Kidney Tubular Biomarkers Predict Risk of Death and Heart Failure Readmission in Acute Heart Failure.

Background: Kidney dysfunction, defined by measures of glomerular health, in patients hospitalized with acute heart failure (HF) is associated with death and HF readmission. We aimed to determine if kidney tubule damage and dysfunction are associated with these outcomes in acute HF.

Methods: In AKINESIS (Acute Kidney Injury Neutrophil Gelatinase-Associated Lipocalin [NGAL] Evaluation of Symptomatic Heart Failure Study), 218 individuals admitted with acute HF experiencing acute kidney injury were matched with 218 individuals without acute kidney injury.

Chronic kidney disease and contemporary guideline-directed medical therapy during hospitalization in patients with heart failure: Insights from PRE-UPFRONT-HF.

Background: Chronic kidney disease (CKD) strongly affects prognosis in patients with heart failure (HF). However, the difference in the implementation of guideline-directed medical therapy (GDMT) during HF-related hospitalization between patients with and without CKD and its association with worsening heart failure (WHF) events remain unclear.

Methods: A post-hoc analysis was conducted using data from a retrospective, multicenter, observational registry of patients hospitalized for HF with a left ventricular ejection fraction (LVEF) of <50 %.

Impact of pericoronary adipose tissue attenuation and coronary microvascular dysfunction on cardiac remodeling and dysfunction.

We aimed to examine the impact of coronary inflammation, coronary microvascular dysfunction (CMD), and coronary artery spasm (CAS) on cardiac remodeling and dysfunction in patients suspected of angina with non-obstructive coronary artery disease (ANOCA). This retrospective single-center study included consecutive patients who underwent coronary spasm provocation testing between July 2020 and January 2025 for suspected ANOCA without prior revascularization and coronary stenosis ≥ 75%. Those who underwent coronary angiography after September 2022 also underwent invasive coronary physiology studies to diagnose structural CMD.

Diuretic resistance measured by sodium excretion and urine output in acute heart failure: The DIURESIS-AHF study.

Background: The dynamics and prognostic value of diuretic metrics in response to initial intravenous (IV) diuretic therapy in patients with acute heart failure (AHF) remain unclear. We assessed the association between urinary sodium concentration, diuretic response (DR) following IV furosemide administration, and their prognostic implications in patients with AHF.

Methods: The diuretic resistance measured by sodium excretion and urine output (DIURESIS)-AHF study was a prospective, multicenter, observational study that assessed spot urinary sodium concentrations at 0/1/2 h, total urine output, and urinary sodium excretion achieved within the first 6 h following initial IV furosemide administration.

Validation of MitraScore in diverse mitral regurgitation subtypes: Insights from the OCEAN-mitral registry.

Background: MitraScore is a newly developed tool for predicting mortality risk in patients undergoing mitral transcatheter edge-to-edge repair (M-TEER). Although its performance has been demonstrated in a derivation study, external validation beyond functional mitral regurgitation (MR) remains limited.

Objective: To externally validate the performance of MitraScore across diverse MR subtypes.

DOAC Score for Predicting Clinical Outcomes After Left Atrial Appendage Closure.

Background: The direct-acting oral anticoagulant (DOAC) score has been validated for assessing the bleeding risk in patients with atrial fibrillation (AF). However, data on DOAC scores in patients undergoing percutaneous left atrial appendage closure (LAAC) is limited. This study aimed to evaluate the predictive impact of the DOAC score on clinical events following LAAC and compare it with that of the HAS-BLED (ypertension, bnormal renal and liver function, troke, leeding history or predisposition, abile international normalized ratio [INR], lderly [age ≥65 years], rugs and alcohol concomitantly) score.

Contemporary Guideline-Directed Medical Therapy and Outpatient Worsening Heart Failure Events in Hospitalized Patients With Heart Failure - Preliminary Observational Study on Utilizing Predischarge Period for Optimizing Medications in Hospitalized Patients With Heart Failure (PRE-UPFRONT-HF).

Background: Adherence to contemporary guideline-directed medical therapy (GDMT) and its association with incident outpatient worsening heart failure (WHF) events after discharge in hospitalized patients with heart failure (HF) remain unclear.

Methods And Results: The PRE-UPFRONT-HF study was a retrospective multicenter observational registry of patients hospitalized for HF between June 2022 and March 2023 with a left ventricular ejection fraction <50%. Data on medications at admission, discharge, and 6 months after admission were collected.

Diagnostic Performance of Angiography-Based Vessel-Fractional Flow Reserve Compared with Various Wire-Based Physiological Assessments.

Background: Although considered the gold standard, pressure wire-derived fractional flow reserve (PW-FFR) and instantaneous wave-free ratio (PW-iFR) are not sufficiently adopted. Vessel fractional flow reserve (vFFR) is a potentially less invasive surrogate.

Aims: To validate the diagnostic performance of vFFR against the wire-based physiological assessments in real-world clinical settings.

Racial differences in diuretic therapy, B-type natriuretic peptide values, and prognosis in acute heart failure.

Background: Whether variability of B-type natriuretic peptide (BNP) values between races affects its clinical integration as a marker for congestion and predictor of prognosis in acute heart failure (AHF) remains unknown. We aimed to investigate the relationship between diuretic therapy, change in BNP value, and prognosis in AHF in relation to racial differences.

Methods: This analysis combined data from the AKINESIS and REALITY-AHF studies.

Impact of lactate levels on admission in STEMI patients with cardiogenic shock treated with IMPELLA.

The concomitant use of IMPELLA and veno-arterial extracorporeal membrane oxygenation (V-A ECMO) (ECPELLA) has been increasingly used to treat severe cardiogenic shock. However, the relationship between severity of heart failure on admission and prognosis based on differences in the mechanical circulatory support (MCS) is not fully understood. This study evaluated the association between lactate levels on admission and clinical outcomes based on differences in MCS.

Efficacy and Safety of Sodium Zirconium Cyclosilicate in the Management of Hyperkalemia in Patients with Heart Failure with Reduced and Mildly Reduced Ejection Fraction and Chronic Kidney Disease Treated with Spironolactone: Rationale for and Design of the REGISTA-K Trial.

Background: To evaluate whether sodium zirconium cyclosilicate (SZC) enables the up-titration of spironolactone without increasing the risk of hyper- and hypokalemia in patients with heart failure with reduced and mildly reduced ejection fraction (HFrEF and HFmrEF) and moderate/severe chronic kidney disease (CKD) who developed hyperkalemia during treatment with suboptimal spironolactone dose.

Methods: The REGISTA-K is a randomized, double-blind, placebo-controlled, multicenter trial that examined the efficacy and safety of SZC in up-titrating spironolactone without the occurrence of hyperkalemia or hypokalemia. A total of 266 patients with HFrEF and HFmrEF and hyperkalemia will be randomized in a 1:1 ratio to receive either SZC or placebo after treating hyperkalemia with SZC at 25 sites in Japan.

Ventricular rupture during the removal of Impella 5.5 in a patient with fulminant myocarditis.

Unlabelled: Ventricular perforation or rupture caused by Impella (Abiomed Inc., Danvers, MA, USA) is extremely rare. The Japanese registry of Impella usage reported that the incidence of perforation was 0.

Absence of Kidney Tubular Injury in Patients With Acute Heart Failure With Acute Kidney Injury.

Background: Worsening renal function (WRF) is common in hospitalized patients being treated for acute heart failure. However, discriminating clinically significant WRF remains challenging. In patients hospitalized with acute heart failure, we evaluated if blood and urine biomarkers of cardiac and kidney dysfunction were associated with adverse outcomes.

Glucagon-like peptide-1 receptor agonists improve outcomes in individuals with type 2 diabetes with and without heart failure.

Background: The effectiveness of glucagon-like peptide-1 receptor agonists (GLP1Ras) for prevention of heart failure (HF) in patients with type 2 diabetes (T2DM) without HF and for risk of death in patients with T2DM with HF has not been fully elucidated in routine clinical practice.

Methods: Using the real-world global electronic medical record TriNetX database, individuals with T2DM and with or without HF who initiated either GLP1Ras or sitagliptin from 2017 to 2020 were retrospectively analyzed. In individuals with T2DM without HF, the primary outcome was a composite of all-cause mortality and a new diagnosis of HF within three years.

Global use of angiotensin receptor neprilysin inhibitor in heart failure and reduced, below normal and supranormal ejection fraction.

Background: The global use of angiotensin receptor neprilysin inhibitor (ARNI) in clinical practice, especially in patients with heart failure and below-normal ejection fraction (HFbnEF), has not been thoroughly evaluated. We aimed to investigate the characteristics, outcomes, and adverse events in patients treated with ARNI for HF with reduced (HFrEF), below-normal (HFbnEF), and supranormal left ventricular EF (HFsnEF).

Methods: This observational study analyzed data from the electronic healthcare records (EHR) of patients with HF treated with ARNI between 2015 and 2022 in North and South America, Europe, the Middle East, Africa, and Asia-Pacific.

Significance of an Early Repeat Troponin Measurement Upon Presentation to the Hospital for Acute Heart Failure.

Background: Higher cardiac troponin is associated with worse outcomes in patients with acute heart failure. The significance of repeat measurements over hours remains unclear. We assessed whether a repeat measurement and the Δ between measurements of high-sensitivity cardiac troponin I (hs-cTnI) were associated with outcomes in hypervolemic patients with acute heart failure without acute coronary syndrome.

Association Between Late Gadolinium Enhancement with or Without Reverse Remodeling and Prognosis.

Late gadolinium enhancement (LGE) in cardiovascular magnetic resonance imaging (CMR) prevents left ventricular reverse remodeling (LVRR), resulting in a poor prognosis. However, the prognosis of patients who have LGE and achieve LVRR and patients who do not have LGE and do not achieve LVRR remains unknown. This study aimed to answer this question by sorting patients with heart failure based on the presence of LGE and LVRR and comparing their prognoses.