disease phase and genetic background into clinical decision-making. It offers practical guidance across the disease spectrum, including diagnostic evaluation, therapeutic strategies, and longitudinal follow-up. The document was jointly developed by the European Heart Rhythm Association of the European Society of Cardiology (ESC) in collaboration with the Heart Failure Association of the ESC, the ESC Working Group on Myocardial & Pericardial Diseases, and the European Association of Preventive Cardiology of the ESC, together with the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society. Consensus advice is organized using a phase-aware framework distinguishing hot, hot-to-cold, and cold phases, with clinical consensus statements graded according to opinion-, observational-, or randomized trial-based evidence and supported by formal author voting. Arrhythmia management is stratified by disease phase. During active inflammation, antiarrhythmic therapy is combined with aetiology-targeted treatment or immunosuppression when indicated. In later stages, substrate-based strategies include pharmacological therapy, device implantation, or ablation. Emphasis is placed on hot-to-cold transition as an arrhythmogenic window and on risk stratification.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838517","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":"Early SGLT2 Inhibitor Initiation in Acute Heart Failure: Moving from Therapeutic Delay to Selective Early Implementation.","authors":"Binyamin Ben Avraham, Tuvia Ben Gal, Linda W van Laake","doi":"10.1093/ejhf/xuag279","DOIUrl":"https://doi.org/10.1093/ejhf/xuag279","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823812","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":"Treatment effects of dapagliflozin in patients with aortic stenosis undergoing transcatheter aortic valve implantation across left ventricular ejection fraction.","authors":"Sergio Raposeiras Roubín, Rafael Gonzalez-Manzanares, Ignacio Amat-Santos, María Melendo Viu, David Dobarro, Diego López Otero, Luis Nombela Franco, Livia Gheorge, Jorge Sanz-Sánchez, Baladrón Zorita Carlos, Soledad Ojeda, Andrés Iñiguez Romo, Antonio Jesús Muñoz García, Victoria Vilalta, Gabriela Veiga Fernández, Juan Gabriel Córdoba Soriano, Ander Regueiro, Miriam Sandín Rollán, Xacobe Flores Ríos, Aitor Uribarri, Roberto Martín Reyes, Rafael Romaguera, Pablo Avanzas, Sergio García Blas, Juan A Franco-Peláez, Javier Martín Moreiras, José Ramón Gonzalez Juanatey, Gabriela Tirado, German Calle, José Luis Díez, Sandra Santos-Martínez, Rocío González Ferreiro, Erika Muñoz García, Xavier Carrillo Suarez, Xoan Sanmartín, Nieves Gonzalo, Alejandro Gutierrez Barri, Lluis Asmarats, Felipe Díaz Del Hoyo, Santiago Camacho Freire, Geoffrey Yanes, Juan C Astorga Burgo, Eduardo Molina Navarro, Juan Caballero Borrego, Inmaculada González Bermúdez, Valentín Fuster, Borja Ibáñez","doi":"10.1093/ejhf/xuag242","DOIUrl":"https://doi.org/10.1093/ejhf/xuag242","url":null,"abstract":"<p><strong>Aims: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve outcomes in heart failure (HF) across the left ventricular ejection fraction (LVEF) spectrum, but patients with severe valvular heart disease have been excluded from pivotal trials. We investigated the efficacy and safety of dapagliflozin across the full range of baseline LVEF in elderly patients undergoing transcatheter aortic valve implantation (TAVI).</p><p><strong>Methods and results: </strong>DapaTAVI was a pragmatic, multicentre, randomized, open-label trial with blinded endpoint adjudication conducted at 39 Spanish centres. Patients with severe aortic stenosis undergoing TAVI were randomized after the procedure to dapagliflozin 10 mg once daily or standard of care. The primary endpoint was a composite of all-cause death or worsening HF. Among 1223 patients with available baseline LVEF, 213 (17.4%) had LVEF ≤40% and 1010 (82.6%) had LVEF >40%. During 1-year follow-up, the primary endpoint occurred in 20.2% of patients with LVEF ≤40% and 17.0% of those with LVEF >40% (adjusted HR 1.28, 95% CI 0.91-1.80; P = .15). Dapagliflozin reduced the risk of the primary endpoint consistently across LVEF subgroups, with no significant interaction between treatment effect and baseline LVEF (P for interaction = .41). Analyses modelling LVEF as a continuous variable confirmed a homogeneous treatment effect across the entire LVEF spectrum. Dapagliflozin was well tolerated, with a safety profile comparable to control across all LVEF categories, although genitourinary infections were more frequent with dapagliflozin.</p><p><strong>Conclusion: </strong>In elderly patients undergoing TAVI, dapagliflozin reduced the risk of all-cause death or worsening HF irrespective of baseline LVEF and was safe across the full LVEF spectrum. These findings extend the benefits of SGLT2 inhibition to patients with severe aortic stenosis treated with TAVI, independent of systolic function.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823753","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":"Artificial Intelligence and Heart Failure Guidelines: Prediction or Judgement?","authors":"Muhammad Shahzeb Khan, Andrew J S Coats, Sarah Cushman, Yann Colardelle, Stefan D Anker","doi":"10.1093/ejhf/xuag278","DOIUrl":"https://doi.org/10.1093/ejhf/xuag278","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823841","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 C-MIC II Follow-Up Study: Safety and Efficacy Results 12 months After Deactivation of Cardiac Microcurrent Therapy.","authors":"Jesus E Rame, Dragana N Kosevic, Tamara Kovacevic-Preradovic, Sasko Jovev, Marija Zdravkovic, Nermir Granov, Tanja Popov, Igor Rudez, Petar Vukovic, Velibor Ristic, Annette Holtdirk, Tim Friede, Muhammad Shahzeb Khan, Miodrag Peric, Faouzi Kallel, Marat Fudim, Stefan D Anker","doi":"10.1093/ejhf/xuag274","DOIUrl":"https://doi.org/10.1093/ejhf/xuag274","url":null,"abstract":"<p><strong>Background: </strong>The C-MIC II trial demonstrated benefits of 6 months of cardiac microcurrent (C-MIC) therapy in patients with non-ischemic heart failure with reduced ejection fraction (HFrEF). The prospective C-MIC II Follow-Up Study evaluates safety and efficacy outcomes post-device deactivation.</p><p><strong>Methods: </strong>Primary safety-related endpoints included all-cause, cardiovascular and device-related mortality and hospitalizations and adverse events (AEs). Secondary efficacy-related endpoints included changes in left ventricular ejection fraction (LVEF), Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS), 6-minute walk distance (6MWD), New York Heart Association (NYHA) class and device reactivation rate. Here, we report 12-month results comparing the 6-month time-point (at the end of active therapy) with the 18-month time-point (12 months post-deactivation).</p><p><strong>Results: </strong>Of 32 eligible patients, 31 (97%) were enrolled. At 12 months post-device deactivation, 3 patients (10%) were hospitalized and 1 died (3%); none were device-related. One device-related AE occurred and resolved completely. Improvements in LVEF (vs pre-implantation: +6%; 95% CI 5-8; p<0.0001) and KCCQ-OSS (vs pre-implantation: +43 points; 95% CI 36-49; p<0.0001) were sustained and unchanged from 6 months (LVEF: -0.1%; 95% CI -2-2; p=0.87; KCCQ-OSS:-2; 95% CI -8-4; p=0.49). The 6MWD remained improved (vs pre-implantation: +150 m; 95% CI 109-191; p<0.0001), with a modest decrease (-31 m; 95% CI -56- -7; p=0.013) from 6 months. Improvements in NYHA class (≥1-class improvement in 77% patients) were sustained. Three (10%) patients required device reactivation.</p><p><strong>Conclusion: </strong>Among patients previously treated with C-MIC device, improvements in LVEF, 6MWD, NYHA class and KCCQ-OSS were sustained, with a favorable safety profile 12 months post-deactivation.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823838","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":"Heart Failure and Cancer: Incidence and Mortality Patterns, A Systematic Review and Meta-analysis.","authors":"Luigi Sanasi, Antonio Iaconelli, Danila Azzolina, Pasquale Dolce, Christian Cardile, Lorenzo Cacioli, Alessandro Forni, Matteo Busti, Luca Sensini, Nicola Riccardo Pugliese, Domenico D'Amario, Giovanni Pecorini, Mattia Galli, Giovanna Liuzzo, Francesco Burzotta, Riccardo Rinaldi, Moustafa I Morsy, Pasquale Maffia, Pierpaolo Pellicori, Jocelyn M Friday, Mark Petrie, Bernhard Haring, Michael Böhm, Markus S Anker, Javed Butler, Filippo Crea, John G F Cleland","doi":"10.1093/ejhf/xuag265","DOIUrl":"https://doi.org/10.1093/ejhf/xuag265","url":null,"abstract":"<p><strong>Background: </strong>Cancer and heart failure (HF) frequently coexist due to population ageing and improved survival for both conditions. HF is a well-recognised complication of oncologic therapies and a potential association between HF and subsequent cancer incidence has been recently noticed. We therefore conducted a meta-analysis to quantify cancer incidence and mortality in patients with and without HF.</p><p><strong>Methods: </strong>Databases were searched from inception to 15 February 2026. Data from observational studies and randomised trials on individuals with and without HF and reporting cancer incidence and/or mortality during follow-up were included. The main outcome of interest was the incidence of any cancer; secondary outcomes included site-specific cancer incidence (lung, colorectal, breast, and prostate) and all-cause, cardiovascular, and cancer-related mortality.</p><p><strong>Results: </strong>Twelve studies comprising 8,979,195 individuals were included. HF was associated with a higher incidence of cancer (hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.14-1.54), with substantial heterogeneity (I2 = 99.7%). Cancer site-specific analyses showed increased incidences of lung (HR 1.70, 95% CI 1.26-2.29), colorectal (HR 1.28, 95% CI 1.11-1.48), and breast (HR 1.19, 95% CI 1.04-1.37), but not prostate, cancer. Effect estimates varied according to analytical strategy: matched HF and non-HF cohorts reported higher risk estimates than those using covariate adjustment without matching. Mortality data were sparse and heterogeneous.</p><p><strong>Conclusions: </strong>HF is associated with a higher incidence of cancer, although with marked heterogeneity among studies and cancer types. Mortality and cause of death were rarely reported. The observed HF-cancer association is influenced by statistical methodology, shared risk factors, differences in surveillance intensity and cancer type, that confound analyses investigating possible causal biological links. More granular and harmonised studies are required.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811550","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 fibrillation ablation in heart failure: which patients and which intervention?\"","authors":"Antonio Iaconelli, John G F Cleland","doi":"10.1093/ejhf/xuag277","DOIUrl":"https://doi.org/10.1093/ejhf/xuag277","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816712","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}