European Journal of Heart Failure最新文献

{"title":"The Global Epidemiology of Heart Failure: A Comprehensive and Contemporary Review.","authors":"Valeria Valente,Renzo Laborante,Amr Abdin,Peter Moritz Becher,Mitja Lainscak,Marija Polovina,Cristina Gavina,Gianluigi Savarese","doi":"10.1093/ejhf/xuag121","DOIUrl":"https://doi.org/10.1093/ejhf/xuag121","url":null,"abstract":"Heart failure (HF) is a complex and progressive syndrome associated with high morbidity, mortality, impaired quality of life, and substantial healthcare costs. Globally, more than 55 million people live with HF, and prevalence is steadily rising, largely driven by population ageing, improved survival after cardiovascular events, and the increasing burden of comorbidities. While the prevalence of HF with reduced EF(HFrEF) appears to be stable or declining, most likely due to improved treatment of ischaemic heart disease, HF with preserved EF(HFpEF) is steadily increasing and may become the most common form of HF in the future. Overall HF incidence has remained stable or even declined in many Western countries, although rising trends have been reported in younger populations and in specific regions. However, incidence of HFpEF is rising rapidly and has nearly doubled over two decades due to aging and increased prevalence of comorbidities, whereas HFrEF incidence has declined slightly. Considerable geographic variation exists in HF epidemiology, with data from low- and middle-income countries being still limited, although HF in these settings often differs in terms of causes, age at onset, and outcomes. Despite substantial advances in life-saving, evidence-based therapies, prognosis remains poor: depending on the population and care setting 1-year mortality ranges from 5% to 34%, 1-year rehospitalisation is ∼30%, and non-cardiovascular mortality is rising, particularly among patients with HFpEF. In this review, we provide an updated and comprehensive overview of HF epidemiology, summarizing recent evidence on prevalence, incidence, aetiologies, outcomes, and costs across diverse populations and regions worldwide.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641605","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":"AB-1002 gene therapy expressing active protein phosphatase inhibitor-1 in heart failure: Rationale and study design of the GenePHIT trial.","authors":"T D Henry,E S Chung,M Alvisi,D R Murray,J H Traverse,L Roessig,L Roberts,S Sanganalmath,S Reddy,L Ervin,K Walker,S Mikhail,C Jiang,R J Samulski,E G Kranias,A Tretiakova,D D Ascheim,B R Saville,J Butler,R J Hajjar","doi":"10.1093/ejhf/xuag105","DOIUrl":"https://doi.org/10.1093/ejhf/xuag105","url":null,"abstract":"BACKGROUND AND AIMSAB-1002 is an investigational, cardiotropic adeno-associated viral vector gene therapy expressing constitutively active form of protein phosphatase inhibitor-1 intended to restore cardiomyocyte calcium handling and improve cardiac contractility.METHODSGenePHIT is an adaptive, double-blinded, placebo-controlled, randomized multicentre Phase 2 trial evaluating the efficacy, safety, and tolerability of AB-1002 in adults with non-ischaemic cardiomyopathy with left ventricular ejection fraction 15%-35% and New York Heart Association class III symptoms despite standard of care therapy. GenePHIT includes a 52-week observation period and 4-year long-term follow-up. Participants are randomized 1:1:1 (n=30-50/group) to receive a single antegrade intracoronary infusion of AB-1002 at 1 of 2 doses (7.15E13 or 1.43E14 viral genomes/participant), or placebo. The primary endpoint will be assessed at 52 weeks and will comprise a hierarchical composite of cardiovascular death, change from baseline in New York Heart Association class, left ventricular ejection fraction improvement of ≥5%, and six-minute walk test improvement of >30m, with pooled active doses compared to placebo via a win ratio estimate using Finkelstein-Schoenfeld methodology. Several other secondary efficacy, safety, and exploratory endpoints will be assessed at 52 weeks and through long-term follow-up.CONCLUSIONSThis Phase 2, placebo-controlled trial will further elucidate the risk-benefit characterization of single-dose AB-1002 in patients with non-ischaemic heart failure.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"32 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641604","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":"European Journal of Heart Failure International Expert Position Paper Utilisation, Optimisation, and Clinical Benefits of Steroidal Mineralocorticoid Receptor Antagonists in Heart Failure with a Reduced Ejection Fraction.","authors":"Michael Böhm,Jabir Abdullakutty,Johann Bauersachs,Udo Bavendiek,Antoni Bayes-Genis,Kuntal Bhattacharyya,Jan Biegus,Biykem Bozkurt,Javed Butler,J Ezhilan,Joao P Ferreira,Nicolas Girerd,Rahul Gupta,Jagdish Hiremath,Pardeep Jhund,Thorsten Kessler,Dilip Kumar,Philipp Markwirth,Nikolaus Marx,Teresa McDonagh,Girish Navsundi,Arindam Pande,Mark Petrie,Piotr Ponikowski,Amina Rakisheva,Giuseppe Rosano,Naoki Sato,Gianluigi Savarese,Kamal Sharma,Karen Sliwa,B Somaraju,Samuel Sossalla,Stefan Störk,Mert Tokcan,Konstantinos Tsioufis,Yuhui Zhang,Jian Zhang,Shelley Zieroth,Faiez Zannad","doi":"10.1093/ejhf/xuag106","DOIUrl":"https://doi.org/10.1093/ejhf/xuag106","url":null,"abstract":"Heart failure with reduced ejection fraction (HFrEF) imposes a significant clinical burden on patients and a major economic burden on healthcare systems. In HFrEF, mineralocorticoid receptor antagonists (MRAs) constitute a cornerstone of guideline-directed medical therapy (GDMT) reducing both mortality and hospitalisation. Their use in practice remains suboptimal, largely because of physicians' concerns about adverse events, particularly hyperkalaemia, which may deprive eligible patients of benefit. Only the steroidal MRAs spironolactone and eplerenone are approved for HFrEF, and this consensus document is restricted to these agents. We summarise contemporary evidence across multiple domains related to MRA therapy in HFrEF, including pharmacoepidemiology, the role of biomarkers in predicting outcomes and response to MRA, the pathological role of aldosterone and the pharmacology and clinical efficacy of steroidal MRAs. Practical, evidence-based guidance is provided on the prevention and management of hyperkalaemia, the timing of MRA initiation, and strategies to overcome barriers to MRA use. The positioning of MRAs in current guidelines is outlined to reinforce their central role in HFrEF. The process of consensus finding was started in April 2025 with a core group by online conference. We searched PubMed with the terms \"MRA, eplerenone and heart failure with reduced ejection fraction\". Articles published in English with no date restriction were considered. The final manuscript passed two rounds of final approval by all authors. As a result, this consensus statement advocates proactive, evidence-based approaches to optimise MRA use to improve outcomes. These recommendations aim to mitigate the persistent underuse of MRAs in clinical practice.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"12 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641741","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":"Reply to Letter regarding the article 'Prevalence and influence of cardiovascular kidney metabolic syndrome on outcomes after transcatheter aortic valve implantation'.","authors":"Felix Götzinger, Thorald Stolte, Thomas Nestelberger, Felix Mahfoud","doi":"10.1093/ejhf/xuag116","DOIUrl":"https://doi.org/10.1093/ejhf/xuag116","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643455","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":"Liver Disease in Tricuspid Regurgitation: From Congestion to Cirrhosis.","authors":"Karl-Philipp Rommel,Marc Adrian Rogmann,Marco Metra","doi":"10.1093/ejhf/xuag109","DOIUrl":"https://doi.org/10.1093/ejhf/xuag109","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"10 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625813","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":"Letter regarding the article 'Prevalence and influence of cardiovascular kidney metabolic syndrome on outcomes after transcatheter aortic valve implantation'.","authors":"Weicheng Ni,Ruihao Jiang,Hao Zhou","doi":"10.1093/ejhf/xuag111","DOIUrl":"https://doi.org/10.1093/ejhf/xuag111","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"59 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625814","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":"Machine Learning-Based Phenotypes Combined with Comorbidity Burden in Cardiogenic Shock.","authors":"Jonas Sundermeyer,Elric Zweck,Song Li,Van-Khue Ton,Rachna Kataria,Manreet K Kanwar,Jaime Hernandez-Montfort,Shashank S Sinha,Christian Said,A Reshad Garan,Peter S Natov,Jacob Abraham,Paavni Sangal,Kevin J John,Daniel Burkhoff,Navin K Kapur","doi":"10.1093/ejhf/xuag108","DOIUrl":"https://doi.org/10.1093/ejhf/xuag108","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"13 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585625","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":"Seeing congestion before it speaks: inferior vena cava-guided management in heart failure.","authors":"Antoni Bayes-Genis,Birgit Assmus","doi":"10.1093/ejhf/xuag052","DOIUrl":"https://doi.org/10.1093/ejhf/xuag052","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"17 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585629","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? February 2026.","authors":"Matthew M Y Lee, Daniela Tomasoni, Alberto Aimo","doi":"10.1093/ejhf/xuag107","DOIUrl":"https://doi.org/10.1093/ejhf/xuag107","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147588984","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":"Insights into the renin-angiotensin-aldosterone system in transthyretin amyloid cardiomyopathy.","authors":"Christina Kronberger,Oliver Domenig,Noemi Pavo,Johannes Kovarik,Franz Duca,René Rettl,Michael Poledniczek,Lena Marie Schmid,Nikita Ermolaev,Mahshid Eslami,Luciana Camuz Ligios,Christian Hengstenberg,Roza Badr Eslam,Jutta Bergler-Klein,Johannes Kastner,Andreas Anselm Kammerlander,Christina Binder","doi":"10.1093/ejhf/xuag102","DOIUrl":"https://doi.org/10.1093/ejhf/xuag102","url":null,"abstract":"AIMThis study aimed to characterize circulating renin-angiotensin-aldosterone system (RAAS) patterns in transthyretin amyloid cardiomyopathy (ATTR-CM), examine their relationship with clinical and echocardiographic parameters and determine their prognostic value.METHODSIn this prospective study, ATTR-CM patients underwent serum quantification of classical (angiotensin I-IV, aldosterone) and alternative (angiotensin 1-7, angiotensin 1-5) RAAS peptides and angiotensin converting enzyme 2 (ACE2) activity using mass spectrometry. RAAS inhibitor use was recorded. Associations of RAAS peptides with N-terminal pro brain natriuretic peptide (NT-proBNP) and echocardiographic parameters were analyzed. Prognostic associations with the composite endpoint of HF hospitalization or cardiac death were assessed using Kaplan-Meier curves stratified by median peptide values.RESULTSAmong 137 patients, RAAS inhibitor use included ACEi (21.2%), ARBs (34.3%), ARNIs (7.3%) and none (26.0%). RAAS profiles were consistent with the expected effects of the respective RAAS inhibitors. During a median follow-up of 1.6 years, 49 patients (36%) experienced the composite endpoint. Patients with adverse cardiac events had higher ACE2 activity (p<0.001) and alternative RAAS peptides (angiotensin 1-7: p=0.007; angiotensin 1-5: p<0.001). Higher ACE2 activity was associated with higher NT-proBNP (p<0.001) and more advanced echocardiographic markers of biventricular dysfunction. In Kaplan Meier analysis, ACE2 above median predicted adverse cardiac outcomes (p=0.017), while classical RAAS peptides were not predictive.CONCLUSIONATTR-CM patients exhibit distinct RAAS profiles, with increased ACE2 activity and a shift toward the alternative RAAS axis in more advanced disease. Higher ACE2 activity is associated with higher NT-proBNP, biventricular dysfunction and adverse cardiac outcomes, suggesting that ACE2 may represent a promising marker for risk stratification in ATTR-CM.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"7 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578017","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}