Journal of Cardiac Failure

BACKGROUND: This open-label phase 2 trial evaluated the safety and efficacy of aficamten in patients with non-obstructive hypertrophic cardiomyopathy (nHCM). METHODS: Patients with symptomatic nHCM (left ventricular outflow tract obstruction gradient ≤30 mmHg, left ventricular ejection fraction [LVEF] ≥60%, N-terminal pro-B-type natriuretic peptide [NT-proBNP] >300 pg/mL) received aficamten 5-20 mg once daily (doses adjusted according to echocardiographic LVEF) for 10 weeks...

BACKGROUND: Minoritized individuals experience greater heart failure (HF) incidence and mortality, yet racial disparities in palliative care (PC) in HF are unknown. METHODS: This retrospective study used electronic medical records to identify adults who were hospitalized at an academic health system and died from HF between 2012-2018. Using multivariable logistic regression, we examined associations between decedent characteristics and PC consultations (PCC). RESULTS: Of 1,987 decedents, 45...

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BACKGROUND: Cardiogenic shock (CS) is complicated by high mortality. Targeted temperature control (TTC) has been proposed as an adjunct therapy in CS. This study aims to examine the safety of TTC in patients presenting with CS. METHODS AND RESULTS: In this open label, randomized controlled pilot trial, 20 patients with hemodynamic criteria for CS were assigned to standard of care plus TTC vs. standard of care alone. The primary outcome was a composite safety outcome including well described complications of TTC...

BACKGROUND: Patients residing in socioeconomically deprived neighborhoods experience higher hospital readmission following hospitalization for heart failure (HF). The role of medication access in these excess readmissions in this group is poorly understood. This study explored patient perspectives on medication access among individuals living in socioeconomically deprived neighborhoods who had experienced HF readmission. METHODS: We conducted semi-structured in-depth interviews with 25 patients (mean age 61 ± 9 years, 96% Black, 40% women) readmitted with acute HF at Emory Healthcare hospitals and living in highly deprived neighborhoods (top decile of the Social Deprivation Index)...

BACKGROUND: Transthyretin cardiac amyloidosis (ATTR-CA) is increasingly recognized. Clinical outcomes have evolved over time amidst changes in the diagnostic pathway and advances in therapeutics. OBJECTIVE: To evaluate clinical outcomes over time of ATTR-CA patients with access to disease-modifying therapy. METHODS: This is a retrospective cohort study of 419 patients diagnosed with ATTR-CA during 2001-2021, comparing clinical characteristics across eras...

BACKGROUND: Estimation of the effect that a drug or other intervention has on patient symptoms and functions is crucial in heart failure trials. Traditional symptoms and functions clinical outcome assessments have important limitations. Actigraphy may help to overcome these limitations due to its objective nature and the potential for continuous recording of data. However, actigraphy is not currently accepted as clinically relevant by key stakeholders. METHODS AND RESULTS: In this This State-of-the-Art paper, the key aspects to consider when implementing actigraphy in heart failure trials are discussed...

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BACKGROUND: Fontan physiology leads to chronic changes in other organ systems that may affect long-term survival and the success of heart transplantation. Inadequate assessment and treatment of the extra-cardiac effects of Fontan may contribute to poor outcomes. Severity graded/ordinal consensus definitions of Fontan complications are lacking which limits understanding of how Fontan-specific morbidity affects patient outcomes. METHODS AND RESULTS: A panel of Fontan patient and physiology experts, including pediatric, adult congenital, heart failure, and critical care cardiology, and pediatric nephrology, hepatology and psychology, convened to develop definitions of Fontan complications...

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AIMS: To perform a network meta-analysis to determine the effectiveness of lifestyle interventions on exercise tolerance and quality of life (QoL) in people with HFpEF. METHODS: Ten databases were searched for randomised controlled trials that evaluated a diet and/or exercise intervention in people with HFpEF up until May 2022. The co-primary outcomes were peak oxygen uptake (V̇O2peak ) and QoL as assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ)...