Pub Date : 2025-01-01Epub Date: 2024-12-04DOI: 10.1016/j.jchf.2024.09.014
Amin Yehya, Jose Lopez, Andrew J Sauer, Jonathan D Davis, Nasrien E Ibrahim, Roderick Tung, Biykem Bozkurt, Gregg C Fonarow, Sana M Al-Khatib
Implantable cardioverter-defibrillators (ICDs) are recommended to reduce the risk of sudden cardiac death (SCD) in patients with heart failure with reduced ejection fraction (HFrEF). The landmark studies leading to the current guideline recommendations preceded the 4 pillars of guideline-directed medical therapies (GDMTs). Therefore, some have questioned the role of ICDs for primary prevention in current clinical practice. In this paper, the authors provide an overview of the current ICD recommendations, including the instrumental clinical trials, the risk of SCD as observed in clinical trials vs real-world scenarios, disparities in ICD use among different patient populations, the impact of contemporary GDMT on outcomes, and ongoing and future trials and methodologies to help identify patients who are at an increased risk of SCD and who may benefit from an ICD. The authors also propose a pragmatic guidance for clinicians when they engage in the shared decision-making discussions for primary ICD implantation.
{"title":"Revisiting ICD Therapy for Primary Prevention in Patients With Heart Failure and Reduced Ejection Fraction.","authors":"Amin Yehya, Jose Lopez, Andrew J Sauer, Jonathan D Davis, Nasrien E Ibrahim, Roderick Tung, Biykem Bozkurt, Gregg C Fonarow, Sana M Al-Khatib","doi":"10.1016/j.jchf.2024.09.014","DOIUrl":"10.1016/j.jchf.2024.09.014","url":null,"abstract":"<p><p>Implantable cardioverter-defibrillators (ICDs) are recommended to reduce the risk of sudden cardiac death (SCD) in patients with heart failure with reduced ejection fraction (HFrEF). The landmark studies leading to the current guideline recommendations preceded the 4 pillars of guideline-directed medical therapies (GDMTs). Therefore, some have questioned the role of ICDs for primary prevention in current clinical practice. In this paper, the authors provide an overview of the current ICD recommendations, including the instrumental clinical trials, the risk of SCD as observed in clinical trials vs real-world scenarios, disparities in ICD use among different patient populations, the impact of contemporary GDMT on outcomes, and ongoing and future trials and methodologies to help identify patients who are at an increased risk of SCD and who may benefit from an ICD. The authors also propose a pragmatic guidance for clinicians when they engage in the shared decision-making discussions for primary ICD implantation.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":"1-13"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-12-11DOI: 10.1016/j.jchf.2024.10.013
Elizabeth M McNally
{"title":"A Multiple Hit Model for Genetic Susceptibility to Cardiomyopathy.","authors":"Elizabeth M McNally","doi":"10.1016/j.jchf.2024.10.013","DOIUrl":"10.1016/j.jchf.2024.10.013","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":"149-153"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jchf.2024.10.012
Antoni Bayés-Genis, Clare J Taylor
{"title":"Elevated NT-proBNP in Heart Failure and CKD: A Genuine Red Flag for Worse Prognosis-Not a False Positive.","authors":"Antoni Bayés-Genis, Clare J Taylor","doi":"10.1016/j.jchf.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.10.012","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 1","pages":"40-42"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-12-11DOI: 10.1016/j.jchf.2024.09.018
Adriaan A Voors, Kevin Damman, Iris E Beldhuis, Peter van der Meer, Jan A Krikken, Jenifer E Coster, Wybe Nieuwland, Dirk J van Veldhuisen, Jozine M Ter Maaten
{"title":"Discharge Medication After Natriuresis-Guided Dosing of Diuretic Therapy in Patients Hospitalized for Acute Heart Failure: A PUSH-AHF Substudy.","authors":"Adriaan A Voors, Kevin Damman, Iris E Beldhuis, Peter van der Meer, Jan A Krikken, Jenifer E Coster, Wybe Nieuwland, Dirk J van Veldhuisen, Jozine M Ter Maaten","doi":"10.1016/j.jchf.2024.09.018","DOIUrl":"10.1016/j.jchf.2024.09.018","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":"179-181"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jchf.2024.09.020
Maria Rosa Costanzo
{"title":"Ending the Fear Depriving Patients With HFpEF and CKD of Lifesaving Therapies.","authors":"Maria Rosa Costanzo","doi":"10.1016/j.jchf.2024.09.020","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.09.020","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 1","pages":"115-117"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-11-06DOI: 10.1016/j.jchf.2024.08.019
Naman S Shetty, Mokshad Gaonkar, Akhil Pampana, Nirav Patel, Alanna C Morrison, Alexander P Reiner, April P Carson, Bing Yu, Bruce M Psaty, Charles Kooperberg, Diane Fatkin, Eric Boerwinkle, Jerome I Rotter, Kent D Taylor, Lifang Hou, Marguerite R Irvin, Michael E Hall, Mathew Maurer, Myriam Fornage, Nicole D Armstrong, Nicole Bart, Parag Goyal, Stephen S Rich, Ramachandran S Vasan, Peng Li, Garima Arora, Pankaj Arora
Background: Nearly 3% to 4% of Black individuals in the United States carry the transthyretin V142I variant, which increases their risk of heart failure. However, the role of cardiovascular (CV) risk factors (RFs) in influencing the risk of clinical outcomes among V142I variant carriers is unknown.
Objectives: This study aimed to assess the impact of CV RFs on the risk of heart failure in V142I carriers.
Methods: This study included self-identified Black individuals without prevalent heart failure from 6 TOPMed (Trans-Omics for Precision Medicine) cohorts, the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, and the All of Us Research Program. The cohort was stratified based on the V142I genotype and the number of CV RFs (hypertension, diabetes, obesity, and hypercholesterolemia). Adjusted Cox models were used to assess the association of heart failure with the V142I genotype and CV RF profile, taking noncarriers with a favorable CV RF profile as reference.
Results: The cross-sectional analysis, including 1,625 V142I carriers among 48,365 Black individuals, found that the prevalence of CV RFs did not vary by V142I carrier status. In the longitudinal analysis, there were 587 (3.2%) V142I carriers among 18,407 Black individuals (median age: 60 years [Q1-Q3: 52-68 years], 63.0% female). Among carriers, the heart failure risk was attenuated with a favorable (0 or 1 RF) CV RF profile (adjusted HR: 2.26; 95% CI: 1.58-3.23) compared with an unfavorable (3 or 4 RFs) CV RF profile (adjusted HR: 4.14; 95% CI: 2.79-6.14).
Conclusions: A favorable CV RF profile lowers but does not abrogate V142I variant-associated heart failure risk. This study highlights the importance of having a favorable CV RF profile among V142I carriers for risk reduction of heart failure.
背景：在美国，近 3% 至 4% 的黑人携带转甲状腺素 V142I 变异，这会增加他们患心力衰竭的风险。然而，心血管（CV）风险因素（RFs）对 V142I 变异携带者临床结局风险的影响尚不清楚：本研究旨在评估心血管风险因素对 V142I 基因变异携带者心衰风险的影响：本研究纳入了来自 6 个 TOPMed（Trans-Omics for Precision Medicine）队列、REGARDS（Reasons for Geographic And Racial Differences in Stroke）研究和 All of Us Research Program 的无流行性心衰的自认黑人。根据 V142I 基因型和 CV RFs（高血压、糖尿病、肥胖和高胆固醇血症）的数量对队列进行了分层。使用调整后的 Cox 模型评估心力衰竭与 V142I 基因型和心血管射频特征的关系，并以心血管射频特征良好的非携带者作为参照：横断面分析（包括 48 365 名黑人中的 1 625 名 V142I 携带者）发现，心血管射频的患病率并不因 V142I 携带者的身份而异。在纵向分析中，18 407 名黑人中有 587 名（3.2%）V142I 携带者（中位年龄：60 岁 [Q1-Q3：52-68 岁]，63.0% 为女性）。在携带者中，有利的（0 或 1 RF）CV RF 特征（调整后 HR：2.26；95% CI：1.58-3.23）与不利的（3 或 4 RFs）CV RF 特征（调整后 HR：4.14；95% CI：2.79-6.14）相比，心衰风险有所降低：结论：良好的心血管射频谱可降低但不能消除 V142I 变异相关的心力衰竭风险。这项研究强调了在 V142I 基因携带者中建立良好的心血管射频谱对降低心衰风险的重要性。
{"title":"Cardiovascular Risk Factors and Genetic Risk in Transthyretin V142I Carriers.","authors":"Naman S Shetty, Mokshad Gaonkar, Akhil Pampana, Nirav Patel, Alanna C Morrison, Alexander P Reiner, April P Carson, Bing Yu, Bruce M Psaty, Charles Kooperberg, Diane Fatkin, Eric Boerwinkle, Jerome I Rotter, Kent D Taylor, Lifang Hou, Marguerite R Irvin, Michael E Hall, Mathew Maurer, Myriam Fornage, Nicole D Armstrong, Nicole Bart, Parag Goyal, Stephen S Rich, Ramachandran S Vasan, Peng Li, Garima Arora, Pankaj Arora","doi":"10.1016/j.jchf.2024.08.019","DOIUrl":"10.1016/j.jchf.2024.08.019","url":null,"abstract":"<p><strong>Background: </strong>Nearly 3% to 4% of Black individuals in the United States carry the transthyretin V142I variant, which increases their risk of heart failure. However, the role of cardiovascular (CV) risk factors (RFs) in influencing the risk of clinical outcomes among V142I variant carriers is unknown.</p><p><strong>Objectives: </strong>This study aimed to assess the impact of CV RFs on the risk of heart failure in V142I carriers.</p><p><strong>Methods: </strong>This study included self-identified Black individuals without prevalent heart failure from 6 TOPMed (Trans-Omics for Precision Medicine) cohorts, the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, and the All of Us Research Program. The cohort was stratified based on the V142I genotype and the number of CV RFs (hypertension, diabetes, obesity, and hypercholesterolemia). Adjusted Cox models were used to assess the association of heart failure with the V142I genotype and CV RF profile, taking noncarriers with a favorable CV RF profile as reference.</p><p><strong>Results: </strong>The cross-sectional analysis, including 1,625 V142I carriers among 48,365 Black individuals, found that the prevalence of CV RFs did not vary by V142I carrier status. In the longitudinal analysis, there were 587 (3.2%) V142I carriers among 18,407 Black individuals (median age: 60 years [Q1-Q3: 52-68 years], 63.0% female). Among carriers, the heart failure risk was attenuated with a favorable (0 or 1 RF) CV RF profile (adjusted HR: 2.26; 95% CI: 1.58-3.23) compared with an unfavorable (3 or 4 RFs) CV RF profile (adjusted HR: 4.14; 95% CI: 2.79-6.14).</p><p><strong>Conclusions: </strong>A favorable CV RF profile lowers but does not abrogate V142I variant-associated heart failure risk. This study highlights the importance of having a favorable CV RF profile among V142I carriers for risk reduction of heart failure.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":"91-101"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jchf.2024.10.008
Noelle V Pavlovic, Martha Abshire Saylor, Jeannie-Marie Leoutsakos, Cheryl R Himmelfarb, Christopher S Lee, Amil M Shah, Patricia P Chang, Yvonne Commodore-Mensah, Kunihiro Matsushita, Chiadi E Ndumele
{"title":"Association of Fatigue Subtype With Outcomes in Adults with Prevalent Heart Failure: The ARIC Study.","authors":"Noelle V Pavlovic, Martha Abshire Saylor, Jeannie-Marie Leoutsakos, Cheryl R Himmelfarb, Christopher S Lee, Amil M Shah, Patricia P Chang, Yvonne Commodore-Mensah, Kunihiro Matsushita, Chiadi E Ndumele","doi":"10.1016/j.jchf.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.10.008","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 1","pages":"182-184"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jchf.2024.10.010
Evan P Kransdorf, Michelle M Kittleson
{"title":"The Art of Prediction.","authors":"Evan P Kransdorf, Michelle M Kittleson","doi":"10.1016/j.jchf.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.10.010","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 1","pages":"131-132"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jchf.2024.10.011
Tariq Ahmad
{"title":"We Need to Stop Telling Heart Failure Patients to Restrict Their Salt Intake.","authors":"Tariq Ahmad","doi":"10.1016/j.jchf.2024.10.011","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.10.011","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 1","pages":"173-174"},"PeriodicalIF":10.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号