JACC. Heart failure最新文献

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IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-19 DOI: 10.1016/j.jchf.2025.102840

Milica Vukićević, Ameesh Isath, Mandeep R. Mehra

引用次数: 0

Lipoprotein(a) and Outcomes in Worsening Heart Failure With Preserved Ejection Fraction: The PARAGLIDE-HF Trial. 脂蛋白(a)和保留射血分数加重心力衰竭的结局：PARAGLIDE-HF试验。

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-17 DOI: 10.1016/j.jchf.2025.102843

Kaavya Paruchuri,Robert J Mentz,Sotirios Tsimikas,Yuxi Liu,Jonathan H Ward,Samiha Sarwat,Charlotte Paquette,Pradeep Natarajan,James L Januzzi,

引用次数: 0

Mechanically Reducing Cardiac Preload With the preCARDIA System in Acutely Decompensated Heart Failure 在急性失代偿性心力衰竭中，用preCARDIA系统机械地降低心脏预负荷

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-13 DOI: 10.1016/j.jchf.2025.102841

Rayan Yousefzai, Arvind Bhimaraj, Michael S. Kiernan, Jacob Abraham, Irakli Gorgoshvili, Ryan J. Tedford, Shashank Desai, Esther E. Vorovich, Keith H. Benzuly, David Miranda, Manreet K. Kanwar, Andrew J. Sauer, Debbie A. Rinde-Hoffman, Ioana Dumitru, Jaime Hernandez-Montfort, Nima Aghili, Farooq H. Sheikh, Anupam Basuray, Jason Bodnar, Jerry Curran, Daniel Burkhoff, Navin K. Kapur

引用次数: 0

Robot-Assisted Training Improves Physical Activity in Advanced Heart Failure 机器人辅助训练改善晚期心力衰竭患者的身体活动

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-13 DOI: 10.1016/j.jchf.2025.102830

Felix Schoenrath, Denis Fries, Yannick Streef, Luise Roehrich, Frank Edelmann, Bettina Heidecker, Sebastian Spethmann, Chiara Basla, Robert Riener, Volkmar Falk, Isabell A. Just

引用次数: 0

Therapeutic Sequencing in Obstructive Hypertrophic Cardiomyopathy: Seeing the Forest Through the Trees. 阻塞性肥厚性心肌病的治疗顺序：透过树木看到森林。

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-08 DOI: 10.1016/j.jchf.2025.102836

Nosheen Reza

引用次数: 0

BMI in HFpEF: Friend or Foe? HFpEF中的BMI：是敌是友？

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-08 DOI: 10.1016/j.jchf.2025.102826

Jennifer E Ho,Sanjeeb S Bhattacharya

引用次数: 0

Framework for Analytical Validation of DHT-Based Actigraphy and Signal Measures in HF Trials: The VALIDATE-HF Program. HF试验中基于dht的活动图和信号测量分析验证框架：VALIDATE-HF程序。

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-08 DOI: 10.1016/j.jchf.2025.102831

Orhun Kose,Aymen Sahal,Guang K Zhang,Elite Possik,Mona Fiuzat,Mitchell A Psotka,David P Kao,Elise Shalowitz,Trejeeve Martyn,Veraprapas Kittipibul,Wei Ni,Whittemore Tingley,Vanja Vlajnic,Steen Z Abildstrøm,Martin Cowie,Maulik Majmudar,Tariq Ahmad,Eric Leifer,Marat Fudim,Christopher M O'Connor,Abhinav Sharma

引用次数: 0

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-06 DOI: 10.1016/j.jchf.2025.102779

Alberto Foà,Muthiah Vaduganathan,Brian L Claggett,Akshay S Desai,Pardeep S Jhund,Alasdair D Henderson,Safia Chatur,Flaviana Amarante,Lucas Hofmeister,Andrea Horvat-Broecker,Silvia Kuhls,Carolyn S P Lam,Michele Senni,Sanjiv J Shah,Adriaan A Voors,Faiez Zannad,Bertram Pitt,John J V McMurray,Scott D Solomon

BACKGROUNDThe nonsteroidal mineralocorticoid receptor antagonist finerenone reduces clinical events in heart failure with mildly reduced ejection fraction/preserved ejection fraction; however, the implications of treatment-related hypotension are unknown.OBJECTIVESThe authors investigated predictors of systolic blood pressure (SBP) <100 mm Hg and investigator-reported hypotension and their associations with randomized treatment and clinical outcomes in the FINEARTS-HF (Study to Evaluate the Efficacy [Effect on Disease] and Safety of Finerenone in Participants With Heart Failure and Left Ventricular Ejection Fraction [Proportion of Blood Expelled Per Heart Stroke]) trial.METHODSFINEARTS-HF was a randomized, placebo-controlled trial of finerenone in symptomatic patients with chronic heart failure (left ventricular ejection fraction ≥40%). Predictors of SBP <100 mm Hg and hypotension were identified using Cox models. Associations between SBP <100 mm Hg and hypotension, treatment, and clinical outcomes were evaluated using time-updated Cox models. The primary outcome was a composite of total heart failure events and cardiovascular death.RESULTSAmong the 5,815 participants with available data, post-baseline SBP <100 mm Hg occurred in 899 (538 with finerenone vs 361 with placebo; odds ratio: 1.60; 95% CI: 1.38-1.85) and investigator-reported hypotension in 364 patients (225 with finerenone vs 139 with placebo; odds ratio: 1.67; 95% CI: 1.34-2.08). Participants experiencing SBP <100 mm Hg had lower baseline SBP, were older, had higher N-terminal pro-B-type natriuretic peptide levels, a history of smoking, and no diabetes. Treatment-related risk of the primary endpoint was reduced in patients with no/before SBP <100 mm Hg (rate ratio: 0.78; 95% CI: 0.67-0.90) and appeared to attenuate afterwards (rate ratio: 0.99; 95% CI: 0.70-1.39), although no formal statistical interaction was observed (Pinteraction = 0.33).CONCLUSIONSIn this prespecified analysis of the FINEARTS-HF trial, finerenone led to higher rates of post-baseline SBP <100 mm Hg and investigator-reported hypotension. Although hypotension should not prompt automatic treatment discontinuation, these patients should be carefully monitored. (Study to Evaluate the Efficacy (Effect on Disease) and Safety of Finerenone in Participants With Heart Failure and Left Ventricular Ejection Fraction (Proportion of Blood Expelled Per Heart Stroke) Greater or Equal to 40% [FINEARTS-HF]; NCT04435626.).

背景：非甾体类矿物皮质激素受体拮抗剂芬烯酮可通过轻度降低射血分数/保留射血分数来减少心力衰竭的临床事件；然而，治疗相关性低血压的影响尚不清楚。目的研究收缩压(SBP) <100 mm Hg和研究者报告的低血压的预测因素，以及它们与fineards - hf（评估非尼伦酮对心力衰竭和左心室射血分数[每次心脏卒中排出血液比例]参与者的疗效[对疾病的影响]和安全性的研究）试验的随机治疗和临床结局的关系。方法finhearts - hf是一项随机、安慰剂对照试验，芬尼酮治疗有症状的慢性心力衰竭患者（左心室射血分数≥40%）。使用Cox模型确定收缩压<100 mm Hg和低血压的预测因子。使用时间更新的Cox模型评估收缩压<100 mm Hg与低血压、治疗和临床结果之间的关系。主要终点是总心力衰竭事件和心血管死亡的综合结果。结果在5815名有可用数据的参与者中，基线后收缩压<100 mm Hg的患者有899例（菲纳酮组538例，安慰剂组361例；优势比：1.60;95% CI: 1.38-1.85），研究者报告低血压的患者有364例（菲纳酮组225例，安慰剂组139例；优势比：1.67;95% CI: 1.34-2.08）。收缩压<100 mm Hg的参与者基线收缩压较低，年龄较大，n端前b型利钠肽水平较高，有吸烟史，无糖尿病。主要终点的治疗相关风险在收缩压<100 mm Hg的患者中降低（比率比：0.78;95% CI: 0.67-0.90），并且在收缩压<100 mm Hg的患者中出现减弱（比率比：0.99;95% CI: 0.70-1.39），尽管没有观察到正式的统计学相互作用（p相互作用= 0.33）。结论：在FINEARTS-HF试验的预先分析中，finerenone导致基线后收缩压<100 mm Hg和研究者报告的低血压的较高发生率。虽然低血压不应促使自动停止治疗，但这些患者应仔细监测。对心力衰竭和左心室射血分数（每次心脏卒中排出的血液比例）大于或等于40%的参与者芬纳酮的疗效（对疾病的影响）和安全性的评估研究[finhearts - hf]；NCT04435626)。

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引用次数: 0

Finerenone and Cardiovascular Outcomes According to Baseline Kidney Function in Patients With Heart Failure: The FINEARTS-HF Trial. 根据心力衰竭患者的基线肾功能，芬纳烯酮和心血管结局：finhearts - hf试验。

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-05 DOI: 10.1016/j.jchf.2025.102778

Finnian R Mc Causland,Safia Chatur,Muthiah Vaduganathan,Brian L Claggett,Ian J Kulac,Akshay S Desai,Pardeep S Jhund,Alasdair D Henderson,Katja Rohwedder,Flaviana Amarante,Meike Brinker,Patrick Schloemer,Carolyn S P Lam,John W Ostrominski,Michele Senni,Sanjiv J Shah,Adriaan A Voors,Faiez Zannad,Bertram Pitt,John J V McMurray,Scott D Solomon

BACKGROUNDFinerenone is known to reduce the risk of worsening heart failure (HF) events and cardiovascular (CV) death in patients with HF with mildly reduced or preserved ejection fraction.OBJECTIVESThe authors explored whether the benefit of finerenone among patients with HF with mildly reduced or preserved ejection fraction differs according to baseline measures of kidney function.METHODSFINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure) was a global, randomized clinical trial of finerenone vs placebo among patients with HF with mildly reduced or preserved ejection fraction. Finerenone was titrated to 20 mg/d if the estimated glomerular filtration rate (eGFR) was ≤60 mL/min/1.73 m2 or 40 mg/d if eGFR was >60 mL/min/1.73 m2. The authors used a semiparametric proportional rates method, stratified by left ventricular ejection fraction (<60%; ≥60%) and region, to assess for differential treatment effects on the composite of total HF events and CV death according to the baseline eGFR (continuous and categories [≥60 mL/min/1.73 m2, 45 to <60 mL/min/1.73 m2, <45 mL/min/1.73 m2] and urine albumin-creatinine ratio (UACR) (<30 mg/g, 30 to <300 mg/g, ≥300 mg/g).RESULTSThe effect of finerenone to reduce the primary endpoint of total HF events and CV death did not significantly differ according to baseline eGFR (Pinteraction = 0.14 and 0.07 for continuous and categorical eGFR, respectively) with rate ratio 0.72 (95% CI: 0.59-0.88) for eGFR ≥60 mL/min/1.73 m2, 0.83 (95% CI: 0.65-1.06) for eGFR 45 to <60 mL/min/1.73 m2, and 1.02 (95% CI: 0.83-1.26) for eGFR <45 mL/min/1.73 m2. The corresponding absolute event rates were 9.2 vs 12.5, 16.5 vs 19.9, and 28.0 vs 28.0 per 100 patient-years for finerenone vs placebo, respectively. Similar results were noted for total worsening HF events. Finerenone lowered the risk of the composite CV outcome similarly across baseline categories of UACR (Pinteraction = 0.48).CONCLUSIONSIn the FINEARTS-HF trial (where the target dose of finerenone was determined by baseline kidney function), the effect of finerenone to reduce the composite of cardiovascular death and total HF events did not significantly differ across a range of baseline eGFR and UACR.

研究背景：对于射血分数轻度降低或保留的心衰患者，芬烯酮可降低心衰（HF）事件恶化和心血管（CV）死亡的风险。目的：作者探讨芬尼酮对射血分数轻度降低或保留的HF患者的益处是否因肾功能基线测量而有所不同。方法finhearts -HF（芬尼烯酮试验研究心力衰竭患者优于安慰剂的疗效和安全性）是一项全球随机临床试验，在射血分数轻度降低或保持的心力衰竭患者中比较芬尼烯酮和安慰剂。如果估计肾小球滤过率(eGFR)≤60 mL/min/1.73 m2，则将芬烯酮滴定至20 mg/d；如果eGFR≤60 mL/min/1.73 m2，则将芬烯酮滴定至40 mg/d。作者采用半参数比例率方法，根据左室射血分数（<60%;≥60%）和地区分层，根据基线eGFR(连续和分类[≥60ml /min/1.73 m2, 45至< 60ml /min/1.73 m2, < 45ml /min/1.73 m2]和尿白蛋白-肌酐比（UACR）（< 30mg /g， 30至< 300mg /g,≥300mg /g）评估不同治疗对总HF事件和CV死亡复合的影响。结果根据基线eGFR（连续eGFR和分类eGFR分别为0.14和0.07），芬尼酮降低总HF事件和CV死亡的主要终点的效果无显著差异，eGFR≥60 mL/min/1.73 m2时的比率为0.72 (95% CI: 0.59-0.88)， eGFR 45至<60 mL/min/1.73 m2时的比率为0.83 (95% CI: 0.65-1.06), eGFR <45 mL/min/1.73 m2时的比率为1.02 （95% CI: 0.83-1.26）。相应的绝对事件发生率，芬芬酮与安慰剂分别为9.2 vs 12.5, 16.5 vs 19.9, 28.0 vs 28.0 / 100患者年。心力衰竭事件的总恶化情况也有类似的结果。芬尼酮降低复合CV结果的风险在UACR的基线类别中相似（相互作用p = 0.48）。结论：在finearst -HF试验中（芬尼酮的靶剂量由基线肾功能决定），芬尼酮降低心血管死亡和总HF事件的效果在基线eGFR和UACR范围内没有显著差异。

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引用次数: 0

Inflammation and the Need for Biology-Driven Care in Heart Failure. 心力衰竭的炎症和生物学驱动护理的需要。

IF 13 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-12-05 DOI: 10.1016/j.jchf.2025.102834

Abhinav Sharma,Virginia Anagnostopoulou,Anique Ducharme

引用次数: 0

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