Cardiology最新文献

{"title":"Functional Recovery Patterns and Baseline Cardiac Power Output During Impella 5.5 Support in Heart Transplant Candidates: A Descriptive Study.","authors":"Vrutti Patel, Saurabh Sujanyal, Anek Jena, Aayushi Pareek, Said Bateh, Jose Delgado, Aryan Pathak, Gustavo Olaizola, Ivan Huespe, Faiz Ur Rehman Saleem, Timothy Garrahy, Brittney Laskey, Terri Menser, Susana Bauque, Eduardo Manuel Prado, Abby Hansen, Aarti Desai, Jose Ruiz Morales, Deeksha Thatigolla, Ananya Biswas, John Haney, Rachel Hannon, Juan Carlos Leoni Moreno, Rohan Goswami, Jose Soto Soto, Pramod Guru, Sanjay Chaudhary, Anirban Bhattacharyya, Melissa Lyle, Parag Patel, Pablo Moreno Franco, Devang K Sanghavi, Anna Shapiro","doi":"10.1159/crd/absag020","DOIUrl":"https://doi.org/10.1159/crd/absag020","url":null,"abstract":"<p><strong>Background: </strong>The Impella 5.5 microaxial pump facilitates ambulatory mechanical circulatory support via axillary implantation, providing a model for active prehabilitation in critically ill heart transplant candidates. Whether patients with severely reduced baseline cardiac power output (CPO) can achieve meaningful ambulation during Impella 5.5 support remains uncertain.</p><p><strong>Methods: </strong>This is a retrospective descriptive study of consecutive adults with cardiogenic shock (SCAI stages C-E) who received an Impella 5.5 as a bridge to heart transplantation between April 2022 and September 2024. Cardiac Power Output was calculated via pre-implantation right heart catheterization, defined as low (≤0.60 W) or higher (>0.60 W). Measures of functional recovery include maximum walking distance per day, cumulative walking distance during Impella 5.5 support, time to first walk, and percentage of patients who walked at least once. The LOWESS method is used to illustrate overall walking distance trajectories.</p><p><strong>Results: </strong>The final analytic cohort included 80 patients: 37 (46.3%) with baseline CPO ≤0.60 W and 43 (53.8%) with baseline CPO >0.60 W. Overall, 75 of 80 patients (93.8%) ambulated at least once before transplantation, including 89.2% in the low-CPO group and 97.7% in the higher-CPO group (p = 0.176). The time to first walking day was 5 days (IQR 3-7) in the low-CPO group vs. 3 days (IQR 2-7) in the higher-CPO group (p = 0.27). Maximum daily walking distance was 5,200 ft (IQR 2,000-10,400 ft) vs. 4,000 ft (IQR 2,400-8,000 ft) (p = 0.26), while cumulative distance was 15,400 ft vs. 11,000 ft (p = 0.81).</p><p><strong>Conclusions: </strong>Prehabilitation is feasible in patients undergoing Impella 5.5 support across the spectrum of hemodynamic status. Patients with severely compromised baseline cardiac performance achieved early, substantial ambulation. Thus, Impella 5.5 appears feasible as a platform for both hemodynamic support and prehabilitation of patients awaiting heart transplantation, though larger, non-selected cohorts are needed to confirm these findings.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-Blocker Management in Obstructive Hypertrophic Cardiomyopathy Treated with Mavacamten: A Practical Approach.","authors":"Gregorio Menzá, Chiara Leuzzi, Chiara Valenti, Alessandro Navazio","doi":"10.1159/crd/absag014","DOIUrl":"https://doi.org/10.1159/crd/absag014","url":null,"abstract":"<p><p>Beta-blockers are the cornerstone of first-line therapy for symptomatic obstructive hypertrophic cardiomyopathy (oHCM), whereas mavacamten has recently emerged as an effective disease-specific treatment targeting the underlying hypercontractile state. However, the optimal management of concomitant beta-blocker therapy following mavacamten initiation remains uncertain. Available evidence indicates that beta-blockers do not diminish the favorable effects of mavacamten on left ventricular outflow tract obstruction or symptom relief but may attenuate improvements in exercise capacity due to chronotropic limitation. This work reviews the current evidence regarding beta-blocker use during mavacamten therapy and discusses the pathophysiological mechanisms underlying this interaction. Based on the available data, we propose a practical, physiology-guided approach in which continuation of beta-blockers is reserved for patients with specific clinical indications, including atrial fibrillation requiring rate control, myocardial ischemia, or increased ventricular arrhythmic risk, while cautious dose reduction or withdrawal may be considered in selected patients with persistent chronotropic incompetence after effective relief of obstruction. Prospective studies are needed to define the optimal strategy for integrating beta-blockers with cardiac myosin inhibition in oHCM.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empirical Classification of T-Wave Inversion Patterns as Lower Risk or Higher Risk in Black Adults: A Wall-Based Prevalence and Outcome Analysis from the Jackson Heart Study.","authors":"José Nunes de Alencar","doi":"10.1159/crd/absag010","DOIUrl":"10.1159/crd/absag010","url":null,"abstract":"<p><strong>Introduction: </strong>T-wave inversion (TWI) in Black adults is interpreted through criteria derived from White populations or competitive athletes, never tested with outcome data in nonathletic community adults. The aims of the study were to classify TWI patterns as lower risk or higher risk using lead-specific outcome thresholds and derive a race-specific reference from a healthy subcohort.</p><p><strong>Methods: </strong>We analyzed 3,514 Black adults from the Jackson Heart Study Exam 1 (2000-2004). A wall-based system classified higher risk TWI as Tnet <-100 µV in lateral, anterior, or inferior leads; benign patterns were isolated V1 and isolated lead III. A healthy subcohort (N = 668) free of hypertension, diabetes, obesity, CKD, coronary disease, heart failure, and left ventricular hypertrophy (LVH) ECG criteria served as reference. Logistic regression assessed cardiometabolic associations; Cox models assessed incident outcomes over median 11.8-year follow-up.</p><p><strong>Results: </strong>Higher risk TWI was present in 262 (7.5%; healthy: 3.0%) and lower risk patterns in 685 (19.5%). Higher risk TWI independently predicted Hard coronary heart disease (CHD), with an adjusted hazard ratio of 2.47 (95% CI 1.51-4.04), and was associated with hypertension (OR 1.98) and ECG-LVH (OR 3.98). Benign V1 showed inverse associations with diabetes (OR 0.48) and LVH (OR 0.36), with 1 Hard CHD event during follow-up; the higher risk effect was homogeneous across health strata (P-interaction = 0.455). The classic V1-V2-V3 juvenile pattern occurred in 1 of 3,514; V3 inversion carried Hard CHD HR 3.49.</p><p><strong>Conclusion: </strong>Anterior T-wave inversion in V2, V3, or V4 in nonathletic Black community-dwelling adults is not necessarily a benign signal and should not be assumed to represent a persistent juvenile variant. These data provide the first outcomes-anchored ECG reference for this population.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Variations in Lipoprotein(a): Role for Repeat Measurement?","authors":"Shivansh Pande","doi":"10.1159/crd/absag013","DOIUrl":"10.1159/crd/absag013","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential Changes in Lipoprotein(a) during the First Month after Acute Coronary Syndrome: A Historical Prospective Cohort Study.","authors":"José Javier Gómez-Barrado, Miguel Turégano-Yedro, Miguel Ángel Silva-Cerpa, Elias Emilio Majluf, Carla Guillem-Ferrer, Rafael Cantisán-Campillos, Marcos García-Jambrina, Estrella Martínez-Bermúdez, Rocío Soledad González-Garay, Ana Macarro-Soto, Celia González-Peramato, Roberto Pallavera-Sánchez, María Sosa-Sanchez, Paula Gómez-Turégano","doi":"10.1159/crd/absag011","DOIUrl":"10.1159/crd/absag011","url":null,"abstract":"<p><strong>Introduction: </strong>Lipoprotein(a) [Lp(a)] is an independent causal risk factor for atherosclerotic cardiovascular disease, with plasma concentrations largely determined by genetic factors. Despite its relative stability under basal conditions, its behaviour during acute inflammatory states such as acute coronary syndrome (ACS) remains controversial. This exploratory study evaluated serial changes in plasma Lp(a) concentrations during the first month after ACS using the original patient-level data from a historical prospective cohort with high-frequency serial sampling.</p><p><strong>Methods: </strong>Thirty-three men with ACS were prospectively enrolled. Blood samples were collected at hospital admission (≤3 h after symptom onset), and at 12, 24, and 48 h, as well as on days 7 and 30. Plasma Lp(a) concentrations were measured by immunoturbidimetry. Because Lp(a) values were not normally distributed, results are presented as mean ± standard deviation and median (interquartile range [IQR]). Overall temporal differences were assessed using the Friedman test, and prespecified pairwise comparisons were performed using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Twenty-nine patients completed all six scheduled assessments. Plasma Lp(a) concentrations showed a significant overall change over time (Friedman χ2(5) = 33.5, p < 0.001). No statistically significant differences were observed between admission and 12 h (p = 0.473), 24 h (p = 0.621), or 48 h (p = 0.630). Median (IQR) Lp(a) concentrations at these respective time points were 21.0 (36.5), 19.0 (30.5), 16.0 (32.5), and 20.0 (29.5) mg/dL. Lp(a) concentrations increased significantly on day 7 (median 39.0 [54.0] mg/dL; p < 0.001 vs. admission) and subsequently declined by day 30 (median 23.0 [46.0] mg/dL; p = 0.023 vs. day 7).</p><p><strong>Conclusion: </strong>In this historical prospective cohort, no statistically significant change was detected in plasma Lp(a) concentrations during the first 48 h after ACS. Lp(a) concentrations subsequently increased significantly around day 7 and declined by day 30. These findings suggest that Lp(a) undergoes transient changes during the early post-ACS period and that measurements obtained during the first weeks after the index event should be interpreted with caution. Larger contemporary studies are warranted to determine the optimal timing for Lp(a) assessment following ACS.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mavacamten in Non-Obstructive Hypertrophic Cardiomyopathy: Is the Story Over?","authors":"Gregorio Menzá, Chiara Leuzzi, Chiara Valenti, Alessandro Navazio","doi":"10.1159/crd/absag012","DOIUrl":"https://doi.org/10.1159/crd/absag012","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Bundle Branch Block without Anterior ST-Segment Depression: Should It Be Automatically Flagged as Anterior STEMI Equivalent?","authors":"Turner Glenn, Murali Palathinkara, Yochai Birnbaum","doi":"10.1159/crd/absag009","DOIUrl":"10.1159/crd/absag009","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with right bundle branch block (RBBB), the utility of ST-segment abnormalities in assessing for acute myocardial infarction remains a topic of ongoing discussion. We studied whether lack of ST depression in V1-V3 should be added to the computerized algorithms of interpretation as an equivalent of ST elevation in patients with acute myocardial infarction due to LAD occlusion.</p><p><strong>Methods: </strong>A total of 99 patients were selected from a single center based on evaluation of routine electrocardiography (ECG) showing RBBB and an ST-segment which was at or above the isoelectric line in leads V1-V3. A retrospective chart review was then performed to evaluate for diagnosis of acute myocardial infarction (MI), as well as need for revascularization via PCI or CABG. Additional data were collected for this population, including symptomatology at the time of ECG, past medical history, and frequency of additional cardiac workup including stress test and catheterization.</p><p><strong>Results: </strong>In total, 9 of 99 (9.1%) patients were found to have a diagnosis of acute MI based on cardiac catheterization findings and/or troponin elevation from baseline. Of the 9 patients with acute MI, two were referred for possible CABG with revascularization performed on one. No patients with acute MI underwent emergent PCI. PCI and CABG were subsequently performed for 3 (3%) and 5 (5.1%) of all patients, respectively. Only 1 of these revascularized patients received a diagnosis of acute MI.</p><p><strong>Conclusion: </strong>In patients with RBBB lacking ST depression in the anterior leads, the frequency of emergent revascularization was low. These findings demonstrate that while acute occlusion is a possible etiology for ST-segment at or above the isoelectric line in patients with RBBB, these changes are a poor indicator of occlusion in isolation. ECG should be considered in clinical context when deciding whether or not to activate primary percutaneous coronary intervention protocol.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Assessment of Degenerative Mitral Stenosis: The Role of Three-Dimensional Echocardiography.","authors":"Gregorio Menzà, Alessandro Navazio","doi":"10.1159/000553579","DOIUrl":"10.1159/000553579","url":null,"abstract":"<p><strong>Background: </strong>Degenerative mitral stenosis (MS) caused by mitral annular calcification is increasingly recognized in the aging population and differs fundamentally from rheumatic MS in anatomy and pathophysiology. These differences limit the accuracy of conventional two-dimensional echocardiographic assessment.</p><p><strong>Summary: </strong>This review highlights the anatomical differences between rheumatic and degenerative MS and their implications for imaging. In degenerative MS, two-dimensional echocardiography is often limited by acoustic shadowing, complex valve geometry, and flow-dependent Doppler measurements. Three-dimensional echocardiography provides a more accurate anatomical assessment of the mitral valve area by adapting planimetric measurements to the underlying valve morphology. In rheumatic MS, measurements are performed at the leaflet tips, whereas in degenerative MS the narrowest orifice is located at the annular level.</p><p><strong>Key messages: </strong>Three-dimensional echocardiography allows etiology-specific planimetric assessment of mitral valve area by identifying the true anatomical orifice in degenerative and rheumatic MS.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Clinical Nomogram for Predicting Angiographic Progression of Coronary Artery Disease.","authors":"Gang Wang, Jianghong Liu, Jihong Fan, Huina Sun, Ruifeng Liu","doi":"10.1159/crd/absag007","DOIUrl":"10.1159/crd/absag007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The heterogeneous nature of coronary artery disease (CAD) progression significantly contributes to cardiovascular morbidity and mortality. Accurately identifying patients at high risk for progression is paramount for effective secondary prevention. This study aimed to develop and internally validate a novel clinical nomogram to precisely predict the probability of angiographic progression in patients with established CAD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective case-referent study enrolled 333 patients with established CAD who underwent at least two coronary angiograms at Beijing Friendship Hospital between January 2018 and December 2023. The cohort comprised 222 patients with angiographic progression and 111 referents without progression, matched at a 2:1 ratio to minimize potential bias. A comprehensive set of 146 preselected potential predictors was systematically collected. The least absolute shrinkage and selection operator regression was employed for robust initial variable selection, followed by univariable and multivariable logistic regression to identify independent risk factors, which were subsequently integrated into the nomogram. Model performance was rigorously evaluated through assessment of discrimination (area under the receiver operating characteristic curve [AUC]), calibration (calibration curve and Hosmer-Lemeshow test), and clinical utility (decision curve analysis [DCA]). Internal validation was conducted using a nonparametric bootstrap resampling technique to mitigate optimism and provide robust performance estimates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven independent predictors of angiographic progression were identified: a shorter interval between angiograms (odds ratio [OR]: 0.99, 95% confidence interval [CI]: 0.99-1.00, p = 0.015), a higher preoperative Gensini score (OR: 1.08, 95% CI: 1.05-1.10, p &lt; 0.001), male gender (vs. female, OR: 3.31, 95% CI: 1.69-6.45, p &lt; 0.001), the absence of a prior history of stroke (vs. presence of stroke, OR: 0.16, 95% CI: 0.03-0.79, p = 0.025), elevated low-density lipoprotein cholesterol levels (OR: 2.32, 95% CI: 1.46-3.71, p &lt; 0.001), higher glycated hemoglobin levels (OR: 1.52, 95% CI: 1.12-2.05, p = 0.006), and increased antithrombin III levels (OR: 1.04, 95% CI: 1.01-1.07, p = 0.008). The developed nomogram demonstrated promising discrimination (apparent AUC: 0.88, 95% CI: 0.84-0.92) and superior calibration (Hosmer-Lemeshow test, p = 0.990) within the internal validation cohort. DCA indicated that the nomogram offered a statistically and clinically significant net benefit across a range of threshold probabilities (5-80%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We successfully developed and internally validated a novel nomogram integrating seven readily available clinical and laboratory variables to accurately predict angiographic progression in CAD. This tool provides an individualized, quantitative risk assessment with promising predictive p","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TELEMETRIC-HF: Pilot Randomized Study of Telemetry-Guided Guideline-Directed Medical Therapy Optimization and Ventricular Arrhythmia Surveillance in Patients with Heart Failure with Reduced Ejection Fraction.","authors":"Saša Borović, Dragana Košević, Jelena Stefanović Nešković, Jelena Lešanović, Goran Lončar, Jelena Miladinović, Bojana Milovanović, Petar Dabić, Nadiia Rineiska, Milovan Bojić","doi":"10.1159/crd/absag008","DOIUrl":"10.1159/crd/absag008","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of the study was to evaluate the feasibility of telemetry-guided optimization of guideline-directed medical therapy (GDMT) and continuous arrhythmic surveillance in ambulatory patients with heart failure with reduced ejection fraction (HFrEF).</p><p><strong>Methods: </strong>TELEMETRIC-HF was a single-center, randomized, open-label pilot study including 30 patients with HFrEF assigned to telemetry-guided management (n = 15) or standard outpatient care (n = 15). Patients in the telemetry group underwent 8 weeks of continuous ambulatory monitoring using the CPC12 CE MDR class IIb wearable system, providing continuous electrocardiographic and physiological monitoring with clinician oversight. The primary endpoint was the between-group difference in β-blocker (BB) target-dose achievement at 8 weeks. Secondary endpoints included optimization of other GDMT classes, ventricular arrhythmia detection, clinical status, quality of life, safety, and healthcare utilization.</p><p><strong>Results: </strong>Telemetry-guided management was associated with significantly greater BB target-dose achievement at 8 weeks than standard care (60.0% vs. 39.2% of the guideline-recommended target dose; absolute difference 20.8%, 95% CI 2.7-39.2; p = 0.028). Target-dose achievement for angiotensin receptor-neprilysin inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors did not differ significantly between groups. Recurrent non-sustained ventricular tachycardia was detected only in the telemetry group, prompting additional clinical evaluation, antiarrhythmic therapy, and primary prevention implantable cardioverter-defibrillator implantation in one patient. Hemodynamic, laboratory, and echocardiographic parameters remained stable throughout follow-up, and telemetry was well tolerated. No heart failure hospitalizations or deaths occurred during the 8-week study period.</p><p><strong>Conclusion: </strong>In this pilot randomized study, telemetry-guided remote monitoring was feasible and was associated with earlier BB optimization and improved detection of clinically relevant ventricular arrhythmias without compromising safety. These exploratory findings support further evaluation of telemetry-guided outpatient heart failure management in larger, adequately powered multicenter randomized trials.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}