Pub Date : 2026-02-01Epub Date: 2025-04-16DOI: 10.1016/j.cardfail.2025.01.031
TEMIDAYO A. ABE MD , ENDURANCE O. EVBAYEKHA MD , LARRY R. JACKSON II MD, MHSc , SANA M. AL-KHATIB MD, MHS , SABRA C. LEWSEY MD, MPH , KHADIJAH BREATHETT MD, MS
Cardiac resynchronization therapy (CRT) via biventricular pacing has markedly improved heart failure outcomes over the past 2 decades. However, some patients show no clinical improvement or evidence of reverse remodeling following device implantation. Challenges include suboptimal patient selection, limitations in the characterization of conduction disease (especially nonspecific interventricular conduction delays), procedural constraints, inappropriate device programming, and delayed referral. Moreover, there remains no formal consensus on evaluating and characterizing CRT efficacy. Underuse persists among women and minoritized racial and ethnic groups. Targeted research addressing unmet needs has led to evolving guideline indications. Novel electrocardiographic and imaging techniques are continually being developed to improve patient selection, and alternative pacing strategies have emerged. Conduction system pacing may allow for a more physiological approach to CRT. Observational studies and small clinical trials have shown comparable or superior efficacy of conduction system pacing over traditional biventricular pacing; however, more studies are needed.
{"title":"Evolving Indications, Challenges and Advances in Cardiac Resynchronization Therapy for Heart Failure","authors":"TEMIDAYO A. ABE MD , ENDURANCE O. EVBAYEKHA MD , LARRY R. JACKSON II MD, MHSc , SANA M. AL-KHATIB MD, MHS , SABRA C. LEWSEY MD, MPH , KHADIJAH BREATHETT MD, MS","doi":"10.1016/j.cardfail.2025.01.031","DOIUrl":"10.1016/j.cardfail.2025.01.031","url":null,"abstract":"<div><div>Cardiac resynchronization therapy (CRT) via biventricular pacing has markedly improved heart failure outcomes over the past 2 decades. However, some patients show no clinical improvement or evidence of reverse remodeling following device implantation. Challenges include suboptimal patient selection, limitations in the characterization of conduction disease (especially nonspecific interventricular conduction delays), procedural constraints, inappropriate device programming, and delayed referral. Moreover, there remains no formal consensus on evaluating and characterizing CRT efficacy. Underuse persists among women and minoritized racial and ethnic groups. Targeted research addressing unmet needs has led to evolving guideline indications. Novel electrocardiographic and imaging techniques are continually being developed to improve patient selection, and alternative pacing strategies have emerged. Conduction system pacing may allow for a more physiological approach to CRT. Observational studies and small clinical trials have shown comparable or superior efficacy of conduction system pacing over traditional biventricular pacing; however, more studies are needed.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 499-514"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019045","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 : 2026-02-01Epub Date: 2025-08-20DOI: 10.1016/j.cardfail.2025.07.020
ARVIND BHIMARAJ MD, MPH , ARTHUR R. GARAN MD , QIUYUE KONG , JU KIM MD , MOHIT PAHUJA MD , AJAR KOCHAR MD , SMITHA NARAYANGOWDA , BORUI LI , SONG LI MD , SHASHANK S. SINHA MD, MSc , GAVIN W. HICKEY MD , RACHNA KATARIA MD , VAN-KHUE TON MD, PhD , SCOTT LUNDGREN MD , SANDEEP NATHAN MD , ESTHER VOROVICH MD , SHELLEY HALL MD , WISSAM KHALIFE MD , ANDREW SCHWARTZMAN MD , OLEG ALEC VISHNEVSKY MD , NAVIN K. KAPUR MD
Background
IABPs traditionally are placed via the femoral artery. Single-center studies have shown the utility of axillary placement to promote ambulation. The utility of Ax IABP in CS has not been established. Therefore, we sought to describe the outcomes of patients receiving axillary (Ax) intra-aortic balloon pump (IABP) and compare them with those receiving femoral (Fem) IABP for heart failure-related cardiogenic shock (HF-CS).
Methods
Data from 2020 to 2023 from the Cardiogenic Shock Working Group, a multicenter academic consortium, were analyzed. We examined the demographic, metabolic, hemodynamic characteristics, and outcomes of patients with HF-CS treated with Ax-IABP and compared them with those who primarily received a Fem-IABP.
Results
Of 6201 CS patients in the registry, 557 (8.9%) patients received an IABP for HF-CS, of whom 244 (43.8%) and 313 (56.2%) received Ax-IABP and Fem-IABP, respectively. Compared with Fem-IABP, patients who received Ax-IABP were more likely to have previous intracardiac defibrillators (42.5% vs 68.9%, P < .001). Time to IABP implant from admission (7.9 ± 10.6 vs 1.8 ± 6.1, P < .01) and duration of support (9.6 ± 14.6 vs 4.0 ± 4.5, P < .01) were longer among Ax-IABP, relative to Fem-IABP. Patients who received Ax-IABP were more likely to undergo heart-replacement therapy (65% vs 21%, P < .001) compared with the Fem-IABP cohort. The rate of reported complications was similar between the 2 groups.
Conclusion
Axillary IABP is being used beyond single-center reports to support HF-CS mostly as a bridge to heart-replacement therapies. Its use might provide advantages over fem-IABP.
目的：探讨腋部（Ax） IABP与股部（Fem） IABP治疗心力衰竭相关性心源性休克（HF-CS）的疗效。背景：IABPs通常通过股动脉放置。单中心研究显示腋窝放置对促进活动的效用。axiabp在CS中的应用尚未确定。方法：对2020-2023年多中心学术联盟心源性休克工作组（CSWG）的数据进行分析。我们检查了接受Ax-IABP治疗的HF-CS患者的人口学、代谢、血流动力学特征和结果，并将其与主要接受Fem- IABP治疗的患者进行了比较。结果：在登记的6201例CS患者中，557例（8.9%）患者接受了针对HF-CS的IABP，其中244例（43.8%）和313例（56.2%）分别接受了Ax-IABP和fm -IABP。与fm -IABP相比，Ax-IABP患者更有可能先前使用过心脏内除颤器（42.5% vs 68.9%）。结论：腋窝IABP正在被单中心报告用于支持HF-CS，主要作为心脏替代治疗的桥梁。它的使用可能比fem-IABP更有优势。
{"title":"Comparison of Heart Failure Cardiogenic Shock Patients with Axillary and Femoral Intra-aortic Balloon Pump: Cardiogenic Shock Working Group report","authors":"ARVIND BHIMARAJ MD, MPH , ARTHUR R. GARAN MD , QIUYUE KONG , JU KIM MD , MOHIT PAHUJA MD , AJAR KOCHAR MD , SMITHA NARAYANGOWDA , BORUI LI , SONG LI MD , SHASHANK S. SINHA MD, MSc , GAVIN W. HICKEY MD , RACHNA KATARIA MD , VAN-KHUE TON MD, PhD , SCOTT LUNDGREN MD , SANDEEP NATHAN MD , ESTHER VOROVICH MD , SHELLEY HALL MD , WISSAM KHALIFE MD , ANDREW SCHWARTZMAN MD , OLEG ALEC VISHNEVSKY MD , NAVIN K. KAPUR MD","doi":"10.1016/j.cardfail.2025.07.020","DOIUrl":"10.1016/j.cardfail.2025.07.020","url":null,"abstract":"<div><h3>Background</h3><div>IABPs traditionally are placed via the femoral artery. Single-center studies have shown the utility of axillary placement to promote ambulation. The utility of Ax IABP in CS has not been established. Therefore, we sought to describe the outcomes of patients receiving axillary (Ax) intra-aortic balloon pump (IABP) and compare them with those receiving femoral (Fem) IABP for heart failure-related cardiogenic shock (HF-CS).</div></div><div><h3>Methods</h3><div>Data from 2020 to 2023 from the Cardiogenic Shock Working Group, a multicenter academic consortium, were analyzed. We examined the demographic, metabolic, hemodynamic characteristics, and outcomes of patients with HF-CS treated with Ax-IABP and compared them with those who primarily received a Fem-IABP.</div></div><div><h3>Results</h3><div>Of 6201 CS patients in the registry, 557 (8.9%) patients received an IABP for HF-CS, of whom 244 (43.8%) and 313 (56.2%) received Ax-IABP and Fem-IABP, respectively. Compared with Fem-IABP, patients who received Ax-IABP were more likely to have previous intracardiac defibrillators (42.5% vs 68.9%, <em>P</em> < .001). Time to IABP implant from admission (7.9 ± 10.6 vs 1.8 ± 6.1, <em>P</em> < .01) and duration of support (9.6 ± 14.6 vs 4.0 ± 4.5, <em>P</em> < .01) were longer among Ax-IABP, relative to Fem-IABP. Patients who received Ax-IABP were more likely to undergo heart-replacement therapy (65% vs 21%, <em>P</em> < .001) compared with the Fem-IABP cohort. The rate of reported complications was similar between the 2 groups.</div></div><div><h3>Conclusion</h3><div>Axillary IABP is being used beyond single-center reports to support HF-CS mostly as a bridge to heart-replacement therapies. Its use might provide advantages over fem-IABP.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 394-405"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955496","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 : 2026-02-01Epub Date: 2025-11-10DOI: 10.1016/j.cardfail.2025.08.028
SHAHNAWAZ AMDANI MD, FAHA, FACC, FAAP , EDO BEDZRA MD , DEVIN KOEHL MS , RYAN CANTOR PhD , JAMES K. KIRKLIN MD , RYAN L. KOBAYASHI MD , NATALIE SHWAISH MD , ADAM PUTSCHOEGL MD , STEVEN D. ZANGWILL MD , NEHA BANSAL MD , NANCY J. HALNON MD
Background
Pediatric patients with Fontan circulation represent a growing, high-risk cohort of heart transplant (HT) candidates. However, contemporary multi-institutional data on their waitlist and post-transplant outcomes are limited.
Methods
We conducted a retrospective analysis of children aged 2 to <18 years listed for HT in the Pediatric Heart Transplant Society database from 1993 to 2023. Patients were categorized as having Fontan circulation, non-Fontan congenital heart disease (CHD), or cardiomyopathy (CMP). Outcomes were analyzed across early (1993–2014) and current (2015–2023) eras. Cox proportional hazards models identified risk factors for waitlist mortality and post-transplant graft loss.
Results
Among 6061 listed patients, 22.3% had Fontan circulation, 24.1% non-Fontan CHD, and 53.6% CMP. In the current era, 54.6% of CHD listings are Fontan patients. Fontan patients were significantly less likely to receive ventricular assist device (VAD) support at listing (2.6%) or transplant (4.7%) compared to CMP (16.4%, 29.5%; P < .001). Waitlist survival has improved significantly, with no differences among diagnostic groups in the current era (P = .109). However, Fontan patients had a 2-fold higher risk of post-transplant graft loss compared to CMP (HR 1.99, P < .0001) and experienced higher rates of post-transplant infection and malignancy (P < .05). Among Fontan patients, VAD-supported individuals had similar post-transplant survival to those without mechanical support and significantly better survival than those supported with extracorporeal membrane oxygenation (P < .0001).
Conclusions
Fontan patients now represent the largest CHD subgroup listed for HT. While waitlist outcomes have improved, posttransplant outcomes remain inferior. Selective and timely use of VAD support may improve survival in this high-risk population.
{"title":"Contemporary Waitlist and Post–Heart Transplant Outcomes for Fontan patients: An International Multi-Institutional Analysis","authors":"SHAHNAWAZ AMDANI MD, FAHA, FACC, FAAP , EDO BEDZRA MD , DEVIN KOEHL MS , RYAN CANTOR PhD , JAMES K. KIRKLIN MD , RYAN L. KOBAYASHI MD , NATALIE SHWAISH MD , ADAM PUTSCHOEGL MD , STEVEN D. ZANGWILL MD , NEHA BANSAL MD , NANCY J. HALNON MD","doi":"10.1016/j.cardfail.2025.08.028","DOIUrl":"10.1016/j.cardfail.2025.08.028","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric patients with Fontan circulation represent a growing, high-risk cohort of heart transplant (HT) candidates. However, contemporary multi-institutional data on their waitlist and post-transplant outcomes are limited.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of children aged 2 to <18 years listed for HT in the Pediatric Heart Transplant Society database from 1993 to 2023. Patients were categorized as having Fontan circulation, non-Fontan congenital heart disease (CHD), or cardiomyopathy (CMP). Outcomes were analyzed across early (1993–2014) and current (2015–2023) eras. Cox proportional hazards models identified risk factors for waitlist mortality and post-transplant graft loss.</div></div><div><h3>Results</h3><div>Among 6061 listed patients, 22.3% had Fontan circulation, 24.1% non-Fontan CHD, and 53.6% CMP. In the current era, 54.6% of CHD listings are Fontan patients. Fontan patients were significantly less likely to receive ventricular assist device (VAD) support at listing (2.6%) or transplant (4.7%) compared to CMP (16.4%, 29.5%; <em>P</em> < .001). Waitlist survival has improved significantly, with no differences among diagnostic groups in the current era (<em>P</em> = .109). However, Fontan patients had a 2-fold higher risk of post-transplant graft loss compared to CMP (HR 1.99, <em>P</em> < .0001) and experienced higher rates of post-transplant infection and malignancy (<em>P</em> < .05). Among Fontan patients, VAD-supported individuals had similar post-transplant survival to those without mechanical support and significantly better survival than those supported with extracorporeal membrane oxygenation (<em>P</em> < .0001).</div></div><div><h3>Conclusions</h3><div>Fontan patients now represent the largest CHD subgroup listed for HT. While waitlist outcomes have improved, posttransplant outcomes remain inferior. Selective and timely use of VAD support may improve survival in this high-risk population.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 430-438"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504134","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 : 2026-02-01Epub Date: 2025-08-08DOI: 10.1016/j.cardfail.2025.07.012
DUKE APPIAH Ph.D., M.Ph., M.S. , OLUWATOBI E. OLADEJI M.D., M.Ph. , ERIC K. BRONI M.D., M.Ph. , IMO A. EBONG M.D., M.S. , CATHERINE KIM M.D.
{"title":"Outcomes Among Pregnant Women With Hypertrophic Cardiomyopathy: Racial and Ethnic Differences in the United States","authors":"DUKE APPIAH Ph.D., M.Ph., M.S. , OLUWATOBI E. OLADEJI M.D., M.Ph. , ERIC K. BRONI M.D., M.Ph. , IMO A. EBONG M.D., M.S. , CATHERINE KIM M.D.","doi":"10.1016/j.cardfail.2025.07.012","DOIUrl":"10.1016/j.cardfail.2025.07.012","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 538-540"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816745","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 : 2026-02-01Epub Date: 2025-11-04DOI: 10.1016/j.cardfail.2025.10.011
RANDALL C. STARLING MD, MPH, FACC, FAHA, FESC, FHFSA, MICHAEL Z. TONG MD, MBA, EDWARD G. SOLTESZ MD, MPH
{"title":"Pumping up Survival: Strategy of LVAD First in Younger Patients for Net Prolongation of Life","authors":"RANDALL C. STARLING MD, MPH, FACC, FAHA, FESC, FHFSA, MICHAEL Z. TONG MD, MBA, EDWARD G. SOLTESZ MD, MPH","doi":"10.1016/j.cardfail.2025.10.011","DOIUrl":"10.1016/j.cardfail.2025.10.011","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 541-543"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458804","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 : 2026-02-01Epub Date: 2025-09-28DOI: 10.1016/j.cardfail.2025.09.016
AHMAD MASRI MD, MS , MARK V. SHERRID MD , LUBNA CHOUDHURY MD , PABLO GARCIA-PAVIA MD, PhD , CHRISTOPHER M. KRAMER MD , ROBERTO BARRIALES-VILLA MD , ROBERT M. COOPER MBChB, PhD , PERRY M. ELLIOTT MBBS, MD , SHEILA M. HEGDE MD, MPH , MARTIN S. MARON MD , MICHAEL E. NASSIF MD , Artur Oreziak MD, PhD , ANJALI T. OWENS MD , SCOTT D. SOLOMON MD , ALBREE TOWER-RADER MD , STEPHEN B. HEITNER MD , DANIEL L. JACOBY MD , STUART KUPFER MD , FADY I. MALIK MD, PhD , CHIARA MELLONI MD, MHSc , SARA SABERI MD
{"title":"Safety and Efficacy of Aficamten in Patients With Nonobstructive Hypertrophic Cardiomyopathy: A 96-Week Analysis From FOREST-HCM","authors":"AHMAD MASRI MD, MS , MARK V. SHERRID MD , LUBNA CHOUDHURY MD , PABLO GARCIA-PAVIA MD, PhD , CHRISTOPHER M. KRAMER MD , ROBERTO BARRIALES-VILLA MD , ROBERT M. COOPER MBChB, PhD , PERRY M. ELLIOTT MBBS, MD , SHEILA M. HEGDE MD, MPH , MARTIN S. MARON MD , MICHAEL E. NASSIF MD , Artur Oreziak MD, PhD , ANJALI T. OWENS MD , SCOTT D. SOLOMON MD , ALBREE TOWER-RADER MD , STEPHEN B. HEITNER MD , DANIEL L. JACOBY MD , STUART KUPFER MD , FADY I. MALIK MD, PhD , CHIARA MELLONI MD, MHSc , SARA SABERI MD","doi":"10.1016/j.cardfail.2025.09.016","DOIUrl":"10.1016/j.cardfail.2025.09.016","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 533-537"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199502","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}
{"title":"Navigating Scarcity: How We Enhanced Heart Failure Service Delivery in a Resource-Constrained Health Care System","authors":"NICOLA MELARKEY MD, EDITH DONNELLY ANP, PATRICIA CAMPBELL MD","doi":"10.1016/j.cardfail.2025.11.487","DOIUrl":"10.1016/j.cardfail.2025.11.487","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 544-546"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633688","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 : 2026-02-01Epub Date: 2025-03-03DOI: 10.1016/j.cardfail.2025.01.027
FERNANDO G. ZAMPIERI MD, PhD , SARAH RATHWELL MSc , FINLAY A. MCALISTER MD, MSc , HEATHER ROSS MD, MHSc , JORGE ESCOBEDO MD , CLARA SALDARRIAGA MD , ELOISA COLIN-RAMIREZ PhD , RICHARD W. TROUGHTON MBChB , PETER MACDONALD MD , WENDIMAGEGN ALEMAYEHU PhD , JUSTIN A. EZEKOWITZ MBBCh, MSc , SODIUM-HF Investigators
Background
SODIUM-HF (Study of Dietary Intervention of Sodium Under100 mmol in Heart Failure) compared usual care with dietary sodium restriction in patients with heart failure (HF) and produced neutral results for the primary endpoint. Heterogeneity in treatment effects (HTE) analysis could enhance the original findings.
Objective
Explore the presence of HTE in the SODIUM-HF trial using a risk-effect–based approach.
Methods
HTE was assessed using a risk-based approach based on the Meta-Analysis Global Group in Chronic (MAGGIC) HF risk score. Interaction between MAGGIC quartiles and outcomes was assessed using a Bayesian regression model with neutral priors. The primary endpoint was the same for the original trial (composite of cardiovascular-related admission to hospital, cardiovascular-related emergency department visit, or all-cause death within 12 months in the intention-to-treat population); KCCQ was the secondary endpoint.
Results
Were included 806 patients. MAGGIC quartiles used for the risk-based analyses were 0.036 to 0.102 (low), >0.102 to 0.147 (medium-low), >0.147 to 0.209 (medium-high), and >0.209 to 0.591 (high). There was very strong evidence for the interaction between MAGGIC quartile and intervention (Bayes factor of 68). There was a strong suggestion of association between intervention arm and a lower occurrence of the primary endpoint for the medium-low MAGGIC quartile (>0.98 probability), and a suggestion that the intervention was associated with more frequent occurrence of the primary endpoint in the high MAGGIC quartile (probability of benefit of 0.06). Suggestion of HTE was also found for KCCQ with a strong suggestion of benefit for the intervention for those in the lowest MAGGIC quartiles.
Conclusions
HTE effects in the SODIUM-HF trial is probable. Further trials in sodium retention may benefit by incorporating this information.
目的：采用基于风险效应的方法，探讨100 mmol以下钠饮食干预心力衰竭（Sodium - hf）试验中治疗效果（HTE）的异质性。背景：钠-HF比较了心力衰竭患者（HF）的常规护理和饮食钠限制，并在主要终点产生中性结果。HTE分析可以增强原始发现。方法：采用基于Meta-Analysis Global Group in Chronic (MAGGIC) HF风险评分的基于风险的方法评估HTE。使用具有中性先验的贝叶斯回归模型评估MAGGIC四分位数与结果之间的相互作用。原始试验的主要终点相同（心血管相关入院、心血管相关急诊科就诊或意图治疗人群中12个月内全因死亡的综合数据）；KCCQ是次要终点。结果：共纳入806例患者。用于基于风险分析的MAGGIC四分位数为0.036至0.102（低），>0.102至0.147（中低），>0.147至0.209（中高），>0.209至0.591（高）。有非常有力的证据表明MAGGIC四分位数与干预之间存在相互作用（贝叶斯因子为68）。在中低MAGGIC四分位数中，干预组与较低的主要终点发生之间存在强烈的关联（>.98概率），而在高MAGGIC四分位数中，干预组与更频繁的主要终点发生相关（获益概率为0.06）。对KCCQ也发现了HTE的建议，强烈建议对最低MAGGIC四分位的患者进行干预。结论：HTE在钠- hf试验中的作用是可能的。进一步的钠潴留试验可能会受益于纳入这一信息。
{"title":"Heterogeneity in Treatment Effects in the Reduction of Dietary Sodium to Less Than 100 mmol in Heart Failure (SODIUM-HF): A Secondary Post Hoc Analysis","authors":"FERNANDO G. ZAMPIERI MD, PhD , SARAH RATHWELL MSc , FINLAY A. MCALISTER MD, MSc , HEATHER ROSS MD, MHSc , JORGE ESCOBEDO MD , CLARA SALDARRIAGA MD , ELOISA COLIN-RAMIREZ PhD , RICHARD W. TROUGHTON MBChB , PETER MACDONALD MD , WENDIMAGEGN ALEMAYEHU PhD , JUSTIN A. EZEKOWITZ MBBCh, MSc , SODIUM-HF Investigators","doi":"10.1016/j.cardfail.2025.01.027","DOIUrl":"10.1016/j.cardfail.2025.01.027","url":null,"abstract":"<div><h3>Background</h3><div>SODIUM-HF (Study of Dietary Intervention of Sodium Under100 mmol in Heart Failure) compared usual care with dietary sodium restriction in patients with heart failure (HF) and produced neutral results for the primary endpoint. Heterogeneity in treatment effects (HTE) analysis could enhance the original findings.</div></div><div><h3>Objective</h3><div>Explore the presence of HTE in the SODIUM-HF trial using a risk-effect–based approach.</div></div><div><h3>Methods</h3><div>HTE was assessed using a risk-based approach based on the Meta-Analysis Global Group in Chronic (MAGGIC) HF risk score. Interaction between MAGGIC quartiles and outcomes was assessed using a Bayesian regression model with neutral priors. The primary endpoint was the same for the original trial (composite of cardiovascular-related admission to hospital, cardiovascular-related emergency department visit, or all-cause death within 12 months in the intention-to-treat population); KCCQ was the secondary endpoint.</div></div><div><h3>Results</h3><div>Were included 806 patients. MAGGIC quartiles used for the risk-based analyses were 0.036 to 0.102 (low), >0.102 to 0.147 (medium-low), >0.147 to 0.209 (medium-high), and >0.209 to 0.591 (high). There was very strong evidence for the interaction between MAGGIC quartile and intervention (Bayes factor of 68). There was a strong suggestion of association between intervention arm and a lower occurrence of the primary endpoint for the medium-low MAGGIC quartile (>0.98 probability), and a suggestion that the intervention was associated with more frequent occurrence of the primary endpoint in the high MAGGIC quartile (probability of benefit of 0.06). Suggestion of HTE was also found for KCCQ with a strong suggestion of benefit for the intervention for those in the lowest MAGGIC quartiles.</div></div><div><h3>Conclusions</h3><div>HTE effects in the SODIUM-HF trial is probable. Further trials in sodium retention may benefit by incorporating this information.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 371-381"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567063","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 : 2026-02-01Epub Date: 2025-09-22DOI: 10.1016/j.cardfail.2025.07.007
{"title":"HF STATS 2025: Heart Failure Epidemiology and Outcomes Statistics An Updated 2025 Report from the Heart Failure Society of America","authors":"","doi":"10.1016/j.cardfail.2025.07.007","DOIUrl":"10.1016/j.cardfail.2025.07.007","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 439-498"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131008","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 : 2026-02-01Epub Date: 2026-02-10DOI: 10.1016/j.cardfail.2026.01.005
Kenneth B. Margulies MD (President)
{"title":"Advancing the Future of Heart Failure Care Through the HFSA Devices Initiative","authors":"Kenneth B. Margulies MD (President)","doi":"10.1016/j.cardfail.2026.01.005","DOIUrl":"10.1016/j.cardfail.2026.01.005","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"32 2","pages":"Pages 553-554"},"PeriodicalIF":8.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147214","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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