ESC Heart Failure

Predicting right ventricular failure after left ventricular assist device implant: A novel approach
Livingston CE, Kim D, Serletti L, Jin A, Rao S, Genuardi MV and Peyster EG
Right ventricular (RV) failure (RVF) after left ventricular assist device (LVAD) implant is an important cause of morbidity and mortality. Modern, data-driven approaches for defining and predicting RVF have been under-utilized.
Relaxin mimetic in pulmonary hypertension associated with left heart disease: Design and rationale of Re-PHIRE
Ufnal M, Connolly K, Millegard M, Surkova E, Guazzi M, Bonderman D, Ezekowitz J, Gustafsson F, Ciurzyński M, Vilella RL, Ahmad T, Gardner R, Jansa P, van Wijk S, Kinugawa K, Björklund E, Jing ZC and Rosenkranz S
Despite receiving guideline-directed medical heart failure (HF) therapy, patients with pulmonary hypertension associated with left heart disease (PH-LHD) experience higher mortality and hospitalization rates than the general HF population. AZD3427 is a functionally selective, long-acting mimetic of relaxin, a hormone that has the potential to induce vasodilation and prevent fibrosis. In a phase 1b study conducted in patients with HF, AZD3427 demonstrated a favourable safety and pharmacokinetic profile. To address the unmet medical need in patients with PH-LHD in the context of HF, AZD3427 is currently under development as a potential treatment option.
Left ventricular function improvement during angiotensin receptor-neprilysin inhibitor treatment in a cohort of HFrEF/HFmrEF patients
Appenzeller F, Harm T, Sigle M, Aidery P, Kreisselmeier KP, Baas L, Goldschmied A, Gawaz MP and Müller KAL
Heart failure (HF) patients may lack improvement of left ventricular (LV) ejection fraction (LVEF) despite optimal HF medication comprising an angiotensin receptor-neprilysin inhibitor (ARNI). Therefore, we aimed to identify key predictors for LV functional enhancement and prognostic reverse cardiac remodelling in HF patients on ARNI treatment.
Exercise-induced dynamic mitral regurgitation is associated with outcomes in patients with ischaemic cardiomyopathy
Spieker M, Sidabras J, Lagarden H, Christian L, Günther N, Angendohr S, Bejinariu A, Schulze PC, Pfister R, Öztürk C, Westenfeld R, Horn P, Polzin A, Kelm M and Rana O
Ischaemic mitral regurgitation (MR) is a dynamic condition influenced by global and regional left ventricular remodelling as well as mitral valvular deformation. Exercise testing plays a substantial role in assessing the haemodynamic relevance of MR and is recommended by current guidelines. We aimed to assess the prevalence, haemodynamic consequences, and prognostic impact of dynamic MR using isometric handgrip exercise.
Vericiguat improves cardiac remodelling and function in rats with doxorubicin-induced cardiomyopathy
Chen W, Wu Y, Li W, Song M, Xu K, Wu M and Lin L
Vericiguat, a soluble guanylate cyclase (sGC) stimulator, has been demonstrated effective in improving prognosis of patients with heart failure with reduced ejection fraction. However, there are limited data concerning the effect of vericiguat in patients with doxorubicin (DOX)-induced cardiomyopathy (DIC). In this study, we investigated the effects of vericiguat on cardiac structure and function in rats with DIC as well as their potential mechanisms of action.
Temporal profiling of M-TEER-related complications
Haschemi J, Schrameck H, Haurand JM, Oehler D, Spieker M, Voss F, Kelm M, Polzin A and Horn P
Transcatheter edge-to-edge repair of the mitral valve (M-TEER) is known for its low complication rates. However, the optimal level and duration of post-procedural care remain unclear. This study aimed to identify the specific timeframe of post-procedural complications following M-TEER.
State of precision medicine for heart failure with preserved ejection fraction in a new therapeutic age
Rasalam R, Sindone A, Deed G, Audehm RG and Atherton JJ
Heart failure with preserved ejection fraction (HFpEF) is defined by heart failure (HF) with a left ventricular ejection fraction (LVEF) of at least 50%. HFpEF has a complex and heterogeneous pathophysiology with multiple co-morbidities contributing to its presentation. Establishing the diagnosis of HFpEF can be challenging. Two algorithms, the 'Heavy, 2 or more Hypertensive drugs, atrial Fibrillation, Pulmonary hypertension, Elderly age >60, elevated Filling pressures' (HFPEF) and the 'Heart Failure Association Pre-test assessment, Echocardiography and natriuretic peptide, Functional testing, Final aetiology' (HFA-PEFF), can help to determine the likelihood of HFpEF in individuals with symptoms of HF. Phenotype clusters defined largely by the total number and types of co-morbidities may delineate groups of patients with HFpEF with different management needs. It is important to recognize alternative diagnoses or HFpEF mimics such as infiltrative cardiomyopathies, coronary artery disease, lung disease, anxiety, depression, anaemia, severe obesity, and physical deconditioning, among others. Treatment with sodium-glucose co-transporter 2 inhibitors (dapagliflozin and empagliflozin) is recommended for all patients with HFpEF unless contraindicated. Future research should consider alternative approaches to guide the initial diagnosis and treatment of HFpEF, including phenotype clustering models and artificial intelligence, and consider whether LVEF is the most useful distinguishing feature for categorizing HF. Ongoing clinical trials are evaluating novel pharmacological and device-based approaches to address the pathophysiological consequences of HFpEF.
Poor communication impairs optimal care of patients with heart failure and erectile dysfunction
Leist L, Hausmann L and Pohlink C
Heart failure (HF) and erectile dysfunction (ED) share numerous risk factors and pathogenetic mechanisms, resulting in a high prevalence of ED among male patients with HF. This questionnaire-based study aimed to better understand the patient's journey from a patient perspective and that of healthcare professionals (HCPs) regarding communication, education and treatment of ED as a recognized comorbid condition.
Association between the Tpeak-Tend interval on admission and coronary microvascular dysfunction in Takotsubo syndrome
Onishi K, Ueno M, Yamada N, Kakehi K, Fujita K, Matsumura K and Nakazawa G
The Tpeak-Tend interval on electrocardiogram may be a predictor of worse outcomes in Takotsubo syndrome (TTS), but the mechanisms have not been fully determined. This study aimed to investigate the relationships between the corrected Tpeak-Tend (cTp-e) interval and coronary microvascular-dysfunction (CMD) assessed by the angiography-derived index of microvascular resistance (Angio-IMR) and the in-hospital prognosis in patients with TTS.
Cardiac myosin binding protein C correlate with cardiac troponin I during an exercise training program in patients with HFrEF
Riveland E, Ushakova A, Valborgland T, Karlsen T, Dalen H, Prescott E, Omland T, Linke A, Halle M, Marber M, Ellingsen Ø, Larsen AI and
Cardiac myosin binding protein C (cMyC) is an emerging new biomarker of myocardial injury rising earlier and cleared faster than cardiac troponins. It has discriminatory power similar to high-sensitive troponins in diagnosing myocardial infarction in patients presenting with chest pain. It is also associated with outcome in patients with acute heart failure. It is currently unclear how it relates to cardiac troponins in patients with chronic heart failure undergoing exercise training.
Frailty determinants in heart failure: Inflammatory markers, cognitive impairment and psychosocial interaction
Wleklik M, Lee CS, Lewandowski Ł, Czapla M, Jędrzejczyk M, Aldossary H and Uchmanowicz I
This study aimed to identify factors associated with frailty in heart failure (HF) patients, focusing on demographic, biochemical and health-related variables. It also explored the correlation between frailty and comorbidities such as malnutrition, cognitive impairment and depression, assessing how these factors interact to influence frailty risk.
Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment
Haonan L, Qiaorui H, Wenqing Z, Yanjun Z, Wangjia P, Shikai Y, Zhuoga D, Yi Z and Yifan Z
We aim to elucidate the association of baseline eGFR and incident heart failure on patients receiving intensive BP treatment.
Nephrological perspectives on the underutilization of SGLT2is in heart failure and chronic kidney disease
Helvacı Ö, Akçay ÖF, Yaşar E, Derici Ü and Güz G
The efficacy and safety of sodium-glucose cotransporter 2 inhibitors in patients aged over 80 years with heart failure
Nakano K, Kanenawa K, Isotani A, Morinaga T, Yamamoto K, Miyawaki N, Ko E, Nakamura M, Tanaka Y, Ishizu K, Morofuji T, Hayashi M, Fukunaga M, Hyodo M, Shirai S and Ando K
Sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2i) have demonstrated effectiveness in reducing cardiovascular death and heart failure hospitalization (HFH). However, the efficacy and safety of SGLT2 inhibitors in elderly patients with poor general status, such as very low bodyweight or low nutritional status, who are not included in randomized controlled trials, has not yet been examined. In a real-world setting, the introduction of SGLT2 inhibitors to such elderly patients is a very difficult decision to make. We therefore examined the efficacy and safety of these drugs in elderly heart failure patients in a real-world setting.
In a quest for better outcome prediction in cardiogenic shock
Kuliczkowski W
Guideline-directed medical therapy rates in heart failure patients with reduced ejection fraction in a diverse cohort
Berry NC, Sheu YS, Chesbrough K, Bishop RC and Vupputuri S
Guideline-directed medical therapy (GDMT) is recommended for all patients with heart failure with reduced ejection fraction (HFrEF). Despite this, little data exist describing GDMT use in diverse, real-world populations including the use of vasodilators, prescribed primarily to Black populations. We sought, among a diverse population of HFrEF patients, to determine (1) GDMT use rates and target dosing by medication class and (2) predictors of GDMT use and target dosing by medication class.
Correction to 'Incidence and predictors of heart failure with improved ejection fraction category in a HFrEF patient population'
Cardiopulmonary exercise testing as a prognosis-assessing tool in heart failure with preserved ejection fraction
da Conceicao CR, Krannich A, Zach V, Pinto R, Deichl A, Feuerstein A, Schleussner L and Edelmann F
Patients with heart failure with preserved ejection fraction represent half of the heart failure patients nowadays, an at least steady trend due to the aging of the population. We investigated whether the parameters obtained from cardiopulmonary exercise testing (CPET) correlated with the prognosis of these patients. This prospective observational cohort study assesses the relationship between the CPET parameters peakVO and VE/VCO slope and the number of heart failure hospitalizations or cardiovascular death of these patients.
Comparative performance of risk prediction indices for mortality or readmission following heart failure hospitalization
Averbuch T, Zafari A, Islam S, Lee SF, Sankaranarayanan R, Greene SJ, Mamas MA, Pandey A and Van Spall HG
Risk prediction indices used in worsening heart failure (HF) vary in complexity, performance, and the type of datasets in which they were validated. We compared the performance of seven risk prediction indices in a contemporary cohort of patients hospitalized for HF.
Mortality risk stratification for Takotsubo syndrome: Evaluating CRP measurement alongside the InterTAK prognostic score
Faucher L, Matsushita K, Kikuchi S, Tatarcheh T, Marchandot B, Granier A, Amissi S, Trimaille A, Jesel L, Ohlmann P, Hibi K, Schini-Kerth V and Morel O
Initially described as a benign acute cardiomyopathy, Takotsubo syndrome has been linked to elevated mortality rates. Emerging evidence suggests that unresolved myocardial inflammation may contribute to this adverse prognosis. This study aimed to evaluate the incremental prognostic utility of C-reactive protein (CRP) in conjunction with the InterTAK prognosis score for stratifying long-term mortality in Takotsubo syndrome.
Health-related quality of life across heart failure categories: associations with clinical characteristics and outcomes
Settergren C, Benson L, Dahlström U, Thorvaldsen T, Savarese G, Lund LH and Shahim B
The study aims to examine characteristics and outcomes associated with health-related quality of life (HRQoL) in patients with heart failure (HF) with preserved, mildly reduced and reduced ejection fraction (EF) (HFpEF, HFmrEF and HFrEF).