Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2024.11.008
JOZINE M. TER MAATEN MD, PhD , WILFRIED MULLENS MD, PhD
{"title":"Counterpoint: Natriuresis-Guided Diuresis in Patients Admitted to Hospital With Heart Failure – Barking Up the Wrong Tree? Towards Direct Insights Into the Efficacy of Diuretic Therapy","authors":"JOZINE M. TER MAATEN MD, PhD , WILFRIED MULLENS MD, PhD","doi":"10.1016/j.cardfail.2024.11.008","DOIUrl":"10.1016/j.cardfail.2024.11.008","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 469-470"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2024.12.002
JESSICA A. REGAN MD , SVATI H. SHAH MD, MHS
{"title":"CHIP-ing Away at Post-Transplant Outcomes: the Role of Somatic Mutations in Heart Transplant Outcomes","authors":"JESSICA A. REGAN MD , SVATI H. SHAH MD, MHS","doi":"10.1016/j.cardfail.2024.12.002","DOIUrl":"10.1016/j.cardfail.2024.12.002","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 411-414"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2025.01.002
Michael Sobieraj MD, MS , Kannu Bansal MD , Katherine AA Clark MD, MBA
{"title":"From Inflammation to Inspiration and Innovation: A New Perspective on the Utility of Anti-inflammatory Therapies for Acute Heart Failure","authors":"Michael Sobieraj MD, MS , Kannu Bansal MD , Katherine AA Clark MD, MBA","doi":"10.1016/j.cardfail.2025.01.002","DOIUrl":"10.1016/j.cardfail.2025.01.002","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 367-368"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2024.09.002
JAN BIEGUS MD, PhD , GAD COTTER MD , BETH A. DAVISON PhD , YONATHAN FREUND MD , ADRIAAN A. VOORS MD, PhD , CHRISTOPHER EDWARDS BS, , MARIA NOVOSADOVA MD , KOJI TAKAGI MD , Hamlet HAYRAPETYAN MD , ANDRANIK MSHETSYAN MD , DRAMBYAN MAYRANUSH MD , ALAIN COHEN-SOLAL MD, PhD , JOZINE M. TER MAATEN MD, PhD , GERASIMOS FILIPPATOS MD , OVIDIU CHIONCEL MD, PhD , MALHA SADOUNE MSc , MATTEO PAGNESI MD, PhD , TABASSOME SIMON MD , MARCO METRA MD, PhD , DOUGLAS L. MANN MD , PIOTR PONIKOWSKI MD, PhD
Background
The effect of steroids on congestion in patients with acute heart failure (AHF) is not known.
Methods and Results
Patients with AHF, NT-proBNP levels > 1500 pg/mL and high-sensitivity C-reactive protein (hsCRP) levels > 20 mg/L were randomized to once-daily oral 40 mg prednisone for 7 days or usual care. In this post hoc analysis, congestion score was calculated on the basis of orthopnea, edema and rales (0 reflecting lack of congestion, and 9 maximal congestion) at each time point. Among 100 eligible patients randomized, those assigned to prednisone had a greater improvement in congestion score at day 31 (win odds for the prednisone group compared to usual care at day 31 was 1.77 (95% CI 1.17–2.84; P = 0.0066) in all patients and 2.41 (95% CI 1.37–5.05; P = 0.0016) in patients with IL-6 > 13 pg/mL at baseline. In patients with congestion scores ≥ 7 at baseline, the effects of prednisone therapy on the EQ-5D visual analog scale score were 4.30 (95% CI 0.77-7.83) points at day 7 and 5.40 (0.51–10.29) points at day 31, accompanied by lower heart rate and respiratory rate and higher oxygen saturation compared to usual care.
Conclusions
In patients with AHF and inflammatory activation, 7-day steroid therapy was associated with reduction in signs of congestion up to day 31. These results need confirmation in larger studies examining potential effects of steroids on congestion, diuresis, fluid redistribution and vascular permeability as well as clinical effects in AHF.
{"title":"The Effects of Burst Steroid Therapy on Short-term Decongestion in Acute Heart Failure Patients With Pro-inflammatory Activation: A Post Hoc Analysis of the CORTAHF Randomized, Open-label, Pilot Trial","authors":"JAN BIEGUS MD, PhD , GAD COTTER MD , BETH A. DAVISON PhD , YONATHAN FREUND MD , ADRIAAN A. VOORS MD, PhD , CHRISTOPHER EDWARDS BS, , MARIA NOVOSADOVA MD , KOJI TAKAGI MD , Hamlet HAYRAPETYAN MD , ANDRANIK MSHETSYAN MD , DRAMBYAN MAYRANUSH MD , ALAIN COHEN-SOLAL MD, PhD , JOZINE M. TER MAATEN MD, PhD , GERASIMOS FILIPPATOS MD , OVIDIU CHIONCEL MD, PhD , MALHA SADOUNE MSc , MATTEO PAGNESI MD, PhD , TABASSOME SIMON MD , MARCO METRA MD, PhD , DOUGLAS L. MANN MD , PIOTR PONIKOWSKI MD, PhD","doi":"10.1016/j.cardfail.2024.09.002","DOIUrl":"10.1016/j.cardfail.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><div>The effect of steroids on congestion in patients with acute heart failure (AHF) is not known.</div></div><div><h3>Methods and Results</h3><div>Patients with AHF, NT-proBNP levels > 1500 pg/mL and high-sensitivity C-reactive protein (hsCRP) levels > 20 mg/L were randomized to once-daily oral 40 mg prednisone for 7 days or usual care. In this post hoc analysis, congestion score was calculated on the basis of orthopnea, edema and rales (0 reflecting lack of congestion, and 9 maximal congestion) at each time point. Among 100 eligible patients randomized, those assigned to prednisone had a greater improvement in congestion score at day 31 (win odds for the prednisone group compared to usual care at day 31 was 1.77 (95% CI 1.17–2.84; <em>P</em> = 0.0066) in all patients and 2.41 (95% CI 1.37–5.05; <em>P</em> = 0.0016) in patients with IL-6 > 13 pg/mL at baseline. In patients with congestion scores ≥ 7 at baseline, the effects of prednisone therapy on the EQ-5D visual analog scale score were 4.30 (95% CI 0.77-7.83) points at day 7 and 5.40 (0.51–10.29) points at day 31, accompanied by lower heart rate and respiratory rate and higher oxygen saturation compared to usual care.</div></div><div><h3>Conclusions</h3><div>In patients with AHF and inflammatory activation, 7-day steroid therapy was associated with reduction in signs of congestion up to day 31. These results need confirmation in larger studies examining potential effects of steroids on congestion, diuresis, fluid redistribution and vascular permeability as well as clinical effects in AHF.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 354-366"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2024.05.013
MARAT FUDIM MD, MHS , VERAPRAPAS KITTIPIBUL MD , JEROEN MOLINGER MS , DMITRY M. YARANOV MD , WAYNE L. MILLER MD, PhD
Background
Quantitative methods have shown clinically significant heterogeneity in blood volume (BV) profiles in patients with chronic heart failure (HF). How patients’ sex might impact this volume heterogeneity and its relationship to cardiac hemodynamics remains to be defined.
Methods
Retrospective analysis of clinical and quantitative BV, plasma volume (PV) and red blood cell (RBC) mass data was undertaken across 3 medical centers. BV was quantitated using nuclear medicine I-131-labeled plasma albumin indicator-dilution methodology with cardiac hemodynamics obtained within 24 hours.
Results
In an analysis of 149 males and 106 females, absolute BV was greater, on average, in males (6.9 ± 1.7 vs 5.0 ± 1.2 liters; P < 0.001); however, a wide range in BVs was demonstrated in both sexes (2.9–14.5 liters). Male sex was associated with higher prevalence of large (+ 25% of normal) BV and PV expansions (36% vs 15% and 51% vs 21%, respectively; both P < 0.001). In contrast, female sex was associated with higher prevalence of normal total BV (44% vs 27%; P = 0.005), PV (54% vs 27%; P < 0.001), hypovolemia (23% vs 11%; P = 0.005), and true anemia (42% vs 26%; P < 0.001). Cardiac hemodynamics differed by sex, but only modest associations were demonstrated between volume profiles and cardiac filling pressures.
Conclusions
Findings support unique intravascular volume profiles reflecting sex-specific differences in the prevalence and distributions of total BV, PV and RBC mass profiles in patients with chronic HF. This underscores the importance of recognizing patients’ sex as a significant factor influencing volume homeostasis, which needs to be taken into account to individualize volume-management strategies effectively.
{"title":"Patient Sex Impacts Volume Phenotypes and Hemodynamics in Chronic Heart Failure: A Multicenter Analysis","authors":"MARAT FUDIM MD, MHS , VERAPRAPAS KITTIPIBUL MD , JEROEN MOLINGER MS , DMITRY M. YARANOV MD , WAYNE L. MILLER MD, PhD","doi":"10.1016/j.cardfail.2024.05.013","DOIUrl":"10.1016/j.cardfail.2024.05.013","url":null,"abstract":"<div><h3>Background</h3><div>Quantitative methods<span> have shown clinically significant heterogeneity in blood volume (BV) profiles in patients with chronic heart failure (HF). How patients’ sex might impact this volume heterogeneity and its relationship to cardiac hemodynamics remains to be defined.</span></div></div><div><h3>Methods</h3><div><span><span>Retrospective analysis of clinical and quantitative BV, plasma volume (PV) and red blood cell (RBC) mass data was undertaken across 3 medical centers. BV was quantitated using </span>nuclear medicine I-131-labeled </span>plasma albumin<span> indicator-dilution methodology with cardiac hemodynamics obtained within 24 hours.</span></div></div><div><h3>Results</h3><div>In an analysis of 149 males and 106 females, absolute BV was greater, on average, in males (6.9 ± 1.7 vs 5.0 ± 1.2 liters; P < 0.001); however, a wide range in BVs was demonstrated in both sexes (2.9–14.5 liters). Male sex was associated with higher prevalence of large (+ 25% of normal) BV and PV expansions (36% vs 15% and 51% vs 21%, respectively; both P < 0.001). In contrast, female sex was associated with higher prevalence of normal total BV (44% vs 27%; P = 0.005), PV (54% vs 27%; P < 0.001), hypovolemia<span> (23% vs 11%; P = 0.005), and true anemia (42% vs 26%; P < 0.001). Cardiac hemodynamics differed by sex, but only modest associations were demonstrated between volume profiles and cardiac filling pressures.</span></div></div><div><h3>Conclusions</h3><div>Findings support unique intravascular volume profiles reflecting sex-specific differences in the prevalence and distributions of total BV, PV and RBC mass profiles in patients with chronic HF. This underscores the importance of recognizing patients’ sex as a significant factor influencing volume homeostasis, which needs to be taken into account to individualize volume-management strategies effectively.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 379-387"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2024.05.007
MAXIME BENEYTO MD MS , RAPHAËL MARTINS MD, PhD , VINCENT GALAND MD , MICHEL KINDO MD, PhD , CLÉMENT SCHNEIDER MD , ALEXANDRE SEBESTYEN MD , AUDE BOIGNARD MD , LAURENT SEBBAG MD , MATTEO POZZI MD, PhD , THIBAUD GENET MD , THIERRY BOURGUIGNON MD , ANNE-CÉLINE MARTIN MD, PhD , PAUL ACHOUH MD, PhD , FABRICE VANHUYSE MD, PhD , HUGUES BLANG MD , CHARLES HENRI DAVID MD, PhD , MAGALI MICHEL MD , FRÉDÉRIC ANSELME MD, PhD , PIERRE-YVES LITZLER MD, PhD , MARIE JUNGLING MD , CLEMENT DELMAS MD, PhD
Background
Prediction of outcomes remains an unmet need in candidates for LVADs. The development of right-heart failure portends an excess in mortality rates, but imaging parameters of right ventricular systolic function have failed to demonstrate a prognostic role. By integrating pulmonary pressure, right ventriculoarterial coupling could fill this gap.
Methods
The ASSIST-ICD registry was used to test right ventriculoarterial coupling as a surrogate parameter at implantation for the prediction of all-cause mortality.
Results
The ratio of the tricuspid annular-plane systolic excursion over the estimated systolic pulmonary pressure (TAPSE/sPAP) was not associated with long-term survival in univariate analysis (P = 0.89), nor was the pulmonary artery pulsatility index (PAPi) (P = 0.13). Conversely, the ratio of the right atrial pressure over the pulmonary capillary wedge pressure (RAP/PCWP) was associated with all-cause mortality (P < 0.01). After taking tricuspid regurgitation severity, LVAD indication, LVAD model, age, blood urea nitrogen levels, and pulmonary vascular resistance into account, RAP/PCWP remained associated with survival (HR 1.35 [1.10 – 1.65]; P < 0.01).
Conclusion
Among pre-implant RVAC surrogates, only RAP/PCWP was associated with long-term all-cause mortality in LVAD recipients. This association was independent of established risk factors.
{"title":"Right Ventriculoarterial Coupling Surrogates and Long-Term Survival in LVAD Recipients: Results of the ASSIST-ICD Multicentric Registry","authors":"MAXIME BENEYTO MD MS , RAPHAËL MARTINS MD, PhD , VINCENT GALAND MD , MICHEL KINDO MD, PhD , CLÉMENT SCHNEIDER MD , ALEXANDRE SEBESTYEN MD , AUDE BOIGNARD MD , LAURENT SEBBAG MD , MATTEO POZZI MD, PhD , THIBAUD GENET MD , THIERRY BOURGUIGNON MD , ANNE-CÉLINE MARTIN MD, PhD , PAUL ACHOUH MD, PhD , FABRICE VANHUYSE MD, PhD , HUGUES BLANG MD , CHARLES HENRI DAVID MD, PhD , MAGALI MICHEL MD , FRÉDÉRIC ANSELME MD, PhD , PIERRE-YVES LITZLER MD, PhD , MARIE JUNGLING MD , CLEMENT DELMAS MD, PhD","doi":"10.1016/j.cardfail.2024.05.007","DOIUrl":"10.1016/j.cardfail.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Prediction of outcomes remains an unmet need in candidates for LVADs. The development of right-heart failure portends an excess in mortality rates, but imaging parameters of right ventricular systolic function have failed to demonstrate a prognostic role. By integrating pulmonary pressure, right ventriculoarterial coupling could fill this gap.</div></div><div><h3>Methods</h3><div>The ASSIST-ICD registry was used to test right ventriculoarterial coupling as a surrogate parameter at implantation for the prediction of all-cause mortality.</div></div><div><h3>Results</h3><div>The ratio of the tricuspid annular-plane systolic excursion over the estimated systolic pulmonary pressure (TAPSE/sPAP) was not associated with long-term survival in univariate analysis (<em>P</em> = 0.89), nor was the pulmonary artery pulsatility index (PAPi) (<em>P</em> = 0.13). Conversely, the ratio of the right atrial pressure over the pulmonary capillary wedge pressure (RAP/PCWP) was associated with all-cause mortality (<em>P</em> < 0.01). After taking tricuspid regurgitation severity, LVAD indication, LVAD model, age, blood urea nitrogen levels, and pulmonary vascular resistance into account, RAP/PCWP remained associated with survival (HR 1.35 [1.10 – 1.65]; <em>P</em> < 0.01).</div></div><div><h3>Conclusion</h3><div>Among pre-implant RVAC surrogates, only RAP/PCWP was associated with long-term all-cause mortality in LVAD recipients. This association was independent of established risk factors.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 388-396"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2024.09.003
NIR URIEL , KUNJAN BHATT , RAMI KAHWASH , THOMAS R. MCMINN , MANESH R. PATEL , SCOTT LILLY , JOHN R. BRITTON , LOUISE CORCORAN , BARRY R. GREENE , ROBYN M. KEALY , ANNETTE KENT , WILLIAM S. SHERIDAN , AJAY J. KIRTANE , SANJUM S. SETHI , JEREMIAH P. DEPTA , SCOTT C. FEITELL , GABRIEL SAYER , MARAT FUDIM
Background
A novel implantable sensor has been designed to measure the inferior vena cava (IVC) area accurately so as to allow daily monitoring of the IVC area and collapse to predict congestion in heart failure (HF).
Methods
A prospective, multicenter, single-arm, Early Feasibility Study enrolled 15 patients with HF (irrespective of ejection fraction) and with an HF event in the previous 12 months, an elevated NT-proBNP level, and receiving ≥ 40 mg of furosemide equivalent. Primary endpoints included successful deployment without procedure-related (30 days) or sensor-related complications (3 months) and successful data transmission to a secure database (3 months). Accuracy of sensor-derived IVC area, patient adherence, NYHA classification, and KCCQ were assessed from baseline to 3 months. Patient-specific signal alterations were correlated with clinical presentation to guide interventions.
Results
Fifteen patients underwent implantation: 66 ± 12 years; 47% female; 27% with HFpEF, NT-ProBNP levels 2569 (median, IQR: 1674–5187, ng/L; 87% NYHA class III). All patients met the primary safety and effectiveness endpoints. Sensor-derived IVC areas showed excellent agreement with concurrent computed tomography (R2 = 0.99, mean absolute error = 11.15 mm2). Median adherence to daily readings was 98% (IQR: 86%–100%) per patient-month. A significant improvement was seen in NYHA class and a nonsignificant improvement was observed in KCCQ.
Conclusions
Implantation of a novel IVC sensor (FIRE1) was feasible, uncomplicated and safe. Sensor outputs aligned with clinical presentations and improvements in clinical outcomes. Future investigation to establish the IVC sensor remote management of HF is strongly warranted.
{"title":"Safety and Feasibility of an Implanted Inferior Vena Cava Sensor for Accurate Volume Assessment: FUTURE-HF2 Trial","authors":"NIR URIEL , KUNJAN BHATT , RAMI KAHWASH , THOMAS R. MCMINN , MANESH R. PATEL , SCOTT LILLY , JOHN R. BRITTON , LOUISE CORCORAN , BARRY R. GREENE , ROBYN M. KEALY , ANNETTE KENT , WILLIAM S. SHERIDAN , AJAY J. KIRTANE , SANJUM S. SETHI , JEREMIAH P. DEPTA , SCOTT C. FEITELL , GABRIEL SAYER , MARAT FUDIM","doi":"10.1016/j.cardfail.2024.09.003","DOIUrl":"10.1016/j.cardfail.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>A novel implantable sensor has been designed to measure the inferior vena cava (IVC) area accurately so as to allow daily monitoring of the IVC area and collapse to predict congestion in heart failure (HF).</div></div><div><h3>Methods</h3><div>A prospective, multicenter, single-arm, Early Feasibility Study enrolled 15 patients with HF (irrespective of ejection fraction) and with an HF event in the previous 12 months, an elevated NT-proBNP level, and receiving ≥ 40 mg of furosemide equivalent. Primary endpoints included successful deployment without procedure-related (30 days) or sensor-related complications (3 months) and successful data transmission to a secure database (3 months). Accuracy of sensor-derived IVC area, patient adherence, NYHA classification, and KCCQ were assessed from baseline to 3 months. Patient-specific signal alterations were correlated with clinical presentation to guide interventions.</div></div><div><h3>Results</h3><div>Fifteen patients underwent implantation: 66 ± 12 years; 47% female; 27% with HFpEF, NT-ProBNP levels 2569 (median, IQR: 1674–5187, ng/L; 87% NYHA class III). All patients met the primary safety and effectiveness endpoints. Sensor-derived IVC areas showed excellent agreement with concurrent computed tomography (R<sup>2</sup> = 0.99, mean absolute error = 11.15 mm<sup>2</sup>). Median adherence to daily readings was 98% (IQR: 86%–100%) per patient-month. A significant improvement was seen in NYHA class and a nonsignificant improvement was observed in KCCQ.</div></div><div><h3>Conclusions</h3><div>Implantation of a novel IVC sensor (FIRE1) was feasible, uncomplicated and safe. Sensor outputs aligned with clinical presentations and improvements in clinical outcomes. Future investigation to establish the IVC sensor remote management of HF is strongly warranted.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 369-376"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2024.05.011
PANAGIOTIS SIMITSIS MD, MSc , ANJU NOHRIA MD , JANE KELLEHER MSc , JACINTHE BOULET MDCM, MPH , MAURO R.B. WANDERLEY Jr MD, PhD , PRADEEP NATARAJAN MD, MMSc , PETER LIBBY MD , MANDEEP R. MEHRA MD, MSc
Background
Clonal hematopoiesis of indeterminate potential (CHIP) mutations, a trait of aging, has been associated with the progression of cardiovascular disease and the development of malignancy. Uncertainty prevails regarding a robust association between CHIP and heart-transplantation (HT) outcomes.
Objectives
To determine the prevalence of CHIP mutations in HT and their association with long-term outcomes, including cardiac allograft vasculopathy (CAV), graft failure, malignancy, and all-cause mortality.
Methods
We conducted a mixed retrospective-prospective observational study of HT recipients with targeted sequencing for CHIP mutations (variant allele frequency [VAF] of ≥ 2%). The primary composite outcome was the first occurrence of CAV grade ≥ 2, graft failure, malignancy, cardiac retransplantation, or all-cause death. Secondary outcomes were the individual components of the composite primary outcome. Sensitivity analyses with base-case and extreme scenarios were performed.
Results
Among 95 HT recipients, 30 had CHIP mutations (31.6%). DNMT3A mutations were most common (44.7%), followed by PPM1D (13.2%), SF3B1 (10.5%), TET2 (7.9%), and TP53 (7.9%). The only significant independent predictor of CHIP was age at enrollment or age at transplantation. After multivariable adjustment, CHIP mutations were not associated with the primary outcome, which occurred in 44 (46.3%) patients (HR = 0.487; 95% CI:0.197–1.204; P = 0.119), nor were they associated with mlalignancy alone, or death.
Conclusion
We demonstrated no association between CHIP mutations and post-transplant outcomes, including CAV, graft failure, malignancy, and all-cause mortality. In line with previously published data, our analysis provides additional evidence about the lack of clinical value of using CHIP mutations as a biomarker for surveillance in outcomes after HT.
{"title":"Clonal Hematopoiesis of Indeterminate Potential and Long-term Outcomes in Heart Transplantation","authors":"PANAGIOTIS SIMITSIS MD, MSc , ANJU NOHRIA MD , JANE KELLEHER MSc , JACINTHE BOULET MDCM, MPH , MAURO R.B. WANDERLEY Jr MD, PhD , PRADEEP NATARAJAN MD, MMSc , PETER LIBBY MD , MANDEEP R. MEHRA MD, MSc","doi":"10.1016/j.cardfail.2024.05.011","DOIUrl":"10.1016/j.cardfail.2024.05.011","url":null,"abstract":"<div><h3>Background</h3><div><span>Clonal hematopoiesis of indeterminate potential (CHIP) mutations, a trait of aging, has been associated with the progression of cardiovascular disease and the development of </span>malignancy. Uncertainty prevails regarding a robust association between CHIP and heart-transplantation (HT) outcomes.</div></div><div><h3>Objectives</h3><div><span>To determine the prevalence of CHIP mutations in HT and their association with long-term outcomes, including cardiac allograft vasculopathy (CAV), </span>graft failure, malignancy, and all-cause mortality.</div></div><div><h3>Methods</h3><div><span>We conducted a mixed retrospective-prospective observational study of HT recipients with targeted sequencing for CHIP mutations (variant allele frequency [VAF] of ≥ 2%). The primary composite outcome was the first occurrence of CAV grade ≥ 2, graft failure, malignancy, cardiac </span>retransplantation, or all-cause death. Secondary outcomes were the individual components of the composite primary outcome. Sensitivity analyses with base-case and extreme scenarios were performed.</div></div><div><h3>Results</h3><div>Among 95 HT recipients, 30 had CHIP mutations (31.6%). <span><span>DNMT3A</span></span> mutations were most common (44.7%), followed by <em>PPM1D</em> (13.2%), <span><em>SF3B1</em></span> (10.5%), <em>TET2</em> (7.9%), and <em>TP53</em> (7.9%). The only significant independent predictor of CHIP was age at enrollment or age at transplantation. After multivariable adjustment, CHIP mutations were not associated with the primary outcome, which occurred in 44 (46.3%) patients (HR = 0.487; 95% CI:0.197–1.204; <em>P</em> = 0.119), nor were they associated with mlalignancy alone, or death.</div></div><div><h3>Conclusion</h3><div>We demonstrated no association between CHIP mutations and post-transplant outcomes, including CAV, graft failure, malignancy, and all-cause mortality. In line with previously published data, our analysis provides additional evidence about the lack of clinical value of using CHIP mutations as a biomarker for surveillance in outcomes after HT.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 400-410"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141405124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cardfail.2024.08.046
MICHELLE WEISFELNER BLOOM MD, Co-Chair , JACQUELINE B. VO PhD, RN, MPH , JO E. RODGERS PharmD, BCPS, BCCP , ALANA M. FERRARI PharmD, BCOP , ANJU NOHRIA MD, MSc , ANITA DESWAL MD, MPH , RICHARD K. CHENG MD, MSc , MICHELLE M. KITTLESON MD, PhD , JENICA N. UPSHAW MD, MS , NICOLAS PALASKAS MD , ANNE BLAES MD MS , SHERRY-ANN BROWN MD, PhD , BONNIE KY MD, MSCE , DANIEL LENIHAN MD , MATHEW S. MAURER MD , ANECITA FADOL PhD, NP , KERRY SKURKA RN, BSN , CHRISTINE CAMBARERI PharmD, BCOP , ANA BARAC MD, PhD, (Co-Chair)
{"title":"Cardio-Oncology and Heart Failure: AL Amyloidosis for the Heart Failure Clinician: a Supplement to the Scientific Statement from the Heart Failure Society of America","authors":"MICHELLE WEISFELNER BLOOM MD, Co-Chair , JACQUELINE B. VO PhD, RN, MPH , JO E. RODGERS PharmD, BCPS, BCCP , ALANA M. FERRARI PharmD, BCOP , ANJU NOHRIA MD, MSc , ANITA DESWAL MD, MPH , RICHARD K. CHENG MD, MSc , MICHELLE M. KITTLESON MD, PhD , JENICA N. UPSHAW MD, MS , NICOLAS PALASKAS MD , ANNE BLAES MD MS , SHERRY-ANN BROWN MD, PhD , BONNIE KY MD, MSCE , DANIEL LENIHAN MD , MATHEW S. MAURER MD , ANECITA FADOL PhD, NP , KERRY SKURKA RN, BSN , CHRISTINE CAMBARERI PharmD, BCOP , ANA BARAC MD, PhD, (Co-Chair)","doi":"10.1016/j.cardfail.2024.08.046","DOIUrl":"10.1016/j.cardfail.2024.08.046","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 2","pages":"Pages 456-463"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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