American Journal of Cardiology最新文献

{"title":"Prevalence and Prognostic Differences Between Sarcopenia and Sarcopenic Obesity in Heart Failure","authors":"Yule Hu MS, PhD ,&nbsp;Yan Li PhD ,&nbsp;Huiying Ma MS ,&nbsp;Lulu Sun MS, PhD ,&nbsp;Yan Zhang MS, PhD ,&nbsp;Yueying Wang MS, PhD ,&nbsp;Changhong Zou PhD ,&nbsp;Frank F. Huang MSc, PhD ,&nbsp;Tao Liang PhD","doi":"10.1016/j.amjcard.2025.08.031","DOIUrl":"10.1016/j.amjcard.2025.08.031","url":null,"abstract":"<div><div>Evidence directly comparing sarcopenia and sarcopenic obesity in hospitalized heart failure (HF) patients, especially in young and middle-aged individuals, remains limited. This study aimed to (1) investigate the prevalence and clinical characteristics of sarcopenia and sarcopenic obesity, and (2) compare their prognostic impacts on adverse outcomes to identify protective body composition phenotypes. The findings are hypothesized to provide new perspectives on the HF obesity paradox. This prospective cohort study was conducted from June 2022 to October 2023. The primary endpoint was 1-year HF-related readmission or all-cause mortality. Prolonged hospital stays and 90-day HF-related readmission or all-cause mortality were set as secondary outcomes. Associations of sarcopenia and sarcopenic obesity with poor clinical outcomes were analyzed using multivariate logistic regression and Cox proportional hazards regression. Sarcopenia and sarcopenic obesity prevalence were 26.4% (n = 57) and 19.4% (n = 42) among 216 participants, with malnutrition present in 77.2% (44/57) and 71.4% (30/42) of cases, respectively. After adjusting for covariates, both sarcopenia and sarcopenic obesity independently predicted 1-year HF-related readmission or all-cause mortality (sarcopenia vs nonsarcopenia: HR = 2.048 [95% CI:1.064∼3.940], p = 0.032; sarcopenic obesity vs nonsarcopenic obesity: HR = 1.932 [95% CI:1.062∼3.515], p = 0.031). Sarcopenic obesity also independently predicted the prolonged hospital stay (OR = 2.418 [95% CI:1.050∼5.567], p = 0.038). In conclusion, hospitalized HF patients were susceptible to sarcopenia, sarcopenic obesity, and the double burden of malnutrition and obesity. Muscle mass, rather than fat mass, may exert protective effects, which could partially explain the HF obesity paradox. Interventions aimed at reducing obesity while ensuring the maintenance of, or an increase in, muscle mass should be developed.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 127-130"},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Implications of Regional Cerebral Blood Flow Abnormality Assessed by Single Photon Emission Computed Tomography in Chronic Heart Failure Patients","authors":"Takeshi Niizeki MD,&nbsp;Tadateru Iwayama MD,&nbsp;Toshiki Sasaki MD","doi":"10.1016/j.amjcard.2025.08.019","DOIUrl":"10.1016/j.amjcard.2025.08.019","url":null,"abstract":"<div><div>Mild cognitive impairment (MCI) acts as strong barriers to treatment adherence and self-care has been linked to increased mortality in patients with chronic heart failure (CHF). Accordingly, early detection of MCI is of critical importance. Evaluating cerebral blood flow using single-photon emission computed tomography (SPECT) offers a reliable approach for identifying MCI at an early stage. This study aimed to investigate the prevalence and the prognostic relevance of regional cerebral blood flow (rCBF) abnormality, as assessed by brain perfusion scintigraphy, in CHF patients. Among the 952 CHF patients enrolled, 231 exhibited the rCBF abnormality. These patients had a higher incidence of atrial fibrillation, hypoalbuminemia, and adverse cardiac events compared to those without the rCBF abnormality. Both Cox proportional hazards modeling and Kaplan–Meier survival analysis demonstrated a significant association between the rCBF abnormality and the occurrence of cardiac events. In conclusion, the rCBF abnormality serves as an independent predictor of adverse prognosis in patients with CHF and may contribute to more effective risk stratification in this population.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 116-121"},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Angiotensin Receptor/Neprilysin Inhibitor in Moderate Ischemic Mitral Regurgitation After Isolated Coronary Artery Bypass Grafting (ARNI-MIMIC): Study Protocol for a Randomized Controlled Trial","authors":"Xieraili Tiemuerniyazi MD, PhD ,&nbsp;Lianxin Chen MD ,&nbsp;Liaoming He MD ,&nbsp;Ziang Yang MD, PhD,&nbsp;Shengkang Huang MD,&nbsp;Yifeng Nan MD, PhD,&nbsp;Yangwu Song MD, PhD,&nbsp;Xin Yuan MD, PhD,&nbsp;Zhan Hu MD, PhD,&nbsp;Dong Zhao MD, PhD,&nbsp;Wei Zhao MD,&nbsp;Wei Feng MD, PhD","doi":"10.1016/j.amjcard.2025.08.029","DOIUrl":"10.1016/j.amjcard.2025.08.029","url":null,"abstract":"<div><div>Debates have been existed regarding the treatment of moderate ischemic mitral regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG). While it might have priority on reducing the risk of recurrent IMR, studies showed that concomitant mitral valve repair increases the risk of adverse outcomes, such as neurological events, as well as the in-hospital costs. In recent studies, angiotensin receptor/neprilysin inhibitor (ARNI) was discovered to have potential benefit in reducing the severity of IMR. The ARNI-MIMIC is a randomized controlled clinical trial aiming to reduce the risk of recurrent IMR in isolated CABG patients. A total of 220 eligible patients with moderate IMR will be allocated into control (non-ARNI) and intervention (ARNI) groups in a 1:1 pattern after isolated CABG. Patients in the intervention group will be administered with continuous sacubitril/valsartan for 6 months postoperatively, while patients in the control group will receive guideline recommended therapy only. All of the patients will be invited to complete 6-month follow-up. The primary endpoint is the change in the effective regurgitant orifice area (EROA) of the mitral valve, which is obtained by echocardiography and calculated by subtracting the follow-up EROA from the preoperative EROA. This trial aims to investigate the potential role of ARNI as compared to the control in moderate IMR patients undergoing isolated CABG. If ARNI is proven to reduce the risk of moderate IMR recurrence, patients will benefit from both improved life quality and decreased medical costs. The This study was approved by the Institutional Review Board of Fuwai Hospital on October 18th 2024, with an approval number of 2024-2446. The results of this trail will be disseminated through international academic conferences and publication in medical journals regardless of the study outcomes. <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID <span><span>NCT06917664</span><svg><path></path></svg></span></div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"256 ","pages":"Pages 102-106"},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Myocardial Bridging on Hemodynamics Evaluated by Coronary Angiography-Derived Fractional Flow Reserve","authors":"Yiqun Shi MD,&nbsp;Jian Liu MD","doi":"10.1016/j.amjcard.2025.08.027","DOIUrl":"10.1016/j.amjcard.2025.08.027","url":null,"abstract":"<div><div>Myocardial bridging (MB) is a kind of congenital coronary abnormality. The functional impact of MB on coronary artery remains a subject of debate. This study aimed to assess the hemodynamic effects of MB using coronary angiography-derived fractional flow reserve (caFFR) and elucidate the relationship between MB anatomical parameters and diastolic caFFR (dcaFFR) in patients with isolated MB (iMB) and MB combined with proximal coronary atherosclerosis (MB+AS). A total of 683 patients diagnosed with MB located on left anterior descending (LAD) via coronary angiography (CAG) were retrospectively enrolled and categorized into two groups: iMB (n = 377) and MB+AS (n = 306). The dcaFFR was calculated to evaluate the hemodynamic impact of MB. Multivariate linear regression and mediation analysis were performed to identify predictors of dcaFFR. In the iMB group, diastolic minimal lumen diameter (MLD) of MB segment was the sole independent predictor of dcaFFR (<em>B</em> = 0.036, <em>β</em> = 0.253, p &lt;0.001). In the group of MB+AS, the severity of proximal stenosis emerged as the only independent predictor of dcaFFR (<em>B</em> = −0.004, <em>β</em> = −0.674, p &lt;0.001), with the hemodynamic effects of MB fully mediated by proximal stenosis. In conclusion, the hemodynamic impact of MB depends on the presence of proximal coronary atherosclerosis. In iMB cases, the diastolic MLD of MB segment directly determines hemodynamic impairment. However, the hemodynamic impact of MB is nonsignificant in cases of MB+AS, as its effect is fully mediated through proximal stenosis severity.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 141-146"},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ostial Stent Implantation or Crossover Stenting for Ostial LAD Lesions: The Multicenter CROSS-ANATOLIA Registry","authors":"Veysel Ozan Tanık MD ,&nbsp;Ahmet Güner MD ,&nbsp;Ebru Serin MD ,&nbsp;Ali Nazmi Çalık MD ,&nbsp;Furkan Deniz MD ,&nbsp;Mehmet Erdoğan MD ,&nbsp;Serkan Asil MD ,&nbsp;Ahmet Anıl Başkurt MD ,&nbsp;Sezer Markirt MD ,&nbsp;Semih Kalkan MD ,&nbsp;Enes Arslan MD ,&nbsp;Faruk Kara MD ,&nbsp;Saner Bahadır Gök MD ,&nbsp;Özge Çebi MD ,&nbsp;Mustafa Kırmızıgül MD ,&nbsp;Onur Sönmez MD ,&nbsp;Fatih Uzun MD ,&nbsp;Ahmet Yaşar Çizgici MD ,&nbsp;Fatih Furkan Bedir MD ,&nbsp;Aybüke Şimşek MD ,&nbsp;Bülent Özlek MD","doi":"10.1016/j.amjcard.2025.08.023","DOIUrl":"10.1016/j.amjcard.2025.08.023","url":null,"abstract":"<div><div>Percutaneous coronary intervention (PCI) for isolated ostial left anterior descending artery (LAD) lesions remains technically difficult. Accurate ostial stenting (AOS) aims to prevent involvement of the left main coronary artery (LMCA), while crossover stenting (COS) ensures complete ostial coverage but may increase procedural complexity. This study aimed to evaluate the long-term outcomes of patients who underwent AOS or COS for ostial LAD disease. From 2014 to 2025, patients who underwent PCI for ostial LAD lesions were retrospectively collected. The primary outcome was major adverse cardiac events (MACE), including cardiac death, target lesion revascularization (TLR), and target vessel myocardial infarction (TVMI). This large-scale multicenter (<em>n</em> = 12) observational study included a total of 1,167 consecutive patients [men: 859 (73.6%), mean age: 61.70 ± 12.73 years] with ostial LAD lesions who underwent PCI; 590 (50.6%) of the cases were revascularized with AOS, and 577 (49.4%) were treated with COS. The incidences of MACE (18.1 vs 9.5%, p &lt;0.001), TVMI (9.2 vs 4.7%, p = 0.003), and clinically driven TLR (10.7 vs 4.2%, p &lt;0.001) were notably higher in the AOS group compared to the COS group. Treatment (AOS) (HR:2.469, p &lt;0.001), chronic kidney disease (HR:1.832, p = 0.003), reduced LVEF (HR:1.016, p = 0.042), SYNTAX score (HR:1.089, p &lt;0.001), lack of intravascular imaging (HR:1.451, p = 0.049), direct stenting (HR:2.171, p = 0.001), stent length (HR:1.036, p = 0.001) were found to be independent predictors of MACE. In conclusion, this nonrandomized study suggests that COS was associated with better long-term MACE, TVMI, and clinically driven TLR rates compared with AOS in patients with ostial LAD disease.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 131-140"},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Healthcare Utilization and Outcomes in Patients Hospitalized for Heart Failure With and Without Atrial Fibrillation","authors":"Faro R. Verelst ,&nbsp;Brandon Zagorski ,&nbsp;Tauben Averbuch ,&nbsp;Rodrigo Bagur ,&nbsp;Christopher Granger ,&nbsp;Andreas B. Gevaert ,&nbsp;Harriette G.C. Van Spall","doi":"10.1016/j.amjcard.2025.08.022","DOIUrl":"10.1016/j.amjcard.2025.08.022","url":null,"abstract":"<div><div>The long-term association between AF and clinical outcomes, healthcare resource utilization, and healthcare costs among patients with HF remains underexplored. We conducted an exploratory analysis of 5-year outcomes among patients enrolled in the patient-centered care transitions in HF (PACT-HF) stepped-wedge cluster randomized trial who were hospitalized for HF and discharged alive between February 2015 and March 2016. Patients were stratified by baseline AF status. Administrative health databases were linked to assess mortality, rehospitalizations, emergency department visits, healthcare utilization, and costs. Mortality was analyzed using Cox proportional hazards models adjusted for baseline comorbidities. Healthcare utilization and cost differences were assessed using Wilcoxon and generalized linear models. Among 4,441 patients, 2,151 patients (48.4%) had AF at baseline. Patients with AF were older and had a higher prevalence of hypertension, stroke, and vascular disease. Patients with AF had a shorter life span (mean [SD] days alive 957.9 [697.8] vs 1,119.6 [698.2], p &lt;0.01) and a higher 5-year all-cause mortality (adjusted HR 1.09 95% CI 1.01 to 1.17; p = 0.03) relative to those without AF. Patients with AF experienced more all-cause rehospitalizations (mean [SD] 3.2 [8.3] vs 2.6 [7.9], p = 0.03) and longer hospital length of stays (mean [SD] days 29.6 [48.6] vs 24.8 [46.9], p &lt;0.01), but no difference in HF rehospitalizations (mean [SD] 0.9 [4.5] vs 0.8 [3.6], p = 0.24) than those without AF. Annual healthcare costs were greater in the AF cohort (mean [SD] $83,748 [114,398] vs $77,792 [114,874]) CAD. In conclusion, despite only modestly increased mortality, patients with AF experienced substantially greater healthcare utilization and cost, largely unrelated to HF-specific care. These exploratory findings underscore the need for a multidisciplinary approach to reduce morbidity and optimize care delivery for patients with HF and comorbid AF.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"256 ","pages":"Pages 115-124"},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Pharmacological Treatment Practices for Patients With Congenital Heart Disease and Pulmonary Hypertension in Japan: Insights From the Japanese Association of Congenital Heart Disease Registry.","authors":"Shahzad G Raja","doi":"10.1016/j.amjcard.2025.08.018","DOIUrl":"10.1016/j.amjcard.2025.08.018","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Sodium Glucose Co-Transporter-2 Inhibitor Utilization in Elderly Heart Failure Patients: A Real-World Population-Level Dataset Analysis","authors":"Zubair Bashir MD, MPH,&nbsp;Ritika Saxena MPH,&nbsp;Wissam Khalife MD,&nbsp;Hani Jneid MD,&nbsp;Khalid Chatila MD,&nbsp;Aiham Albaeni MD","doi":"10.1016/j.amjcard.2025.08.028","DOIUrl":"10.1016/j.amjcard.2025.08.028","url":null,"abstract":"<div><div>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated robust cardiovascular benefits in patients with heart failure (HF), yet disparities in their real-world utilization remain unclear. Our study aims to evaluate predictors of SGLT2i prescription and identify sociodemographic disparities among HF patients. A retrospective cohort study was conducted using the Texas Medicare dataset between January 2017 and June 2022 to evaluate factors associated with SGLT2i prescription among HF patients. Descriptive statistics were used to compare baseline characteristics between groups, and multivariable logistic regression reported independent predictors of SGLT2i prescription. Adjusted marginal probabilities of SGLT2i use were estimated across racial/ethnic groups. Of 309,577 HF patients, those prescribed SGLT2i were less likely to be ≥80 years (16.9% vs 44%), female (45.7% vs 57.4%), and Non-Hispanic Whites (64.1% vs 75.1%) compared to those not prescribed SGLT2i. Diabetes (aOR: 4.66, 95% CI: 4.45–4.87), hypertension (aOR: 1.09, 95% CI: 1.01–1.18), and obesity (aOR: 1.35, 95% CI: 1.29–1.41) were strongly associated with higher odds of prescription, while CKD stage III and IV, peripheral vascular disease, and urinary tract infection were associated with significantly lower odds. Adjusted probability of SGLT2i prescription was highest among Asians (3.96%) and lowest among Blacks (2.26%). In conclusion, significant disparities exist in SGLT2i prescription among HF patients, particularly by age, race/ethnicity, and comorbidity burden. Efforts to promote equitable access to guideline-directed medical therapy are warranted to reduce disparities in HF care.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"256 ","pages":"Pages 130-138"},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes Related to Patent Foramen Ovale in Group 1 Pulmonary Hypertension","authors":"Abdelrahman Hafez MD ,&nbsp;Ramzi Ibrahim MD ,&nbsp;Hoang Nhat Pham MD ,&nbsp;Nikita Rafie MD ,&nbsp;Juan M. Farina MD ,&nbsp;Timothy Barry MB, BCh, BAO ,&nbsp;Robert L. Scott MD, PhD ,&nbsp;F. David Fortuin MD ,&nbsp;Chadi Ayoub MBBS, PhD ,&nbsp;Reza Arsanjani MD","doi":"10.1016/j.amjcard.2025.08.026","DOIUrl":"10.1016/j.amjcard.2025.08.026","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"255 ","pages":"Pages 106-108"},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Epidemiological Profile of Heart Failure Patients With Chagas Disease: Insights From the SEPE-HF Registry","authors":"Juliana Giorgi MD ,&nbsp;Roberto Cristodulo MD ,&nbsp;Carlos Vaca MD ,&nbsp;Daniela Ureña MD ,&nbsp;Isabel Rejas MD ,&nbsp;Jimena Rojas MD ,&nbsp;Fabricio Espinoza MD ,&nbsp;Edgardo Kaplinsky MD ,&nbsp;Alejandro Barbagelata MD","doi":"10.1016/j.amjcard.2025.08.024","DOIUrl":"10.1016/j.amjcard.2025.08.024","url":null,"abstract":"<div><div>Chagas cardiomyopathy (Ch-CMP) represents a unique and understudied phenotype of heart failure (HF) in endemic regions, with distinct clinical, electrocardiographic, and therapeutic characteristics compared to non-Chagas HF. In this retrospective cohort of 417 patients hospitalized for decompensated HF at a tertiary center in Brazil, 155 (37.1%) had confirmed Ch-CMP. Chagas patients were younger (mean age 67.5 vs 67.7 years, p = 0.86), had lower BMI (28.65 vs 25.40, p &lt; 0.001), and a higher proportion of males (50.9% vs 47.7%, p = 0.56). Comorbidities were less frequent in the Chagas group, including hypertension (49.6% vs 70.1%, p = 0.001) and ischemic heart disease (3.2% vs 16.6%, p = 0.001). Electrocardiographic abnormalities were more prevalent among Chagas patients, such as right bundle branch block (17.6% vs 9%, p = 0.015), atrial fibrillation (37.9% vs 23%, p = 0.001), and pacemaker rhythms (22.2% vs 3.7%, p = 0.001). Systolic dysfunction (LVEF &lt; 40%) was more common in Chagas (59.4% vs 27.1%, p = 0.001). Despite these differences, cardiovascular inhospital mortality did not significantly differ (8.4% vs 5.2%, p = 0.279). The use of guideline-directed medical therapy at discharge was suboptimal in both groups, but even lower in Chagas patients, particularly for beta-blockers (52% vs 64%, p = 0.02) and ACEi/ARB/ARNi (54% vs 68%, p = 0.01). Loop diuretics were used in only 64% of the entire cohort; among those not requiring diuretics, arrhythmias and infections were the leading causes of admission, atrial fibrillation in 22 patients, and infection in 21. In conclusion, Chagas cardiomyopathy remains a major contributor to HF hospitalizations in endemic regions, with a unique arrhythmogenic and vasodilated profile, lower prevalence of traditional risk factors, and concerning therapeutic gaps at discharge that merit targeted intervention.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"255 ","pages":"Pages 126-133"},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}