Zenghong Wu, Fangnan Xia, Weijun Wang, Kun Zhang, Mengke Fan, Rong Lin
Aims
Understanding the global burden of disease attributable to high body mass index (BMI) is essential for informing public health strategies and interventions to mitigate the impact of obesity-related conditions.
Methods and results
The global deaths and disability-adjusted life years (DALYs) caused by high BMI were examined based on age, sex, year, and geographical location as well as socio-demographic index. Globally in 2021, the deaths and DALYs attributable to high BMI have risen 2.54-fold and 2.68-fold for both sexes when compared to 1990. The number of global deaths linked to high BMI has risen for females from 828 147.16 (95% uncertainty interval [UI] 407 103.20–1 302 480.38) in 1990 to 2 013 089.03 (95% UI 979 000.37–3 076 044.71) in 2021, and for males from 631 386.07 (95% UI 315 452.97–988 213.75) in 1990 to 1 695 974.32 (95% UI 861 972.49–2 635 343.31) in 2021. The number of DALYs related to high BMI worldwide has risen for females from 26 097 463.34 (95% UI 11 042 501.33–42 206 794.07) in 1990 to 67 213 785.86 (95% UI 28 417 735.35–105 552 568.89) in 2021, and for males from 21 944 645.99 (95% UI 10 106 039.21–35 110 379.12) in 1990 to 61 306 297.23 (95% UI 27 566 755.49–94 931 874.52) in 2021. However, the age-standardized rate of high-BMI-related deaths for females increased by 4.06% and 15.06% for males between 1990 and 2021, while the age-standardized rate of high-BMI-related DALYs increased by 21.60% for females and 31.22% for males. Across the 21 Global Burden of Disease regions, in 2021, the highest age-standardized rates of high-BMI-related deaths and DALYs were observed in Southern Sub-Saharan Africa (125.12, 95% UI 71.21–183.13) and Oceania (3712.97, 95% UI 1666.49–5765.84), respectively.
Conclusion
Efforts to promote healthy weight management, lifestyle modifications, and early intervention for obesity-related health complications are essential in reducing the morbidity and mortality associated with obesity and improving overall population health.
{"title":"The global burden of disease attributable to high body mass index in 204 countries and territories from 1990 to 2021 with projections to 2050: An analysis of the Global Burden of Disease Study 2021","authors":"Zenghong Wu, Fangnan Xia, Weijun Wang, Kun Zhang, Mengke Fan, Rong Lin","doi":"10.1002/ejhf.3539","DOIUrl":"10.1002/ejhf.3539","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Understanding the global burden of disease attributable to high body mass index (BMI) is essential for informing public health strategies and interventions to mitigate the impact of obesity-related conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>The global deaths and disability-adjusted life years (DALYs) caused by high BMI were examined based on age, sex, year, and geographical location as well as socio-demographic index. Globally in 2021, the deaths and DALYs attributable to high BMI have risen 2.54-fold and 2.68-fold for both sexes when compared to 1990. The number of global deaths linked to high BMI has risen for females from 828 147.16 (95% uncertainty interval [UI] 407 103.20–1 302 480.38) in 1990 to 2 013 089.03 (95% UI 979 000.37–3 076 044.71) in 2021, and for males from 631 386.07 (95% UI 315 452.97–988 213.75) in 1990 to 1 695 974.32 (95% UI 861 972.49–2 635 343.31) in 2021. The number of DALYs related to high BMI worldwide has risen for females from 26 097 463.34 (95% UI 11 042 501.33–42 206 794.07) in 1990 to 67 213 785.86 (95% UI 28 417 735.35–105 552 568.89) in 2021, and for males from 21 944 645.99 (95% UI 10 106 039.21–35 110 379.12) in 1990 to 61 306 297.23 (95% UI 27 566 755.49–94 931 874.52) in 2021. However, the age-standardized rate of high-BMI-related deaths for females increased by 4.06% and 15.06% for males between 1990 and 2021, while the age-standardized rate of high-BMI-related DALYs increased by 21.60% for females and 31.22% for males. Across the 21 Global Burden of Disease regions, in 2021, the highest age-standardized rates of high-BMI-related deaths and DALYs were observed in Southern Sub-Saharan Africa (125.12, 95% UI 71.21–183.13) and Oceania (3712.97, 95% UI 1666.49–5765.84), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Efforts to promote healthy weight management, lifestyle modifications, and early intervention for obesity-related health complications are essential in reducing the morbidity and mortality associated with obesity and improving overall population health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 2","pages":"354-365"},"PeriodicalIF":16.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782370","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}
Neil Keshvani, Syed Rizvi, Matthew W. Segar, James W. Miller, Juan David Coellar, Kershaw V. Patel, Bethany Roehm, W.H. Wilson Tang, Ambarish Pandey
Aims
Diuretic resistance (DR) in heart failure (HF) is associated with worse outcomes. Furoscix®, a self-administered subcutaneous (sc) furosemide injection administered via on-body infusor, is approved for HF congestion relief. However, its efficacy in patients with DR post-HF hospitalization remains unknown.
Methods and results
In this open-label pilot randomized controlled trial, 70 participants were randomized within 14 days post-HF hospitalization to receive a single dose of 80 mg sc furosemide or home oral dose furosemide. Enrolment was stratified by presence of DR (admission BAN-ADHF score ≥12) with a 2:1 enrolment of those with versus without DR. Key outcomes included diuretic efficiency, the total urine output per mg of diuretic administered, and peak urine sodium within 8 h of dose administration. Treatment effects were calculated as the difference in estimated marginal means across study groups and DR strata using linear mixed-effect models. Overall, 70 participants were enrolled (57 years, 27% female, 70% Black, 79% with HF with reduced ejection fraction). Participants with DR (n = 46) had worse kidney function, higher N-terminal pro-B-type natriuretic peptide, and higher home diuretic dose. Among participants with DR, sc furosemide versus oral furosemide led to significantly greater diuretic efficiency (34.0 vs. 22.6 ml/mg, p = 0.002) and peak urine sodium (100 vs. 83 mmol/L, p = 0.029), while participants without DR had similar diuretic efficiency (29.8 vs. 30.1 ml/mg, p = 0.94) and peak urine sodium (96 vs. 95 mmol/L, p = 0.93) across both treatments. DR significantly modified the effect of sc versus oral furosemide on diuretic efficiency (pinteraction: treatment × diuretic resistance = 0.022).
Conclusion
Single-dose sc furosemide was associated with greater diuretic efficiency and peak urine sodium than oral furosemide in participants with DR discharged following recent HF hospitalization.
{"title":"Diuretic efficiency of a single dose of subcutaneous versus oral furosemide after heart failure hospitalization across diuretic resistance strata: A pilot randomized controlled trial","authors":"Neil Keshvani, Syed Rizvi, Matthew W. Segar, James W. Miller, Juan David Coellar, Kershaw V. Patel, Bethany Roehm, W.H. Wilson Tang, Ambarish Pandey","doi":"10.1002/ejhf.3537","DOIUrl":"10.1002/ejhf.3537","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diuretic resistance (DR) in heart failure (HF) is associated with worse outcomes. Furoscix®, a self-administered subcutaneous (sc) furosemide injection administered via on-body infusor, is approved for HF congestion relief. However, its efficacy in patients with DR post-HF hospitalization remains unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>In this open-label pilot randomized controlled trial, 70 participants were randomized within 14 days post-HF hospitalization to receive a single dose of 80 mg sc furosemide or home oral dose furosemide. Enrolment was stratified by presence of DR (admission BAN-ADHF score ≥12) with a 2:1 enrolment of those with versus without DR. Key outcomes included diuretic efficiency, the total urine output per mg of diuretic administered, and peak urine sodium within 8 h of dose administration. Treatment effects were calculated as the difference in estimated marginal means across study groups and DR strata using linear mixed-effect models. Overall, 70 participants were enrolled (57 years, 27% female, 70% Black, 79% with HF with reduced ejection fraction). Participants with DR (<i>n</i> = 46) had worse kidney function, higher N-terminal pro-B-type natriuretic peptide, and higher home diuretic dose. Among participants with DR, sc furosemide versus oral furosemide led to significantly greater diuretic efficiency (34.0 vs. 22.6 ml/mg, <i>p</i> = 0.002) and peak urine sodium (100 vs. 83 mmol/L, <i>p</i> = 0.029), while participants without DR had similar diuretic efficiency (29.8 vs. 30.1 ml/mg, <i>p</i> = 0.94) and peak urine sodium (96 vs. 95 mmol/L, <i>p</i> = 0.93) across both treatments. DR significantly modified the effect of sc versus oral furosemide on diuretic efficiency (<i>p</i><sub>interaction</sub>: treatment × diuretic resistance = 0.022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Single-dose sc furosemide was associated with greater diuretic efficiency and peak urine sodium than oral furosemide in participants with DR discharged following recent HF hospitalization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 2","pages":"347-352"},"PeriodicalIF":16.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.3537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marta Bandini, Nicoletta D'Ettore, Walter Iannotti, Tommaso Capobianco, Giulia Maj, Astrid Cardinale, Alina Gallo, Andrea Audo, Federico Pappalardo
AimsLeft ventricular unloading by percutaneous microaxial flow‐pump devices has been shown to improve survival in patients with cardiogenic shock (CS). The objective of the study is to examine whether Impella 5.0/5.5 (5+) support is effective in facilitating heart recovery, overall survival, and quality of life.Methods and resultsThis single‐centre retrospective study examined midterm (180 days) outcomes of patients with CS supported by Impella 5+ who achieved heart recovery. The primary endpoint was survival at 180 days and freedom from implantable cardioverter‐defibrillator (ICD), heart transplant/left ventricular assist device (LVAD), or readmission for heart failure. Functional status was assessed with New York Heart Association (NYHA) classification. Between June 2022 and April 2024, 20 patients with CS (64 ± 8.9 years, 80% male) received Impella 5+ and discharged with heart recovery. Before Impella placement, mean left ventricular ejection fraction (LVEF) was 19.2 ± 5.2%, 7 (35%) patients were SCAI stage C, 9 (45%) SCAI stage D, and 4 (20%) SCAI stage E, and the mean vasoactive‐inotropic score was 23.2 ± 38.0. The average duration of Impella support was 10.5 ± 8 days. At 180 days, 19 (95%) patients were alive, no patient received a heart transplant/LVAD, 40% were implanted with an ICD and there were two admissions for heart failure. The mean LVEF was 33.5 ± 10.7%, 5 (26.3%) patients were NYHA class I, 9 (47.4%) were NYHA class II, and 5 (26.3%) were NYHA class III. One patient died from a non‐cardiac cause.ConclusionImpella 5+ represents a promising treatment strategy for CS, providing high rates of sustained native heart recovery. A comprehensive platform of mechanical and pharmacological unloading is key.
{"title":"Midterm outcomes of patients with native heart recovery after Impella 5+ for cardiogenic shock","authors":"Marta Bandini, Nicoletta D'Ettore, Walter Iannotti, Tommaso Capobianco, Giulia Maj, Astrid Cardinale, Alina Gallo, Andrea Audo, Federico Pappalardo","doi":"10.1002/ejhf.3544","DOIUrl":"https://doi.org/10.1002/ejhf.3544","url":null,"abstract":"AimsLeft ventricular unloading by percutaneous microaxial flow‐pump devices has been shown to improve survival in patients with cardiogenic shock (CS). The objective of the study is to examine whether Impella 5.0/5.5 (5+) support is effective in facilitating heart recovery, overall survival, and quality of life.Methods and resultsThis single‐centre retrospective study examined midterm (180 days) outcomes of patients with CS supported by Impella 5+ who achieved heart recovery. The primary endpoint was survival at 180 days and freedom from implantable cardioverter‐defibrillator (ICD), heart transplant/left ventricular assist device (LVAD), or readmission for heart failure. Functional status was assessed with New York Heart Association (NYHA) classification. Between June 2022 and April 2024, 20 patients with CS (64 ± 8.9 years, 80% male) received Impella 5+ and discharged with heart recovery. Before Impella placement, mean left ventricular ejection fraction (LVEF) was 19.2 ± 5.2%, 7 (35%) patients were SCAI stage C, 9 (45%) SCAI stage D, and 4 (20%) SCAI stage E, and the mean vasoactive‐inotropic score was 23.2 ± 38.0. The average duration of Impella support was 10.5 ± 8 days. At 180 days, 19 (95%) patients were alive, no patient received a heart transplant/LVAD, 40% were implanted with an ICD and there were two admissions for heart failure. The mean LVEF was 33.5 ± 10.7%, 5 (26.3%) patients were NYHA class I, 9 (47.4%) were NYHA class II, and 5 (26.3%) were NYHA class III. One patient died from a non‐cardiac cause.ConclusionImpella 5+ represents a promising treatment strategy for CS, providing high rates of sustained native heart recovery. A comprehensive platform of mechanical and pharmacological unloading is key.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"44 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758484","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}
Mohammad Kassar, Nicolas Brugger, Lukas Stolz, Muhammed Gerçek, Vera Fortmeier, Karl-Patrik Kresoja, Jennifer von Stein, Benedikt Koell, Wolfgang Rottbauer, Bjoern Goebel, Paolo Denti, Paul Achouh, Tienush Rassaf, Manuel Barreiro-Perez, Peter Boekstegers, Andreas Rück, Monika Zdanyte, Marianna Adamo, Flavien Vincent, Philipp Schlegel, Ralph-Stephan von Bardeleben, Mirjam G. Wild, Stefan Toggweiler, Mathias H. Konstandin, Eric Van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez-Loureiro, Peter Luedike, Nicole Karam, Francesco Maisano, Philipp Lauten, Mirjam Kessler, Daniel Kalbacher, Christos Iliadis, Philipp Lurz, Stephan Windecker, Jörg Hausleiter, Volker Rudolph, Fabien Praz
Conventional parameters of right ventricular (RV) function are load-dependent and therefore do not accurately reflect contractility in patients with relevant tricuspid regurgitation (TR). RV adaptability to load has been characterized using the Dandel's index in patients with heart failure, but its prognostic value in patients undergoing tricuspid transcatheter edge-to-edge repair (T-TEER) has not been investigated so far.
{"title":"The prognostic value of the Dandel's index in patients undergoing tricuspid transcatheter edge-to-edge repair","authors":"Mohammad Kassar, Nicolas Brugger, Lukas Stolz, Muhammed Gerçek, Vera Fortmeier, Karl-Patrik Kresoja, Jennifer von Stein, Benedikt Koell, Wolfgang Rottbauer, Bjoern Goebel, Paolo Denti, Paul Achouh, Tienush Rassaf, Manuel Barreiro-Perez, Peter Boekstegers, Andreas Rück, Monika Zdanyte, Marianna Adamo, Flavien Vincent, Philipp Schlegel, Ralph-Stephan von Bardeleben, Mirjam G. Wild, Stefan Toggweiler, Mathias H. Konstandin, Eric Van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez-Loureiro, Peter Luedike, Nicole Karam, Francesco Maisano, Philipp Lauten, Mirjam Kessler, Daniel Kalbacher, Christos Iliadis, Philipp Lurz, Stephan Windecker, Jörg Hausleiter, Volker Rudolph, Fabien Praz","doi":"10.1002/ejhf.3532","DOIUrl":"https://doi.org/10.1002/ejhf.3532","url":null,"abstract":"Conventional parameters of right ventricular (RV) function are load-dependent and therefore do not accurately reflect contractility in patients with relevant tricuspid regurgitation (TR). RV adaptability to load has been characterized using the Dandel's index in patients with heart failure, but its prognostic value in patients undergoing tricuspid transcatheter edge-to-edge repair (T-TEER) has not been investigated so far.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"261 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758571","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}
Nicolò De Biase, Lavinia Del Punta, Wouter L'Hoyes, Pierpaolo Pellicori, John G F Cleland, Gabriele Masini, Luna Gargani, Sara Moura-Ferreira, Sarah Hoedemakers, Valerio Di Fiore, Lieven Herbots, Jan Stassen, Alessandro Mengozzi, Silvia Armenia, Stefano Taddei, Stefano Masi, Jan Verwerft, Nicola Riccardo Pugliese
Aims: Uncertainty exists about defining true iron deficiency (ID) in heart failure (HF) patients. We assessed the relationship of different ID definitions with cardiac structure and function, congestion, exercise capacity, and prognosis in HF outpatients.
Methods and results: Iron deficiency was defined according to guidelines (G-ID: ferritin <100 ng/ml or ferritin 100-299 ng/ml with transferrin saturation [TSAT] <20%). Alternative ID definitions based on TSAT (<20%), iron (≤13 μmol/L), and ferritin (<100 or < 300 ng/ml) were explored. Relationships with rest/exercise measures of cardiac function and congestion using ultrasound, effort intolerance and adverse outcome (HF hospitalizations or all-cause mortality) were assessed. Of 1502 patients (72% with left ventricular ejection fraction [LVEF] ≥50%), 471 (31%) had TSAT <20%, while 728 (48%) had G-ID. Patients with TSAT <20% or G-ID had greater left atrial volume but similar LVEF. Lower TSAT, iron and haemoglobin, but not ferritin, were associated with more signs of congestion by ultrasound. After correcting for multiple clinical variables, including haemoglobin, TSAT was directly associated with peak oxygen uptake (standardized coefficient 0.069, p = 0.041), while ferritin was not. There was no interaction with HF phenotype (HF with preserved vs. reduced LVEF). During a median follow-up of 18 months, TSAT <20% and iron ≤13 μmol/L were associated with worse outcomes in models adjusted for clinical variables, including LVEF and N-terminal pro-B-type natriuretic peptide (hazard ratio 2.48, 95% confidence interval 1.88-3.17 and 1.93, 1.48-2.52, respectively), while G-ID or ferritin <100 or <300 ng/ml were not.
Conclusion: In HF outpatients, TSAT <20% is more consistently associated with congestion by ultrasound and poorer functional capacity than other ID definitions, irrespective of LVEF. TSAT <20% and iron ≤13 μmol/L, but not G-ID or ferritin-based ID, predict a worse prognosis in HF outpatients with preserved and reduced LVEF.
目的：心力衰竭（HF）患者真正缺铁（ID）的定义存在不确定性。我们评估了不同 ID 定义与心力衰竭门诊患者心脏结构和功能、充血、运动能力和预后的关系：铁缺乏是根据指南定义的（G-ID：铁蛋白结论）：在高血压门诊患者中，TSAT
{"title":"Associations of iron deficiency with cardiac function, congestion, exercise capacity and prognosis in heart failure.","authors":"Nicolò De Biase, Lavinia Del Punta, Wouter L'Hoyes, Pierpaolo Pellicori, John G F Cleland, Gabriele Masini, Luna Gargani, Sara Moura-Ferreira, Sarah Hoedemakers, Valerio Di Fiore, Lieven Herbots, Jan Stassen, Alessandro Mengozzi, Silvia Armenia, Stefano Taddei, Stefano Masi, Jan Verwerft, Nicola Riccardo Pugliese","doi":"10.1002/ejhf.3534","DOIUrl":"https://doi.org/10.1002/ejhf.3534","url":null,"abstract":"<p><strong>Aims: </strong>Uncertainty exists about defining true iron deficiency (ID) in heart failure (HF) patients. We assessed the relationship of different ID definitions with cardiac structure and function, congestion, exercise capacity, and prognosis in HF outpatients.</p><p><strong>Methods and results: </strong>Iron deficiency was defined according to guidelines (G-ID: ferritin <100 ng/ml or ferritin 100-299 ng/ml with transferrin saturation [TSAT] <20%). Alternative ID definitions based on TSAT (<20%), iron (≤13 μmol/L), and ferritin (<100 or < 300 ng/ml) were explored. Relationships with rest/exercise measures of cardiac function and congestion using ultrasound, effort intolerance and adverse outcome (HF hospitalizations or all-cause mortality) were assessed. Of 1502 patients (72% with left ventricular ejection fraction [LVEF] ≥50%), 471 (31%) had TSAT <20%, while 728 (48%) had G-ID. Patients with TSAT <20% or G-ID had greater left atrial volume but similar LVEF. Lower TSAT, iron and haemoglobin, but not ferritin, were associated with more signs of congestion by ultrasound. After correcting for multiple clinical variables, including haemoglobin, TSAT was directly associated with peak oxygen uptake (standardized coefficient 0.069, p = 0.041), while ferritin was not. There was no interaction with HF phenotype (HF with preserved vs. reduced LVEF). During a median follow-up of 18 months, TSAT <20% and iron ≤13 μmol/L were associated with worse outcomes in models adjusted for clinical variables, including LVEF and N-terminal pro-B-type natriuretic peptide (hazard ratio 2.48, 95% confidence interval 1.88-3.17 and 1.93, 1.48-2.52, respectively), while G-ID or ferritin <100 or <300 ng/ml were not.</p><p><strong>Conclusion: </strong>In HF outpatients, TSAT <20% is more consistently associated with congestion by ultrasound and poorer functional capacity than other ID definitions, irrespective of LVEF. TSAT <20% and iron ≤13 μmol/L, but not G-ID or ferritin-based ID, predict a worse prognosis in HF outpatients with preserved and reduced LVEF.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737892","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}
Mert Tokcan, Julian Hoevelmann, Philipp Markwirth, Insa Emrich, Bernhard Haring
{"title":"What's new in heart failure? November 2024","authors":"Mert Tokcan, Julian Hoevelmann, Philipp Markwirth, Insa Emrich, Bernhard Haring","doi":"10.1002/ejhf.3538","DOIUrl":"10.1002/ejhf.3538","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"26 11","pages":"2301-2303"},"PeriodicalIF":16.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737895","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}
{"title":"Reply to ‘Malnutrition and severe heart failure in real-world study settings’","authors":"Matteo Pagnesi, Marco Metra","doi":"10.1002/ejhf.3525","DOIUrl":"10.1002/ejhf.3525","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 1","pages":"181-182"},"PeriodicalIF":16.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724362","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}
Ludwig T Weckbach, Lukas Stolz, Philipp M Doldi, Hannah Glaser, Cecilia Ennin, Michael Kothieringer, Thomas J Stocker, Michael Näbauer, Mohammad Kassar, Sara Bombace, Karl-Patrik Kresoja, Philipp Lurz, Fabien Praz, Holger Thiele, Volker Rudolph, Steffen Massberg, Jörg Hausleiter
Aims: Right ventricular reverse remodelling (RVRR) is linked to improved survival in patients with severe tricuspid regurgitation (TR) and right-sided heart failure who underwent interventional treatment. However, the role of residual TR on RVRR remains unclear. In this analysis the impact of residual TR on RVRR after interventional TR treatment, which was validated by two independent cohorts at four sites using echocardiography or cardiac magnetic resonance (CMR) imaging, was investigated.
Methods and results: Overall, 253 patients who were treated for severe TR and right-sided heart failure using different treatment modalities (tricuspid transcatheter edge-to-edge repair [T-TEER], transcatheter tricuspid valve annuloplasty, orthotopic transcatheter TV replacement [TTVR], heterotopic TTVR) were included. Three-dimensional echocardiographic and CMR-based assessment of RVRR and clinical evaluation of decongestion or exercise capacity were performed at baseline and 30 days after the procedure. Mortality was analysed at 1 year after transcatheter tricuspid valve intervention (TTVI). In patients with residual TR ≤1+ pronounced reduction of right ventricular end-diastolic and end-systolic volumes was observed. In patients with residual TR ≥2+ the effect of RVRR gradually decreased with higher residual TR reinforcing the relevance of optimal procedural results for RVRR. These findings were validated in two independent cohorts. In contrast to RVRR, residual TR ≤1+ and 2+ were associated with similar 1-year survival. RVRR was only observed after T-TEER or orthotopic TTVR, but not after heterotopic TTVR as expected. However, all three treatment modalities were accompanied by significant decongestion and functional improvement at 30-day follow-up.
Conclusion: In patients with severe TR and right-sided heart failure undergoing TTVI, superior procedural results were associated with more pronounced RVRR.
{"title":"Relevance of residual tricuspid regurgitation for right ventricular reverse remodelling after tricuspid valve intervention in patients with severe tricuspid regurgitation and right-sided heart failure.","authors":"Ludwig T Weckbach, Lukas Stolz, Philipp M Doldi, Hannah Glaser, Cecilia Ennin, Michael Kothieringer, Thomas J Stocker, Michael Näbauer, Mohammad Kassar, Sara Bombace, Karl-Patrik Kresoja, Philipp Lurz, Fabien Praz, Holger Thiele, Volker Rudolph, Steffen Massberg, Jörg Hausleiter","doi":"10.1002/ejhf.3529","DOIUrl":"https://doi.org/10.1002/ejhf.3529","url":null,"abstract":"<p><strong>Aims: </strong>Right ventricular reverse remodelling (RVRR) is linked to improved survival in patients with severe tricuspid regurgitation (TR) and right-sided heart failure who underwent interventional treatment. However, the role of residual TR on RVRR remains unclear. In this analysis the impact of residual TR on RVRR after interventional TR treatment, which was validated by two independent cohorts at four sites using echocardiography or cardiac magnetic resonance (CMR) imaging, was investigated.</p><p><strong>Methods and results: </strong>Overall, 253 patients who were treated for severe TR and right-sided heart failure using different treatment modalities (tricuspid transcatheter edge-to-edge repair [T-TEER], transcatheter tricuspid valve annuloplasty, orthotopic transcatheter TV replacement [TTVR], heterotopic TTVR) were included. Three-dimensional echocardiographic and CMR-based assessment of RVRR and clinical evaluation of decongestion or exercise capacity were performed at baseline and 30 days after the procedure. Mortality was analysed at 1 year after transcatheter tricuspid valve intervention (TTVI). In patients with residual TR ≤1+ pronounced reduction of right ventricular end-diastolic and end-systolic volumes was observed. In patients with residual TR ≥2+ the effect of RVRR gradually decreased with higher residual TR reinforcing the relevance of optimal procedural results for RVRR. These findings were validated in two independent cohorts. In contrast to RVRR, residual TR ≤1+ and 2+ were associated with similar 1-year survival. RVRR was only observed after T-TEER or orthotopic TTVR, but not after heterotopic TTVR as expected. However, all three treatment modalities were accompanied by significant decongestion and functional improvement at 30-day follow-up.</p><p><strong>Conclusion: </strong>In patients with severe TR and right-sided heart failure undergoing TTVI, superior procedural results were associated with more pronounced RVRR.</p>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724361","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}
{"title":"Considerations on biological age-related therapeutic intensity. Less numbers, more biology","authors":"Bernhard Haring, Michael Böhm","doi":"10.1002/ejhf.3533","DOIUrl":"10.1002/ejhf.3533","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 1","pages":"107-109"},"PeriodicalIF":16.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724347","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}
Laura Landucci, Ulrika Ljung Faxén, Lina Benson, Ulf Dahlström, Juan J. Carrero, Gianluigi Savarese, Lars H. Lund
Aims
Mineralocorticoid receptor antagonists (MRA) improve outcomes in heart failure with reduced ejection fraction (HFrEF) but are underused. Point prevalent use has been described, but the kinetics of discontinuation and the extent of reinitiation have not been studied.
Methods and results
Patients with HFrEF enrolled in the Swedish Heart Failure Registry between 2006 and 2021 were linked to the Prescribed Drug Register. The rate of discontinuation during the first year of treatment and reinitiation the year after discontinuation were estimated using the Kaplan–Meier method. Multivariable Cox proportional hazards models were used to assess the predictors of discontinuation. Of 11 474 MRA new users, 71% remained on therapy at 1 year. Baseline characteristics independently associated with discontinuation were: estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m2 (hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.34–2.27), hyperkalaemia (HR 1.73, 95% CI 1.25–2.40), eGFR 30–60 ml/min/1.73 m2 (HR 1.51, 95% CI 1.37–1.66), age ≥80 years (HR 1.26, 95% CI 1.10–1.43), enrolment as inpatient (HR 1.25, 95% CI 1.14–1.38), a diagnosis of atrial fibrillation (HR 1.24, 95% CI 1.10–1.39), living alone (HR 1.23, 95% CI 1.13–1.34), ischaemic heart disease (HR 1.20, 95% CI 1.09–1.31), anaemia (HR 1.17, 95% CI 1.07–1.29), diabetes mellitus (HR 1.15, 95% CI 1.04–1.27) and New York Heart Association class III–IV (HR 1.13, 95% CI 1.02–1.24). Reinitiation within a year occurred in 46% of cases, mostly within 3 months after discontinuation.
Conclusion
Among patients with HFrEF initiated on MRA, 71% remained on therapy at 1 year. Discontinuation occurred early and was more common in patients with advanced kidney disease, hyperkalaemia, lack of follow-up in specialty care, more severe heart failure, comorbidities, and markers of sociodemographic frailty. Among those who discontinued, almost half reinitiated treatment the year following discontinuation.
目的：矿物皮质激素受体拮抗剂（MRA）可改善射血分数降低型心力衰竭（HFrEF）的预后，但使用不足。目前已对MRA的普遍使用点进行了描述，但尚未对停药动力学和重新用药的程度进行研究：方法和结果：2006 年至 2021 年间登记入瑞典心衰登记处的 HFrEF 患者与处方药登记处建立了联系。采用卡普兰-梅耶法估算了治疗第一年的停药率和停药后一年的复药率。采用多变量考克斯比例危险模型评估停药的预测因素。在 11 474 名 MRA 新使用者中，71% 的人在 1 年后仍在接受治疗。与停药独立相关的基线特征有：估计肾小球滤过率（eGFR）2（危险比 [HR] 1.75，95% 置信区间 [CI] 1.34-2.27）、高钾血症（HR 1.73，95% CI 1.25-2.40）、eGFR 30-60 ml/min/1.73 m2（HR 1.51，95% CI 1.37-1.66）、年龄≥80 岁（HR 1.26，95% CI 1.10-1.43）、住院患者（HR 1.25，95% CI 1.14-1.38）、心房颤动诊断（HR 1.24，95% CI 1.10-1.39）、独居（HR 1.23，95% CI 1.13-1.34）、缺血性心脏病（HR 1.20，95% CI 1.09-1.31）、贫血（HR 1.17，95% CI 1.07-1.29）、糖尿病（HR 1.15，95% CI 1.04-1.27）和纽约心脏协会 III-IV 级（HR 1.13，95% CI 1.02-1.24）。46%的病例在一年内重新开始用药，大部分是在停药后3个月内：结论：在开始接受 MRA 治疗的 HFrEF 患者中，71% 的患者在 1 年后仍在接受治疗。停药时间较早，更常见于肾病晚期、高钾血症、缺乏专科随访、心衰更严重、合并症和社会人口体质虚弱的患者。在停药的患者中，近一半在停药后一年重新开始治疗。
{"title":"Discontinuation and reinitiation of mineralocorticoid receptor antagonists in patients with heart failure and reduced ejection fraction","authors":"Laura Landucci, Ulrika Ljung Faxén, Lina Benson, Ulf Dahlström, Juan J. Carrero, Gianluigi Savarese, Lars H. Lund","doi":"10.1002/ejhf.3523","DOIUrl":"10.1002/ejhf.3523","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Mineralocorticoid receptor antagonists (MRA) improve outcomes in heart failure with reduced ejection fraction (HFrEF) but are underused. Point prevalent use has been described, but the kinetics of discontinuation and the extent of reinitiation have not been studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>Patients with HFrEF enrolled in the Swedish Heart Failure Registry between 2006 and 2021 were linked to the Prescribed Drug Register. The rate of discontinuation during the first year of treatment and reinitiation the year after discontinuation were estimated using the Kaplan–Meier method. Multivariable Cox proportional hazards models were used to assess the predictors of discontinuation. Of 11 474 MRA new users, 71% remained on therapy at 1 year. Baseline characteristics independently associated with discontinuation were: estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m<sup>2</sup> (hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.34–2.27), hyperkalaemia (HR 1.73, 95% CI 1.25–2.40), eGFR 30–60 ml/min/1.73 m<sup>2</sup> (HR 1.51, 95% CI 1.37–1.66), age ≥80 years (HR 1.26, 95% CI 1.10–1.43), enrolment as inpatient (HR 1.25, 95% CI 1.14–1.38), a diagnosis of atrial fibrillation (HR 1.24, 95% CI 1.10–1.39), living alone (HR 1.23, 95% CI 1.13–1.34), ischaemic heart disease (HR 1.20, 95% CI 1.09–1.31), anaemia (HR 1.17, 95% CI 1.07–1.29), diabetes mellitus (HR 1.15, 95% CI 1.04–1.27) and New York Heart Association class III–IV (HR 1.13, 95% CI 1.02–1.24). Reinitiation within a year occurred in 46% of cases, mostly within 3 months after discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among patients with HFrEF initiated on MRA, 71% remained on therapy at 1 year. Discontinuation occurred early and was more common in patients with advanced kidney disease, hyperkalaemia, lack of follow-up in specialty care, more severe heart failure, comorbidities, and markers of sociodemographic frailty. Among those who discontinued, almost half reinitiated treatment the year following discontinuation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 2","pages":"219-227"},"PeriodicalIF":16.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.3523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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