JACC. Heart failure最新文献

英文中文

Ultrafiltration for Management of Decompensated Heart Failure: A Reappraisal of AVOID-HF.

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-06 DOI: 10.1016/j.jchf.2024.11.018

Sean P Pinney, Maria V DeVita, Bjorn Redfors, Lak N Kotinkaduwa, Megan Cotts, Jennifer Cowger, Maria Rosa Costanzo

引用次数: 0

Disparities Among Immigrants and Native Patients in Denmark With New-Onset Heart Failure With Reduced Ejection Fraction.

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-05 DOI: 10.1016/j.jchf.2024.11.008

Sam Aiyad Ali, Naja Emborg Vinding, Jawad H Butt, Johanna Krøll, Johan E Larsson, Morten Schou, Emil L Fosbøl, Brian B Løgstrup, Inge Schjødt, Pardeep S Jhund, Lars Køber, Finn Gustafsson, Naveed Sattar, John J V McMurray, Søren Lund Kristensen

Background: Worldwide, major health care variations exist in patients with heart failure (HF).

Objectives: In this study, the authors sought to examine and compare immigrants grouped by region of origin and native Danish patients presenting with new-onset heart failure with reduced ejection fraction (HFrEF).

Methods: The authors used data from the Danish Heart Failure Registry and administrative registries comprising information on medication, comorbidity, vital status, income level, and education. The co-primary outcomes were uptitration of guideline-directed medical therapy (GDMT) and a composite of HF hospitalization and all-cause death.

Results: Overall, 55,918 patients were included, of whom 94.8% were native Danish patients, 3.0% originated from Europe/Central Asia, 1.1% from the Middle East/North Africa, 0.6% from South Asia, and 0.5% from other regions. Patients from the non-Western areas were around 10 years younger (median age 62 vs 72 years) and had more diabetes (38%-50% vs 20%) and ischemic heart disease (67%-74% vs 48%) and less atrial fibrillation (9%-15% vs 32%) compared with Danish patients (all P < 0.001). At 12 months' follow-up, no major differences in attainment of ≥50% target daily doses of GDMT were observed across groups. The crude 3-year cumulative risk of HF hospitalization or all-cause death ranged from 25% to 37% and was lowest for non-Western immigrants, although this difference does not persist in age- and sex-matched analyses.

Conclusions: Patients in Denmark with HFrEF originating from non-Western parts of the world were younger and had more ischemic heart disease and diabetes and less atrial fibrillation compared with native Danish patients. The likelihood of GDMT uptitration at 12 months was similar to that of native Danish patients, whereas their risk of HF hospitalization or all-cause death was lower, although the difference between the 2 groups diminished in age- and sex-matched analyses.

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引用次数: 0

Management of patients with Impella 5.5 left ventricular assist devices on a cardiovascular stepdown unit.

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-05 DOI: 10.1016/j.jchf.2025.02.002

Anthony P Carnicelli, Brian A Houston, Jennifer Hajj, Kaylen Dodson, Lindsey Bull, Meg Ospina, Thomas G Di Salvo, Jeffrey D McMurray, Jeffrey Yourshaw, Ryan J Tedford, Lucas Witer, Arman Kilic

引用次数: 0

Ventricular Reconstruction

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-01 DOI: 10.1016/j.jchf.2024.12.001

Frederick G.P. Welt MD, James C. Fang MD

引用次数: 0

24-Month Outcomes of Endovascular Baroreflex Amplification With the MobiusHD Device in Heart Failure With Reduced Ejection Fraction MobiusHD装置血管内压反射扩增治疗心力衰竭伴射血分数降低的24个月疗效

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-01 DOI: 10.1016/j.jchf.2024.11.005

Kerstin Piayda MD, MSc , Stefan Bertog MD , Kolja Sievert MD , Horst Sievert MD , Tamaz Shaburishvili MD , Irakli Gogorishvili MD , Martin Rothman MD , James L. Januzzi Jr. MD , JoAnn Lindenfeld MD , Gregg W. Stone MD

引用次数: 0

Growth Differentiation Factor–15 Is Associated With Congestion-Related Anorexia and Weight Loss in Advanced Heart Failure 生长分化因子-15与晚期心力衰竭患者充血相关性厌食症和体重减轻有关

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-01 DOI: 10.1016/j.jchf.2024.10.023

Luca Monzo MD, PhD , Petr Jarolim MD, PhD , Barry A. Borlaug MD , Jan Benes MD, PhD , Ivana Jurcova MD , Dominik Jenca MD , Katerina Kroupova MD , Peter Wohlfahrt MD, PhD , Martin Kotrc MD , Vojtech Melenovsky MD, PhD

Background

Growth differentiation factor (GDF)-15 is a pleiotropic cytokine that is associated with appetite-suppressing effects and weight loss in patients with malignancy.

Objectives

This study aims to investigate the relationships between GDF-15 levels, anorexia, cachexia, and clinical outcomes in patients with advanced heart failure with reduced ejection fraction (HFrEF).

Methods

In this observational, retrospective analysis, a total of 344 patients with advanced HFrEF (age 58 ± 10 years, 85% male, 67% NYHA functional class III), underwent clinical and echocardiographic examination, body composition evaluation by skinfolds and dual-energy x-ray absorptiometry, circulating metabolite assessment, Minnesota Living with Heart Failure Questionnaire, and right heart catheterization.

Results

The median GDF-15 level was 1,503 ng/L (Q1-Q3: 955-2,332 ng/L) (reference range: <1,200 ng/L). Higher GDF-15 levels were associated with more prevalent anorexia and cachexia. Patients with higher GDF-15 had increased circulating free fatty acids and beta-hydroxybutyrate, lower albumin, cholesterol, and insulin/glucagon ratio, consistent with a catabolic state. Patients with higher GDF-15 had worse congestion and more severe right ventricular dysfunction. In multivariable Cox analysis, elevated GDF-15 was independently associated with risk of the combined endpoint of death, urgent transplantation, or left ventricular assist device implantation, even after adjusting for coexisting anorexia and cachexia (T3 vs T1 HR: 2.31 [95% CI: 1.47-3.66]; P < 0.001).

Conclusions

In patients with advanced HFrEF, elevated circulating GDF-15 levels are associated with a higher prevalence of anorexia and cachexia, right ventricular dysfunction, and congestion, as well as an independently increased risk of adverse events. Further studies are warranted to determine whether therapies altering GDF-15 signaling pathways can affect metabolic status and clinical outcomes in advanced HFrEF.

背景：生长分化因子(GDF)-15是一种多效细胞因子，与恶性肿瘤患者的食欲抑制作用和体重减轻有关。目的：本研究旨在探讨晚期心力衰竭伴射血分数降低（HFrEF）患者GDF-15水平、厌食症、恶病质和临床结局之间的关系。方法：对344例晚期HFrEF患者（年龄58±10岁，85%为男性，67%为NYHA功能III级）进行观察性、回顾性分析，接受临床和超声心动图检查、皮肤折叠体成分评估和双能x线吸收仪评估、循环代谢物评估、明尼苏达州心衰患者问卷调查和右心导管置入术。结果：中位GDF-15水平为1,503 ng/L (Q1-Q3: 955-2,332 ng/L)(参考范围：结论：在晚期HFrEF患者中，循环GDF-15水平升高与厌食症和恶病质、右室功能障碍和充血的患病率升高相关，并且不良事件的风险增加。需要进一步的研究来确定改变GDF-15信号通路的治疗是否会影响晚期HFrEF的代谢状态和临床结果。

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引用次数: 0

Advanced Heart Failure

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-01 DOI: 10.1016/j.jchf.2024.10.026

Johan E. Larsson MD, PhD , Maria Generosa Crespo-Leiro MD, PhD , Finn Gustafsson MD, PhD

引用次数: 0

Upgrading Right Ventricular Pacing to Cardiac Resynchronization in HFrEF Patients Improves Symptoms and Functional Outcomes HFrEF患者将右心室起搏升级为心脏再同步可改善症状和功能结局。

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-01 DOI: 10.1016/j.jchf.2024.09.011

Eperke Merkel MD , Robert Hatala MD, PhD , Mátyás Szigeti PhD , Walter Schwertner MD , Bálint Lakatos MD, PhD , Anett Behon MD , Kinga Goscinska-Bis MD , Goran Milasinovic MD , Roland Papp MD , Mihály Ruppert MD, PhD , László Sághy MD, PhD , Marcell Clemens MD, PhD , Scott D. Solomon MD , Valentina Kutyifa MD, PhD , Attila Kovács MD, PhD , Annamária Kosztin MD, PhD , Béla Merkely MD, PhD

Background

In the BUDAPEST (Biventricular Upgrade on left ventricular reverse remodeling and clinical outcomes in patients with left ventricular Dysfunction and intermittent or permanent APical/SepTal right ventricular pacing)-CRT Upgrade randomized trial, the authors have demonstrated improved mortality and morbidity after cardiac resynchronization therapy (CRT) upgrade in patients with heart failure with reduced ejection fraction (HFrEF) with high right ventricular (RV) pacing burden.

Objectives

This substudy sought to examine the impact of CRT upgrade on symptoms, functional outcome, and exercise capacity.

Methods

In the BUDAPEST-CRT Upgrade trial, 360 HFrEF patients with pacemaker or implantable cardioverter-defibrillator (ICD) and ≥20% RV pacing burden were randomly assigned (3:2) to cardiac resynchronization therapy with defibrillator (CRT-D) upgrade (n = 215) or ICD (n = 145). The prespecified tertiary endpoints were changes in quality of life (QoL) (EQ-5D-3L), NYHA functional class, 6-minute walk test, and N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels.

Results

Up to 12 months, NYHA functional class improved in the CRT-D upgrade arm compared with ICD only (adjusted OR: 0.50 [95% CI: 0.32-0.80]; P = 0.003). A remarkable decrease was observed in NT-proBNP levels in the CRT-D arm (adjusted difference: −1,257 pg/mL [95% CI: −2,287 to −228 pg/mL]; P = 0.017). The progression of age-related worsening of QoL was moderated by CRT-D upgrade (EQ-5D-3L difference by each year: 0.015 [95% CI: 0.005-0.025]; P interaction = 0.003). However, exercise tolerance (6-minute walk test) remained unchanged in both groups.

Conclusions

HFrEF patients with pacemaker/ICD and ≥20% RV pacing burden receiving CRT upgrade showed a substantial improvement in NYHA functional class and decrease in natriuretic peptide levels, as compared with ICD alone. Moreover, CRT-D upgrade could moderate the progression of worsening of QoL attributed to ageing in this vulnerable, elderly patient population. (Biventricular Upgrade on left ventricular reverse remodeling and clinical outcomes in patients with left ventricular Dysfunction and intermittent or permanent APical/SepTal right ventricular pacing [BUDAPEST]-CRT Upgrade trial; NCT02270840)

背景：在布达佩斯（左心室反向重塑双心室升级和左心室功能障碍患者间歇性或永久性心尖/间隔右室起搏的临床结果）-CRT升级随机试验中，作者已经证明，心脏再同步化治疗（CRT）升级后，低射血分数（HFrEF）右心室起搏负担高的心力衰竭患者的死亡率和发病率得到改善。目的：本亚研究旨在探讨CRT升级对症状、功能结局和运动能力的影响。方法：在BUDAPEST-CRT升级试验中，360例使用起搏器或植入式心律转复除颤器（ICD）且RV起搏负担≥20%的HFrEF患者随机（3:2）分配到心脏再同步化治疗与除颤器（CRT-D）升级（n = 215）或ICD （n = 145）。预先指定的第三终点是生活质量（QoL）（EQ-5D-3L）、NYHA功能等级、6分钟步行测试和n端前b型利钠肽（NT-proBNP）水平的变化。结果：与仅ICD组相比，CRT-D升级组的NYHA功能分级在12个月时得到改善(调整OR: 0.50 [95% CI: 0.32-0.80]；P = 0.003)。CRT-D组NT-proBNP水平显著下降(调整差值为-1,257 pg/mL [95% CI: -2,287至-228]；P = 0.017)。年龄相关性生活质量恶化的进展被CRT-D升级所减缓(EQ-5D-3L逐年差异：0.015 [95% CI: 0.005-0.025]；P交互作用= 0.003)。然而，运动耐受性（6分钟步行测试）在两组中保持不变。结论：与单独使用ICD相比，HFrEF合并起搏器/ICD和≥20% RV起搏负担的患者接受CRT升级后，NYHA功能分级有明显改善，利钠肽水平下降。此外，在这些脆弱的老年患者群体中，CRT-D升级可以缓解由于老龄化导致的生活质量恶化的进展。（双心室升级对左心室反向重构和左心室功能障碍患者间歇性或永久性心尖/间隔右心室起搏的临床结果[BUDAPEST]-CRT升级试验）。

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引用次数: 0

Patient-Reported Outcomes in Heart Failure

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-01 DOI: 10.1016/j.jchf.2024.10.019

Gregg C. Fonarow MD , Amber B. Tang MD

引用次数: 0

Can and Should LIVE Be Revived?

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure

Pub Date : 2025-02-01 DOI: 10.1016/j.jchf.2025.01.001

Michael I. Brener MD, MS, Daniel Burkhoff MD, PhD

引用次数: 0

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