Effects of volenrelaxin in worsening heart failure with preserved ejection fraction: a phase 2 randomized trial.

Relaxin is a peptide hormone that may decrease circulatory congestion and improve kidney function. In this study, we conducted a double-blind, international, multicenter trial to test whether volenrelaxin, a long-acting form of human relaxin, can improve left atrial (LA) function, reduce congestion and improve kidney function in patients with heart failure and preserved ejection fraction (HFpEF). We randomly assigned patients with New York Heart Association (NYHA) class II-IV HFpEF and recent heart failure (HF) decompensation to 25-mg, 50-mg or 100-mg volenrelaxin or placebo administered subcutaneously once weekly.

Evaluation of carbohydrate antigen 125 in heart failure with preserved ejection fraction diagnosis.

Background: Current evidence supports the role of circulating carbohydrate antigen 125 (CA125) in risk assessment, disease monitoring and therapeutic guidance in heart failure (HF). However, there is limited data on its diagnostic applicability. This study aimed to assess the diagnostic performance of CA125 in identifying HF with preserved ejection fraction (HFpEF) in an outpatient population.

Impact of fine particulate matter (PM) pollution on hospital admissions and mortality due to acute myocardial infarction in Spain.

Introduction And Objectives: Atherosclerotic vascular disease is the main cause of mortality attributable to air pollution. This study analyzes, for the first time, the association between levels of fine particulate matter (PM, particles ≤ 2.5μm in diameter) and hospital admissions and in-hospital mortality due to acute myocardial infarction (AMI) in hospitals of the Spanish National Health System.

Therapeutic role of venous leg compression in worsening heart failure with predominant extravascular congestion: a case report.

Background: Worsening heart failure (WHF) may occasionally present with predominant extravascular fluid overload without clear intravascular congestion. This scenario can challenge traditional diuretic-based strategies, particularly in patients with infiltrative cardiomyopathies such as amyloid light-chain (AL) amyloidosis, where congestion often manifests as volume overload without substantial intravascular volume expansion.

Case Summary: This case report highlights the potential efficacy of venous leg compression (VLC)-a therapeutic approach traditionally employed in chronic venous diseases to improve venous return-combined with parenteral diuretic therapy in alleviating signs and symptoms in a 50-year-old woman with AL amyloidosis and WHF.

Aging diastole - root cause for atrial fibrillation and heart failure with preserved ejection fraction.

The age-related decline in diastolic function can result in heart failure with a preserved ejection fraction (HFpEF) and atrial fibrillation (AF), which are comorbid conditions that are increasingly prevalent and have a high socioeconomic burden. In humans, diastolic dysfunction results from structural and functional changes that increasingly impede diastolic filling after midlife. Comorbidities and pathomechanisms that lead to additional increases in cardiac filling pressures accelerate the age-related deterioration in diastolic function.

Predictors of long-term survival in patients with a first episode of acute heart failure.

Introduction: Acute heart failure (AHF) represents a critical event in heart failure progression, yet data on long-term outcomes after first hospitalization, remain scarce. The aim is to describe long-term survival and evaluate its predictors after the first episode of AHF.

Material And Methods: Patients from five Spanish hospitals with a confirmed first diagnosis of AHF were categorized based on survival (≥5 or RESULTS: A total of 1986 patients were included, median age 76 years (range: 68-82), 50% women, and 57% with preserved LVEF.

Baseline serum ferritin predicts myocardial iron uptake following intravenous iron therapy - a hypothesis-generating study.

Aims: Many patients with heart failure (HF) are iron-deficient. Intravenous (IV) iron therapy improves symptoms and reduces hospitalizations for HF. Several mechanisms have been proposed, including myocardial iron repletion.

Hypochloremia in chronic and acute heart failure scenarios: Prevalence and risk factors.

Aims: Chloride plays a key role in maintaining volume homeostasis. Low plasmatic chloride levels are associated with diuretic resistance and worse outcomes in patients with heart failure (HF). This study focused on determining the prevalence and factors related to hypochloremia in patients with heart failure (HF) in chronic and acute settings.

Changes in Renal Venous Flow and Liberation from Renal Replacement Therapy in Patients with Acute Heart Failure.

Introduction: In acute heart failure (AHF), the factors associated with successful renal replacement therapy (RRT) discontinuation are largely undefined. We hypothesized that improvements in Doppler-derived renal venous flow (RVF) waveforms may serve as indicators of recovering cardiorenal function associated with successful liberation from RRT.

Methods: We performed a post hoc analysis of a prospective cohort study involving inpatients with AHF undergoing serial renal Doppler evaluations.

Serum chloride and the response to combining loop and thiazide diuretics for acute heart failure: the ALCALOTIC study.

Chloride may play an important role in the pathophysiology of heart failure (HF) as it is associated with HF prognosis and diuretic resistance. This study evaluates the diuretic response across serum chloride in patients admitted with acute heart failure (AHF) and treated with loop and thiazide diuretics. This is a subanalysis of the ALCALOTIC study, a prospective, multicentre, observational cohort study that included 665 patients admitted for AHF at 30 clinical sites in Spain.

Evaluation of mobile health technology combining telemonitoring and teleintervention versus usual care in vulnerable-phase heart failure management (HERMeS): a multicentre, randomised controlled trial.

Background: The potential of mobile health (mHealth) technology combining telemonitoring and teleintervention as a non-invasive intervention to reduce the risk of cardiovascular events in patients with heart failure during the early post-discharge period (ie, the vulnerable phase) has not been evaluated to our knowledge. We investigated the efficacy of incorporating mHealth into routine heart failure management in vulnerable-phase patients.

Methods: The Heart Failure Events Reduction with Remote Monitoring and eHealth Support (HERMeS) trial was a 24-week, randomised, controlled, open-label with masked endpoint adjudication, phase 3 trial conducted in ten centres (hospitals [n=9] and a primary care service [n=1]) experienced in heart failure management in Spain.

Carbohydrate antigen 125 determined on arrival at the emergency department correlates with severity of decompensation and adverse outcomes in patients with acute heart failure.

To investigate the capacity of carbohydrate antigen 125 (CA125) to detect severe decompensation in patients diagnosed with acute heart failure (AHF) in the emergency department (ED) and to predict 1-year mortality. We assessed CA125 at ED arrival in unselected patients diagnosed with AHF in five Spanish hospitals during November-December 2022. CA125 was categorized as tertiles.

NT-proBNP to guide risk stratification after cardiac rehabilitation in patients with ST-segment elevation myocardial infarction.

Introduction And Objectives: The use of N-terminal pro-brain natriuretic peptide (NT-proBNP) after ST-segment elevation acute myocardial infarction (STEMI) is unclear. We evaluated its prognostic significance after post-STEMI cardiac rehabilitation.

Methods: The prognostic significance of NT-proBNP was tested upon completion of cardiac rehabilitation (median, 45 days post-STEMI) in an exploratory group (n = 105 patients with the researchers blinded to NT-proBNP values) and validated in the following 276 patients.

Identification of phenotypes in heart failure with preserved ejection fraction among 8161 patients from 3 Spanish cohorts.

Introduction And Objectives: To identify phenotypes in heart failure with preserved ejection fraction (HFpEF), compare mortality, and investigate whether treatments have different effects according to phenotype.

Methods: We performed a secondary analysis of 8161 patients with HFpEF included in Spanish cardiology (INCLIVA), internal medicine (RICA), and emergency (EAHFE) registries. Phenotypic clusters based on 16 baseline characteristics were identified using latent class analysis.

The Role of Antigen Carbohydrate 125 in Modulating Soluble ST2: Prognostic-Related Effects in Acute Heart Failure.

Background: Acute heart failure (AHF) is a complex syndrome associated with high mortality and hospital readmissions, characterized by volume overload and inflammation. Soluble ST2 (sST2) and antigen carbohydrate 125 (CA125) are emerging biomarkers that reflect these processes and may interact to influence long-term outcomes in AHF patients. This study aims to examine the prognostic relationship between sST2 and CA125 in predicting mortality and heart failure (HF)-related hospitalizations in patients with decompensated heart failure.

Effect of Exercise Training in Patients with Chronotropic Incompetence and Heart Failure with Preserved Ejection Fraction: The TRAINING-HR Randomized Clinical Trial.

Aims: Chronotropic incompetence (ChI) in heart failure with preserved ejection fraction (HFpEF) is associated with a reduced exercise capacity. The role of exercise training in improving chronotropic response (ChR) and functional capacity in these patients remains uncertain. This study assessed the effects of four different exercise programs on peak oxygen consumption (peakVO₂), Kansas City Cardiomyopathy Questionnaire (KCCQ) score and ChR in patients with the ChI HFpEF phenotype.

Adenocarcinoma of the duodenal papilla with synchronous peritoneal metastases-5 years of overall survival: A case report.

Background: Ampullary adenocarcinomas are a rare disease. They can be classified anatomically or according to their histology into intestinal, pancreatobiliary, and mixed subtypes, with different subtypes having distinct prognoses and potential treatments. We report a clinical case of a patient with mixed type adenocarcinoma of the ampulla of Vater, with predominantly intestinal histology, associated with an isolated and synchronous peritoneal carcinomatosis.

Effect of left bundle branch block on maximal functional capacity in asymptomatic individuals without structural heart disease.

Introduction And Objectives: In asymptomatic individuals, left bundle branch block (LBBB) is associated with an increased risk of cardiovascular events, but its impact on maximal functional capacity remains unclear. This study aimed to evaluate maximal aerobic capacity (peakVO) in asymptomatic adults with LBBB without structural heart disease and compare it to an age-, physical activity-, and sex-matched control population.

Methods: This prospective case-control study included asymptomatic adults with isolated LBBB and matched controls.

Prognostic effect of the combined use of thiazides and loop diuretics at discharge following a hospitalization for acute heart failure.

Aims: There is limited information regarding the clinical impact of the concurrent use of thiazides and loop diuretics (LD) after an episode of acute heart failure (AHF) hospitalization. We aimed to evaluate the impact of thiazide prescription at discharge on top of LD on the short-term risk of AHF readmission.

Methods: We included 3384 consecutive patients discharged from January 2008 to September 2021 after an admission for AHF in a single teaching center.

Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.

Heart failure (HF) and chronic kidney disease (CKD) frequently coexist, sharing significant overlap in prevalence and pathophysiological mechanisms. This coexistence, termed cardiorenal syndrome (CRS), often leads to anemia, which exacerbates both HF and CKD, thereby increasing morbidity and death. Managing anemia in CRS is complex due to conflicting guidelines and the multifactorial nature of the condition.