Editorial: Contemporary applications of machine learning and artificial intelligence for the management of heart failure.

Heart failure (HF) is a complex syndrome with substantial clinical and economic impact. This editorial highlights four original articles published in that showcase contemporary applications of machine learning and artificial intelligence (AI) in HF management. These studies address early diagnosis through novel biomarkers, disease stratification based on transcriptomics, mechanistic insight into apoptotic pathways, and predictive telemonitoring using real-time AI models.

Left ventricular reverse remodeling: A predictor of survival in chagasic cardiomyopathy patients with a reduced ejection fraction.

Background: Chagas disease is a major health issue in Latin America and is now spreading globally because of migration. Chronic Chagasic cardiomyopathy (CCC) leads to heart failure with a reduced ejection fraction (HFrEF). Left ventricular reverse remodeling (LVRR), defined as an improved LVEF, is associated with improved outcomes in patients with other HFrEF etiologies.

Development of a hub-and-spoke durable left ventricular assist device program in Brazil, a middle-income country.

Background: In middle-income countries, costs limit widespred use of left ventricular assist device (LVAD) as a strategy for end-stage heart failure. We aim to describe the experience of a LVAD program in a middle-income country in a hub-and-spoke model.

Methods: Patients fulfilling strict inclusion and exclusion criteria were referred from different centers in Brazil for LVAD implantation through a philanthropy program financed via a Brazilian Federal Government tax exemption structure.

Corrigendum to "Development of a hub-and-spoke durable left ventricular assist device program in Brazil, a middle-income country" [JHLT Open, 6 (2024) 100151].

[This corrects the article DOI: 10.1016/j.jhlto.

Heart Rate and Prognosis of Heart Failure with Reduced Ejection Fraction in Women and Men in Sinus Rhythm.

: A resting heart rate (RHR) is a guideline-recommended therapeutic target for all patients with heart failure with reduced ejection fraction (HFrEF), with reductions to 60 bpm linked to improved outcomes. Conversely, elevated RHR is associated with increased mortality in HFrEF. However, sex-specific differences in mortality, particularly for women in sinus rhythm, remain unclear.

Predictors of sustained reverse remodelling in patients with heart failure with reduced ejection fraction.

Background: Patients with heart failure with reduced ejection fraction (HFrEF) who achieve reverse remodelling (RR) can experience a new decrease in ejection fraction (EF), and the predictors of sustained RR (SRR) are not completely understood.

Objectives: The study aims to identify predictors of SRR in patients with HFrEF after an increase in EF and evaluate SRR prognosis.

Methods: In this retrospective, observational study, we evaluated a real-life cohort of patients with HFrEF and ≥2 consecutive echocardiograms, divided according to left ventricular EF (LVEF) trajectory: no RR (NRR: 3/3 LVEF measurements < 40%), non-SRR (NSRR: second LVEF ≥ 40%, third LVEF < 40%), and SRR (SRR: second and third LVEF ≥ 40%).

Novel Therapies to Reduce Rehospitalization Risk in Worsening Heart Failure: Systematic Review and Network Meta-Analysis.

Background: Worsening heart failure (WHF) challenges health care with frequent rehospitalizations and reduced quality of life for patients. Despite therapeutic advances, high rehospitalization risks highlight the urgent need for new treatments.

Objectives: This study evaluated the effectiveness of initiating novel therapies during hospitalization or vulnerable phase for WHF patients to reduce rehospitalization risks and determine the optimal treatment sequence.

Association of potassium disorders with the mode of death and etiology in patients with chronic heart failure: the INCOR-HF study.

Observational studies suggest a U-shaped association between serum potassium (K⁺) levels and mortality in patients with chronic heart failure (CHF). However, the mode of death in patients with HF and K⁺ disorders remains speculative. To investigate the association between potassium disorders and the mode of death in patients with CHF.

Sacubitril/Valsartan Versus Enalapril in Chronic Chagas Cardiomyopathy: Rationale and Design of the PARACHUTE-HF Trial.

Chronic Chagas cardiomyopathy (CCC) has unique pathogenic and clinical features with worse prognosis than other causes of heart failure (HF), despite the fact that patients with CCC are often younger and have fewer comorbidities. Patients with CCC were not adequately represented in any of the landmark HF studies that support current treatment guidelines. PARACHUTE-HF (Prevention And Reduction of Adverse outcomes in Chagasic Heart failUre Trial Evaluation) is an active-controlled, randomized, phase IV trial designed to evaluate the effect of sacubitril/valsartan 200 mg twice daily vs enalapril 10 mg twice daily added to standard of care treatment for HF.

Assessment of biomarkers and clinical parameters as predictors of survival in patients with chagasic heart failure.

Background: Chagas disease, endemic in Latin America and spreading globally due to emigration, has a significant health burden, particularly in relation to chagasic heart failure (HF). Chagasic cardiomyopathy (CCM) is characterized by chronic inflammatory myocardial disease. This study aimed to identify inflammatory parameters and biomarkers that could aid in the management of patients with chagasic HF.

Treatment of fungal infection on left ventricle assist device driveline exit site: a case report and systematic review.

Objective: The use of ventricular assist devices (VAD) is increasing; however, diagnosis and management of device complications, such as the driveline exit site (DES) being the portal of entry for fungal infection, is not well known.

Method: A systematic review involving searching PubMed (2005 to July 2020) was conducted. The case of a 43-year-old female patient who had a left VAD (LVAD) (HeartMate 3, Abbott, US) is also reported.

Sex Differences in Prognosis of Heart Failure Due to Ischemic and Nonischemic Cardiomyopathy.

Background: Limited research has explored sex-specific differences in death predictors of HF patients with ischemic (iCMP) and nonischemic (niCMP) cardiomyopathy. This study assessed sex differences in niCMP and iCMP prognosis.

Methods: We studied 7487 patients with HF between February 2017 and September 2020.

Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis.

Background: The evidence supporting the use of renin-angiotensin-aldosterone system (RAAS) inhibitors and beta-blockers for the prevention of anthracycline-induced cardiomyopathy is controversial.

Objective: We performed a meta-analysis to assess the effectiveness of these drugs in preventing cardiotoxicity.

Methods: The meta-analysis included prospective, randomized studies in adults receiving anthracycline chemotherapy and compared the use of RAAS inhibitors or beta-blockers versus placebo with a follow-up of 6 to 18 months.

Validation of the Portuguese Version of the Kansas City Cardiomyopathy Questionnaire-12.

The Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) is a simple, feasible, and sensitive questionnaire developed in English for assessing the health status (symptoms, function, and quality of life) of patients with heart failure (HF). We aimed to assess the internal consistency and construct validity of the Portuguese version of KCCQ-12. We administered the KCCQ-12, the Minnesota Living Heart Failure (MLHFQ), and the New York Heart Association (NYHA) classification by telephone.

Sex Differences in Heart Failure Mortality with Preserved, Mildly Reduced and Reduced Ejection Fraction: A Retrospective, Single-Center, Large-Cohort Study.

Background: Heart failure (HF) is one of the leading causes of death worldwide. Studies show that women have better survival rates than men despite higher hospitalizations. However, little is known about differences in mortality and predictors of death in women and men with HF with preserved (HFpEF), mildly reduced (HFmrEF), and reduced ejection fraction (HFrEF).