{"title":"Letter regarding the article ‘Sacubitril/valsartan versus enalapril in chronic Chagas cardiomyopathy with heart failure: Baseline characteristics of the PARACHUTE‐HF trial’","authors":"Dan Xiong","doi":"10.1002/ejhf.70058","DOIUrl":"https://doi.org/10.1002/ejhf.70058","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"94 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282739","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}
Alberto Aimo,Laurens F Tops,Stamatis Adamopoulos,Michael Bonios,Ahmet Çelik,Ovidiu Chioncel,Maja Cikes,Maria G Crespo-Leiro,Kevin Damman,Concetta Di Nora,Julien Dreyfus,Finn Gustafsson,Shahrukh Hashmani,Marco Masetti,Ify Mordi,Sanem Nalbantgil,Linda W van Laake,Ralph Stephan von Bardeleben,Marco Metra,Tuvia Ben Gal,Brenda Moura
Heart failure (HF) represents a significant global health burden, with approximately 10% of patients progressing to advanced stages characterized by severe symptoms and recurrent hospitalizations despite conventional treatments such as guideline-directed medical therapy, devices, and surgery. This clinical consensus statement from the Heart Failure Association of the European Society of Cardiology discusses the applications of imaging modalities in patients with advanced HF. Transthoracic echocardiography remains the cornerstone for initial diagnosis and monitoring, providing critical insights into cardiac volumes, function, and valvular integrity, as well as congestion status. Transoesophageal echocardiography offers detailed evaluations of valve pathology, essential for surgical or transcatheter planning. Cardiovascular magnetic resonance provides comprehensive assessments of biventricular size and function, tissue characterization, and flow dynamics, proving particularly useful for diagnosing specific HF aetiologies. Computed tomography offers valuable insights into pulmonary artery diameter, right ventricular volume, and valvular anatomy, which are crucial for guiding percutaneous procedures. Nuclear imaging techniques allow assessing viability and diagnosing non-ischaemic HF conditions, guiding revascularization decisions. Advanced imaging techniques have expanded the understanding and management of right ventricular dysfunction. The integration of these advanced imaging modalities enhances diagnostic accuracy, risk stratification, and therapeutic decision-making, ultimately improving the prognosis and quality of life for patients with advanced HF. This clinical consensus statement highlights the critical role of various imaging modalities in managing patients with advanced HF, excluding those needing mechanical circulatory support or heart transplantation, emphasizing the multifaceted approach required for effective management.
{"title":"Multimodality imaging in advanced heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. Part 1: Multimodality imaging for the evaluation of patients with advanced heart failure.","authors":"Alberto Aimo,Laurens F Tops,Stamatis Adamopoulos,Michael Bonios,Ahmet Çelik,Ovidiu Chioncel,Maja Cikes,Maria G Crespo-Leiro,Kevin Damman,Concetta Di Nora,Julien Dreyfus,Finn Gustafsson,Shahrukh Hashmani,Marco Masetti,Ify Mordi,Sanem Nalbantgil,Linda W van Laake,Ralph Stephan von Bardeleben,Marco Metra,Tuvia Ben Gal,Brenda Moura","doi":"10.1002/ejhf.3762","DOIUrl":"https://doi.org/10.1002/ejhf.3762","url":null,"abstract":"Heart failure (HF) represents a significant global health burden, with approximately 10% of patients progressing to advanced stages characterized by severe symptoms and recurrent hospitalizations despite conventional treatments such as guideline-directed medical therapy, devices, and surgery. This clinical consensus statement from the Heart Failure Association of the European Society of Cardiology discusses the applications of imaging modalities in patients with advanced HF. Transthoracic echocardiography remains the cornerstone for initial diagnosis and monitoring, providing critical insights into cardiac volumes, function, and valvular integrity, as well as congestion status. Transoesophageal echocardiography offers detailed evaluations of valve pathology, essential for surgical or transcatheter planning. Cardiovascular magnetic resonance provides comprehensive assessments of biventricular size and function, tissue characterization, and flow dynamics, proving particularly useful for diagnosing specific HF aetiologies. Computed tomography offers valuable insights into pulmonary artery diameter, right ventricular volume, and valvular anatomy, which are crucial for guiding percutaneous procedures. Nuclear imaging techniques allow assessing viability and diagnosing non-ischaemic HF conditions, guiding revascularization decisions. Advanced imaging techniques have expanded the understanding and management of right ventricular dysfunction. The integration of these advanced imaging modalities enhances diagnostic accuracy, risk stratification, and therapeutic decision-making, ultimately improving the prognosis and quality of life for patients with advanced HF. This clinical consensus statement highlights the critical role of various imaging modalities in managing patients with advanced HF, excluding those needing mechanical circulatory support or heart transplantation, emphasizing the multifaceted approach required for effective management.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"1 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283948","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}
Laurens F Tops,Alberto Aimo,Stamatis Adamopoulos,Michael Bonios,Ahmet Çelik,Ovidiu Chioncel,Maja Cikes,Maria G Crespo-Leiro,Kevin Damman,Concetta Di Nora,Julien Dreyfus,Finn Gustafsson,Shahrukh Hashmani,Marco Masetti,Ify Mordi,Sanem Nalbantgil,Linda W van Laake,Ralph Stephan von Bardeleben,Marco Metra,Brenda Moura,Tuvia Ben Gal
This clinical consensus statement outlines the vital role of multimodality imaging in managing patients with advanced heart failure (HF), particularly those receiving mechanical circulatory support (MCS) and heart transplantation (HT). For both temporary and durable MCS, multimodality imaging, primarily echocardiography, is crucial for selecting candidates, ensuring proper device placement, and monitoring in the post-implantation period. Preoperatively, it helps to identify HF phenotypes, assess ventricular functions, detect intracardiac thrombi, and evaluate valvular conditions. Key measurements include ventricular size, ejection fraction, and cardiac output. Intraoperative imaging ensures optimal device placement and complication detection. Post-implantation echocardiography gives an impression of the interplay between heart and MCS, detects early complications, and evaluates ventricular unloading and right ventricular function. Serial imaging evaluations are essential for the management of the patient and the device and for diagnosing and treatment of complications. In temporary MCS, imaging is vital in the weaning process. Imaging is crucial across various post-transplant phases, from early postoperative monitoring to long-term follow-up. Echocardiography is the first-line technique. Cardiovascular magnetic resonance provides detailed evaluation of cardiac structure and function, offering insights into fibrosis, oedema, and myocardial perfusion. Coronary computed tomography angiography and positron emission tomography are possible alternatives for assessing coronary allograft vasculopathy. Overall, multimodality imaging is pivotal for comprehensive management of patients potentially eligible to or undergoing MCS or HT, enhancing diagnostic accuracy and guiding therapeutic decisions.
{"title":"Multimodality imaging in advanced heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. Part 2: Mechanical circulatory support and heart transplantation.","authors":"Laurens F Tops,Alberto Aimo,Stamatis Adamopoulos,Michael Bonios,Ahmet Çelik,Ovidiu Chioncel,Maja Cikes,Maria G Crespo-Leiro,Kevin Damman,Concetta Di Nora,Julien Dreyfus,Finn Gustafsson,Shahrukh Hashmani,Marco Masetti,Ify Mordi,Sanem Nalbantgil,Linda W van Laake,Ralph Stephan von Bardeleben,Marco Metra,Brenda Moura,Tuvia Ben Gal","doi":"10.1002/ejhf.70018","DOIUrl":"https://doi.org/10.1002/ejhf.70018","url":null,"abstract":"This clinical consensus statement outlines the vital role of multimodality imaging in managing patients with advanced heart failure (HF), particularly those receiving mechanical circulatory support (MCS) and heart transplantation (HT). For both temporary and durable MCS, multimodality imaging, primarily echocardiography, is crucial for selecting candidates, ensuring proper device placement, and monitoring in the post-implantation period. Preoperatively, it helps to identify HF phenotypes, assess ventricular functions, detect intracardiac thrombi, and evaluate valvular conditions. Key measurements include ventricular size, ejection fraction, and cardiac output. Intraoperative imaging ensures optimal device placement and complication detection. Post-implantation echocardiography gives an impression of the interplay between heart and MCS, detects early complications, and evaluates ventricular unloading and right ventricular function. Serial imaging evaluations are essential for the management of the patient and the device and for diagnosing and treatment of complications. In temporary MCS, imaging is vital in the weaning process. Imaging is crucial across various post-transplant phases, from early postoperative monitoring to long-term follow-up. Echocardiography is the first-line technique. Cardiovascular magnetic resonance provides detailed evaluation of cardiac structure and function, offering insights into fibrosis, oedema, and myocardial perfusion. Coronary computed tomography angiography and positron emission tomography are possible alternatives for assessing coronary allograft vasculopathy. Overall, multimodality imaging is pivotal for comprehensive management of patients potentially eligible to or undergoing MCS or HT, enhancing diagnostic accuracy and guiding therapeutic decisions.","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"213 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283954","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}
Edgar Francisco Carrizales-Sepúlveda,Ramiro Flores-Ramírez
{"title":"Sodium chloride versus glucose solute as a volume replacement therapy for more effective decongestion in acute heart failure: It is probably just the chloride! Letter regarding the article 'Sodium chloride versus glucose solute as a volume replacement therapy for more effective decongestion in acute heart failure (SOLVRED-AHF): A prospective, randomized, mechanistic study'.","authors":"Edgar Francisco Carrizales-Sepúlveda,Ramiro Flores-Ramírez","doi":"10.1002/ejhf.70063","DOIUrl":"https://doi.org/10.1002/ejhf.70063","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"136 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277163","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":"Rising burden of heart failure: An urgent global public health concern.","authors":"Biykem Bozkurt","doi":"10.1002/ejhf.70068","DOIUrl":"https://doi.org/10.1002/ejhf.70068","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"122 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277166","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 the letter 'Sodium chloride versus glucose solute as a volume replacement therapy for more effective decongestion in acute heart failure: It is probably just the chloride'.","authors":"Jan Biegus,Gracjan Iwanek,Robert Zymliński","doi":"10.1002/ejhf.70066","DOIUrl":"https://doi.org/10.1002/ejhf.70066","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"37 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277164","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}
Chris Brown,Brian Wang,Carolina Almeida,Tim Sims,Marco Vidal,Pierre Le Page,Oliver J Rider,Andrew R J Mitchell,John A Henry
{"title":"Evaluating early cardiology involvement and survival outcomes across NT-proBNP levels: An island-wide retrospective cohort study.","authors":"Chris Brown,Brian Wang,Carolina Almeida,Tim Sims,Marco Vidal,Pierre Le Page,Oliver J Rider,Andrew R J Mitchell,John A Henry","doi":"10.1002/ejhf.70060","DOIUrl":"https://doi.org/10.1002/ejhf.70060","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"29 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254491","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":"The addition of vericiguat to sacubitril/valsartan improved the composite endpoint. Add a finishing touch on heart failure medical therapy by vericiguat as secret ingredient.","authors":"Haruyuki Kinoshita,Hiroshi Sugino,Masashi Kodama,Misato Saito,Yoji Sumimoto,Kenji Masada,Takashi Shimonaga,Akiyo Suga,Mayumi Toko,Kaori Taniyasu,Saki Ushirozako,Yumiko Katayama,Chiemi Hirahara,Masahiro Takada","doi":"10.1002/ejhf.70059","DOIUrl":"https://doi.org/10.1002/ejhf.70059","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"114 1","pages":""},"PeriodicalIF":18.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246902","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}
Julian Hoevelmann, Philipp Markwirth, Mert Tokcan, Bernhard Haring
<p>In this column, we want to provide clinicians and researchers with short and concise summaries of recently published articles in the <i>European Journal of Heart Failure</i> that we think may be of particular relevance to heart failure (HF) specialists (<i>Figure</i> 1). Key topics of this issue include novel insights into arrhythmia-induced cardiomyopathy (AIC), profiling of hypotension in HF, the association between clonal haematopoiesis and incident HF, as well as the phenotype-specific relationship between blood pressure (BP) and cardiovascular outcomes in different HF subtypes.</p><p>Arrhythmia-induced cardiomyopathy is a reversible cause of left ventricular systolic dysfunction (LVSD) associated with atrial fibrillation (AF).<span><sup>1</sup></span> In current practice, AIC remains poorly defined and insufficiently characterized, and it is most often identified retrospectively, once left ventricular function improves following adequate rhythm control with antiarrhythmic drugs or AF ablation. Catheter ablation has been shown to improve outcomes in patients with AF and HF.<span><sup>2-4</sup></span> However, distinguishing AIC from other primary cardiomyopathies causing LVSD remains a major challenge, as its diagnosis typically depends on retrospective confirmation following recovery of left ventricular ejection fraction (LVEF). In a post-hoc analysis of the DECAAF II trial, Assaf <i>et al</i>.<span><sup>5</sup></span> aimed to evaluate the prevalence and predictors of AIC in patients with persistent AF and LVSD utilizing late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging.</p><p>Among 815 patients undergoing ablation, 119 with LVSD were analysed. At baseline the cohort had a mean LVEF of 39%. Close to two thirds of patients (60.5%) fulfilled criteria for AIC, defined as LVEF recovery to ≥50% with ≥10% absolute improvement or an absolute improvement (≥15%) after ablation. Patients with AIC showed significantly greater LVEF improvement of 19.9 ± 7.6% compared to 4.8 ± 7.5% in non-AIC patients (<i>p</i> < 0.001). Lower AF burden at 12 months post-ablation correlated with higher LVEF at 3 months post-ablation (r = −0.23, <i>p</i> = 0.02). Using the Youden index, an AF burden of <3.8% was identified as the optimal predictor of AIC status (area under the curve 0.706, <i>p</i> = 0.024). LGE-CMR revealed that AIC patients had significantly less atrial septal fibrosis (12.2% vs. 20.7%, <i>p</i> < 0.001), while global left atrial fibrosis burden was not predictive.</p><p>In conclusion, the findings of the study provide evidence that in the majority patients with persistent AF the tachyarrhythmic condition plays a pivotal role in the development of LVSD. A low AF burden as well as atrial septal regional fibrosis were identified as predictors of AIC in these patients.</p><p>Hypotension remains a key concern in the management of HF with reduced ejection fraction (HFrEF), often limiting the optimization of guideline-direc
为此，Karakasis及其同事进行了一项系统综述和荟萃分析，以评估CHIP与hf发病率和临床结局的关系。作者基于5个队列共评估了13项研究，共包含57755人。无论既往是否有冠状动脉疾病史，CHIP患者发生新发HF的风险显著高于非CHIP组（风险比[HR] 1.23, 95%可信区间[CI] 1.12-1.35, p < 0.0001）。基于LVEF或年龄，未观察到发生HF的亚组差异。基因特异性CHIP亚型的亚组分析显示，ASXL1、DNMT3A、TET2和JAK2在HF发生风险方面存在显著差异（p亚组= 0.03）。ASXL1、TET2和JAK2与HF发生风险显著增加相关，而DNMT3A则无显著影响（HR 1.13, 95% CI 0.99-1.28）。然而，应该指出的是，meta分析中包含的研究使用了不同的测序方法，这可能会影响这些突变的检测。有趣的是，共有四个队列，包括362名参与者，也调查了CHIP与既往基线HF患者全因死亡率和HF住院的综合结局的关系。与非CHIP组相比，CHIP患者发生综合结局的风险明显更高（HR 1.84, 95% CI 1.25-2.70, p = 0.002）。CHIP的靶向治疗是一个新的研究领域，有几种很有前景的策略。一种方法涉及抑制与CHIP存在相关的过度活跃的炎症途径。16虽然这种方法不直接针对CHIP，但它减轻了炎症引起的不良反应。另一种方法试图通过选择性靶向来消除突变的血细胞这一策略取决于对CHIP细胞独特的细胞表面抗原的准确鉴定。总之，Karakasis等人的研究强调了CHIP对HF风险分层的重要性及其作为更个性化方法的生物标志物的潜在作用。HF患者的血压管理仍然存在争议，关于各种HF表型的最佳血压目标的证据相互矛盾。[18,19] Li等人20进行了一项大型个体患者数据荟萃分析，纳入了来自8项具有里程碑意义的随机临床试验的28406名参与者，涵盖了LVEF的全谱。使用时间依赖的Cox回归模型，该研究检查了纵向收缩压和舒张压与主要结局（包括心血管死亡和心衰住院）之间的关系。分析揭示了BP与预后之间的非线性、表型特异性关系。在HFrEF患者中，低收缩压（<120 mmHg）始终与心血管死亡和HF住院风险增加相关（HR 1.71, 95% CI 1.60-1.82, p < 0.001），而高收缩压（>140 mmHg）与较差的结果无关。相反，在射血分数轻度降低或保留的HF （HFmrEF/HFpEF）中，低和高收缩压均与不良结局相关（HR分别为1.74,95% CI 1.47-2.07, p <； 0.001和HR 1.77, 95% CI 1.45-2.17, p < 0.001），形成u型风险曲线。舒张压也有类似的变化趋势。这些发现强调了在心衰患者中统一血压目标的局限性，并强调了LVEF是血压-结局关系的关键调节因素。对于HFrEF，低血压可能反映疾病晚期和心输出量受损，而在HFmrEF/HFpEF中，低血压和未控制的高血压都是风险因素。作者认为，动态的、针对表型的血压管理策略可能会改善结果，但强调需要前瞻性试验来确定当代心衰人群的最佳血压目标。
{"title":"What's new in heart failure? September 2025","authors":"Julian Hoevelmann, Philipp Markwirth, Mert Tokcan, Bernhard Haring","doi":"10.1002/ejhf.70054","DOIUrl":"https://doi.org/10.1002/ejhf.70054","url":null,"abstract":"<p>In this column, we want to provide clinicians and researchers with short and concise summaries of recently published articles in the <i>European Journal of Heart Failure</i> that we think may be of particular relevance to heart failure (HF) specialists (<i>Figure</i> 1). Key topics of this issue include novel insights into arrhythmia-induced cardiomyopathy (AIC), profiling of hypotension in HF, the association between clonal haematopoiesis and incident HF, as well as the phenotype-specific relationship between blood pressure (BP) and cardiovascular outcomes in different HF subtypes.</p><p>Arrhythmia-induced cardiomyopathy is a reversible cause of left ventricular systolic dysfunction (LVSD) associated with atrial fibrillation (AF).<span><sup>1</sup></span> In current practice, AIC remains poorly defined and insufficiently characterized, and it is most often identified retrospectively, once left ventricular function improves following adequate rhythm control with antiarrhythmic drugs or AF ablation. Catheter ablation has been shown to improve outcomes in patients with AF and HF.<span><sup>2-4</sup></span> However, distinguishing AIC from other primary cardiomyopathies causing LVSD remains a major challenge, as its diagnosis typically depends on retrospective confirmation following recovery of left ventricular ejection fraction (LVEF). In a post-hoc analysis of the DECAAF II trial, Assaf <i>et al</i>.<span><sup>5</sup></span> aimed to evaluate the prevalence and predictors of AIC in patients with persistent AF and LVSD utilizing late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging.</p><p>Among 815 patients undergoing ablation, 119 with LVSD were analysed. At baseline the cohort had a mean LVEF of 39%. Close to two thirds of patients (60.5%) fulfilled criteria for AIC, defined as LVEF recovery to ≥50% with ≥10% absolute improvement or an absolute improvement (≥15%) after ablation. Patients with AIC showed significantly greater LVEF improvement of 19.9 ± 7.6% compared to 4.8 ± 7.5% in non-AIC patients (<i>p</i> < 0.001). Lower AF burden at 12 months post-ablation correlated with higher LVEF at 3 months post-ablation (r = −0.23, <i>p</i> = 0.02). Using the Youden index, an AF burden of <3.8% was identified as the optimal predictor of AIC status (area under the curve 0.706, <i>p</i> = 0.024). LGE-CMR revealed that AIC patients had significantly less atrial septal fibrosis (12.2% vs. 20.7%, <i>p</i> < 0.001), while global left atrial fibrosis burden was not predictive.</p><p>In conclusion, the findings of the study provide evidence that in the majority patients with persistent AF the tachyarrhythmic condition plays a pivotal role in the development of LVSD. A low AF burden as well as atrial septal regional fibrosis were identified as predictors of AIC in these patients.</p><p>Hypotension remains a key concern in the management of HF with reduced ejection fraction (HFrEF), often limiting the optimization of guideline-direc","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 9","pages":"1603-1605"},"PeriodicalIF":10.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145230519","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：