Cardiac Failure Review最新文献

{"title":"Obesity Definitions and Hospital Stay in Older Adults with Heart Failure: A Post Hoc Analysis of a Prospective Cohort.","authors":"Michał Czapla, Christopher S Lee, Maria Jędrzejczyk, Bartosz Uchmanowicz, Izabella Uchmanowicz","doi":"10.15420/cfr.2025.59","DOIUrl":"10.15420/cfr.2025.59","url":null,"abstract":"<p><strong>Background: </strong>The prognostic significance of obesity in patients hospitalised for acute heart failure (HF) remains uncertain, particularly among older adults. This study aimed to assess whether three obesity definitions - BMI, waist circumference and the clinical obesity framework - predict hospital length of stay (LOS) in older adults hospitalised for acute decompensated HF.</p><p><strong>Methods: </strong>This post hoc exploratory analysis used data from a prospective cohort of 250 adults aged ≥60 years hospitalised for acute decompensated HF. Obesity was defined as: BMI ≥30 kg/m²; waist circumference ≥102 cm in men or ≥88 cm in women; and clinical obesity per the Lancet Diabetes & Endocrinology Commission, applied <i>post</i> hoc. LOS was modelled using univariable and multivariable negative binomial regression.</p><p><strong>Results: </strong>None of the three obesity definitions were independently associated with LOS. In the multivariable models, only N-terminal pro-B-type natriuretic peptide (NT-proBNP) was an independent predictor of LOS in patients with clinical obesity (incidence rate ratio [IRR] 1.004 per 100 pg/ml; p=0.004). Among those with classical obesity, New York Heart Association class IV (IRR 2.355; p=0.004), NT-proBNP (IRR 1.004; p=0.004), and smoking history of 41-50 pack-years (IRR 1.946; p=0.022) remained independently associated with longer LOS. For central obesity, haemoglobin (IRR 0.923; p=0.029) and NT-proBNP (IRR 1.004; p<0.001) were significant predictors.</p><p><strong>Conclusion: </strong>In this cohort of older adults hospitalised for acute decompensated HF, none of the three obesity definitions - including the new clinical obesity framework - were independent predictors of LOS.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e13"},"PeriodicalIF":12.2,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodality Imaging in Hypertrophic Cardiomyopathy.","authors":"Daniel Escribano, Elena Díaz-Peláez, Victoria Delgado","doi":"10.15420/cfr.2025.14","DOIUrl":"10.15420/cfr.2025.14","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is a genetic disease present in 0.2% of the general population. It is defined by the presence of an increased left ventricular wall thickness (with or without right ventricular hypertrophy) or mass that is not solely explained by abnormal loading conditions. The vast majority of genes and mutations underlying HCM encode sarcomere proteins or sarcomere-associated proteins. The clinical presentation of the disease is highly heterogeneous and can present in all age groups. Most affected individuals will achieve a normal life expectancy without disability, but some patients with HCM can present significant complications, including sudden cardiac death, heart failure and AF. The selection of patients for the best therapeutic approach requires accurate diagnosis and phenotyping of the disease. In addition, differential diagnosis with other entities that can present with left ventricular hypertrophy is key to prescribing the most appropriate therapy. Multimodality imaging plays a key role in the characterisation of HCM.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e12"},"PeriodicalIF":12.2,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Contemporary Perspective on Acute Decompensated Heart Failure Classification: A State-of-the-art Review from an International Expert Group.","authors":"Ovidiu Chioncel, Alexandre Mebazaa, Sean P Collins, Gad Cotter, Biykem Bozkurt, Maurizio Volterrani, Piotr Ponikowski, Oliviana Geavlete, Matteo Pagnesi, Giuseppe Mc Rosano, Razvan I Radu, Magdy Abdelhamid, Marianna Adamo, Andrew P Ambrosy, Nicolas Girerd, Stefan D Anker, Beth Davison, Jan Biegus, Feras Bader, John Teerlink, Oscar Miro, Anika S Naidu, Mattia Arrigo, Gianluigi Savarese, Tuvia Ben Gal, G Michael Felker, Petar Seferovic, Mandeep R Mehra, Javed Butler, Andrew Js Coats, Marco Metra","doi":"10.15420/cfr.2025.50","DOIUrl":"10.15420/cfr.2025.50","url":null,"abstract":"<p><p>There is a large spectrum of acute decompensated heart failure presentations resulting from the interaction between an acute precipitant and the patient's underlying cardiac and non-cardiac conditions. A robust classification scheme at admission is crucial for appropriate triage and targeted treatment of high-risk populations. Such a scheme should incorporate timely actionable items to generate immediate management decisions, including characteristics that suggest life-threatening clinical presentations, the factors that could be favourably modified by in-hospital interventions, such as correctable aetiologies and congestion/hypoperfusion status, and in-hospital trajectories determined by patient responses to inpatient treatment. In-hospital trajectories determine the intensity of escalation therapies and timing for initiation/up-titration of guideline-directed medical treatment. In the long term, some patients experience a progressive downsloping course culminating in advanced heart failure, while others maintain a relatively stable remitting-relapsing trajectory. For future clinical trials, a comprehensive classification scheme integrating in-hospital and long-term trajectories could profoundly affect study design by ensuring interventions are tested in more homogeneous patient populations and facilitating nuanced patient stratification.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e11"},"PeriodicalIF":12.2,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Cardio-oncology Service.","authors":"Lloyd E Butel-Simoes, Joshua D Bennetts, Amanda Croft, Trent D Williams, Wojt Janowski, Jarad Martin, James Lynam, Doan Tm Ngo, Aaron L Sverdlov","doi":"10.15420/cfr.2025.44","DOIUrl":"10.15420/cfr.2025.44","url":null,"abstract":"<p><p>Cancer and cardiovascular disease increasingly intersect in clinical practice. An integrated cardio-oncology service is a coordinated, multidisciplinary programme that embeds cardiovascular risk assessment, on-treatment surveillance and post-treatment follow-up within routine cancer care, supported by shared protocols and decision-making. The aim of such services is to maintain the delivery of best-practice cancer therapy while preventing and treating cardiovascular toxicity. This review distils pragmatic, transferable elements for cardiac and oncology teams: a unified programme with risk-based streaming; nurse-enabled triage and surveillance; pharmacist-led drug-drug interaction stewardship and medication optimisation; fast-track imaging and cardiology access; and clear triggers for escalation that minimise unnecessary cancer therapy interruption. The goal for this review is to provide a pragmatic blueprint for such services, illustrated by international models and our Newcastle bench-to-bedside experience.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e09"},"PeriodicalIF":12.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Management of Hyperkalaemia in Patients with Chronic Kidney Disease and Cardiovascular Conditions: Expert Recommendations from Mexico.","authors":"Antonio Méndez-Durán, Juan B Ivey-Miranda, Genaro H Mendoza-Zavala, Amada Álvarez-Sangabriel, Diana C Sánchez-Guerrero, Juan D Díaz-García, Julián A Borges-Vela, Luis E Morales-Buenrostro, Mateo Quilantán-Rodríguez, Ramón Ruíz-Mejía, Sergio A Chávez-Leal","doi":"10.15420/cfr.2025.03","DOIUrl":"10.15420/cfr.2025.03","url":null,"abstract":"<p><p>Patients with chronic kidney disease and/or cardiovascular disease are at heightened risk of developing hyperkalaemia. This electrolyte disorder is prevalent and, if left untreated, typically results in fatal outcomes. The implementation of standardised, specialised management strategies represents a valuable tool for clinicians in the care of these patients. The primary objective of this study is to present a consensus document for the management of hyperkalaemia of cardiorenal origin, developed by a group of experts in cardiology and nephrology, opinion leaders in Mexico. To this end, a Delphi panel was formed, comprising a group of cardiologists and a group of nephrologists, each coordinated by a leader who concentrated the information. The panellists responded to a questionnaire that was sent to them. In a virtual meeting, the responses were reviewed and a consensus was reached by all participants based on the current literature.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e10"},"PeriodicalIF":12.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a): A Novel Risk Factor for Heart Failure and Biomarker of Prognosis? From Pathophysiology to Clinical Practice.","authors":"Anna Kowalczys, Joanna Marlęga-Linert, Marcin Gruchała, Agnieszka Mickiewicz","doi":"10.15420/cfr.2025.46","DOIUrl":"10.15420/cfr.2025.46","url":null,"abstract":"<p><p>Heart failure (HF) is one of the most difficult challenges in cardiology nowadays, constituting a significant global epidemiological, social and economic burden. For many years, there has been a search for new risk factors that predispose to the development of HF and biomarkers that could indicate HF patients with a poorer prognosis. Lipoprotein(a) (Lp[a]) is an estimated risk factor for atherosclerotic cardiovascular disease and aortic valve stenosis, but its causal role in HF has not been clearly defined yet. The results of the few studies regarding the influence of elevated Lp(a) on the development and course of HF are uncertain. However, most authors suggest that elevated Lp(a) increases the risk of HF and may correlate with a higher risk of major adverse cardiovascular events. The aim of this review is to present the current state of knowledge on the importance of the association between Lp(a) levels and HF, from pathophysiology to clinical practice including current management.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e07"},"PeriodicalIF":12.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Vericiguat in a Real-life Population with Heart Failure after 1 Year of Treatment: The VERITA Study.","authors":"Mario Galván-Ruiz, Miguel Fernández de Sanmamed-Girón, María Del Val Groba-Marco, Lorena Rojo-Jorge, Claudia Peña-Saavedra, Elvira Martín-Bou, Rubén Andrade-Guerra, Marcos Antonio Suarez-Benitez, María Aguiar-Bujanda, Luis Burgos-Ramírez, Eduardo Caballero-Dorta, Antonio García-Quintana","doi":"10.15420/cfr.2025.45","DOIUrl":"10.15420/cfr.2025.45","url":null,"abstract":"<p><strong>Aim: </strong>To determine the efficacy and safety of vericiguat in a real-world cohort of patients with heart failure (HF) with reduced ejection fraction in Spain.</p><p><strong>Methods: </strong>A prospective observational study of HF with reduced ejection fraction patients with a recent episode of worsening HF, requiring IV therapy, and who initiated vericiguat in a HF outpatient clinic was carried out. Of the 103 patients included, 28 (27.2%) were women.</p><p><strong>Results: </strong>At baseline, the mean age was 71.3 ± 9.4 years, the median ejection fraction was 34% (interquartile range; IQR 28-39%) and N-terminal pro-B-type natriuretic peptide was 2,034 pg/ml (IQR 910-3,372 pg/ml). Regarding HF treatments, 99% of patients were taking β-blockers, 97.1% sodium-glucose cotransporter 2 inhibitors, 96.1% sacubitril-valsartan, 91.2% mineralocorticoid receptor antagonists and 93.2% loop diuretics. After 1 year of treatment with vericiguat, New York Heart Association functional class improved from 36.9 and 63.1% in classes II and III to 72.1 and 16.3%, respectively, as did the visual analogue scale score, from 60 (50-75) to 70 (50-85; both p<0.001). N-terminal pro-B-type natriuretic peptide levels decreased from 2,034 pg/ml (IQR 910-3,372 pg/ml) to 1,282 pg/ml (IQR 562-3,303 pg/ml; p=0.034). The dosage of angiotensin receptor-neprilysin inhibitors increased significantly (p<0.001), and the dose of furosemide was reduced (p=0.032). The number of HF-related hospitalisations/emergency department visits within the previous year was 1.9 ± 1.3, decreasing to 0.55 ± 0.98 (p<0.001). At study end, 7.8% of patients had died (one-quarter of HF). Only 11.7% of patients discontinued vericiguat (6.8% owing to hypotension), and 77.7% achieved the target dose of 10 mg.</p><p><strong>Conclusion: </strong>In clinical practice, treatment with vericiguat is associated with substantial improvements in functional class and quality of life, reductions in natriuretic peptide levels and clinical events, and a good safety profile.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e08"},"PeriodicalIF":12.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Natriuretic Peptides and Oxygen Metabolism in Heart Failure.","authors":"Olli Arjamaa","doi":"10.15420/cfr.2025.58","DOIUrl":"10.15420/cfr.2025.58","url":null,"abstract":"<p><p>Since the discovery of natriuretic peptides in the 1980s, initially as A-type natriuretic peptide, followed by B-type natriuretic peptide, their measurement has become standard in the management of heart failure (HF), as levels are markedly elevated in patients with HF. However, systematic reviews conducted in this area have yielded inconclusive results. Position and consensus papers on natriuretic peptides and HF have uniformly adopted the paradigm that myocardial stretch is the underlying mechanism explaining elevated circulating natriuretic peptide levels. Although mechanical stress is the primary factor determining myocardial oxygen consumption, this relationship has not been studied in HF. Biological evolution has developed a specific hypoxia-sensitive pathway in which a nuclear transcription factor, hypoxia-inducible factor, serves as the oxygen sensor, enabling myocardial cells to respond to reduced oxygen tension. In myocardial cell cultures, hypoxia was found to be a direct and sufficient stimulus for the expression of natriuretic peptides via the hypoxia-inducible factor pathway. Myocardial oxygen metabolism, which regulates plasma natriuretic peptide levels, presents a new objective for clinical research in HF.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e06"},"PeriodicalIF":12.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Failure in Hypertrophic Cardiomyopathy.","authors":"Olives Nguyen, Daniel Kamna, Ahmad Masri","doi":"10.15420/cfr.2025.25","DOIUrl":"10.15420/cfr.2025.25","url":null,"abstract":"<p><p>End-stage hypertrophic cardiomyopathy (ES-HCM) presents on a spectrum between the classic left ventricular systolic dysfunction and a less-recognised, restrictive phenotype with small-to-normal-sized left ventricular cavity and preserved ejection fraction. Relatively poor prognoses follow those on this morpho-functional spectrum, marked by low cardiac output and high arrhythmic risk. Contemporary guideline-directed therapies, such as ICDs, CRT and cardiac transplantation, have significantly improved outcomes, reshaping the natural history of ES-HCM. Meanwhile, the roles of neurohormonal modulation and left ventricular assist devices remain less well defined. Still, timely recognition and intervention remain essential in patients with ES-HCM, given its considerable morbidity and mortality. As cardiac myosin inhibitors and anti-fibrotic strategies advance, early targeted treatment may modify the natural history of hypertrophic cardiomyopathy, leading to a reduction in the incidence of ES-HCM. Moving forward, broader adoption of phenotype-specific approaches and equitable application of advanced therapies are critical to address the rare but clinically significant burden of ES-HCM.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e05"},"PeriodicalIF":12.2,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetics in Hypertrophic Cardiomyopathy: An Evolving Clinical Landscape.","authors":"María Noël Brögger, Ivonne Johana Cárdenas Reyes, Soledad García Hernández, Juan Pablo Ochoa","doi":"10.15420/cfr.2025.12","DOIUrl":"10.15420/cfr.2025.12","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease and is characterised by unexplained increased wall thickness. Traditionally considered a monogenic disorder, emerging evidence highlights its complex genetic architecture. Genetic testing is now a cornerstone for diagnosis and family screening, although its prognostic and therapeutic impact at the individual level remains limited at present but is expected to grow as more comprehensive approaches are developed. Aimed at general cardiologists, this review summarises the benefits and limitations of current knowledge and genetic testing in HCM, and offers practical guidance on patient selection, interpretation of results, and integration into routine care. In this context, the challenge posed by variants of uncertain significance is discussed, and current and emerging strategies for their re-interpretation are outlined in brief. An updated overview is also provided of the genetic landscape, covering sarcomeric and non-sarcomeric genes, HCM phenocopies and new inheritance models, including oligogenic and polygenic mechanisms. Additionally, the potential of expanded genetic panels incorporating novel candidate genes and deep intronic and structural variants is highlighted. As gene therapy emerges as a future therapeutic option, precise molecular diagnosis will be essential for integrating genetic insights into routine clinical practice and advancing personalised care in HCM.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"12 ","pages":"e04"},"PeriodicalIF":12.2,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}