Systemic Consequences of Pulmonary Hypertension and Right-Sided Heart Failure | Circulation



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Cleveland Clinic Touts At-home Heart Failure Treatment: 6 Takeaways

Some acute heart failure patients can be safely and successfully treated at home, according to a research letter published Nov. 16 in JACC: Heart Failure. 

The letter provides analysis of the Cleveland Clinic Hospital Care at Home program at Weston-based Cleveland Clinic Florida between April 2023 and August 2024, according to a Dec. 26 news release from Cleveland Clinic. 

Here are six takeaways from the letter: 

  • Cleveland Clinic Florida's hospital-at-home program has treated more than 2,800 patients, for conditions including heart failure, pneumonia and kidney infections, since 2023. 
  • Eligible patients admitted to the program receive Bluetooth-enabled equipment to use at home. The equipment transmits data to a clinically integrated virtual command center at a Cleveland Clinic hospital and is overseen by a team of physicians, advanced practice providers and nurses.
  • Cleveland Clinic researchers compared data from 194 heart failure patients enrolled in the at-home program to data from 201 heart failure patients who received care at a hospital.
  • Of the 215 patients who were offered enrollment in the at-home program, 90.2% (194) agreed to enroll, which researchers said speaks to patient acceptance of at-home care.
  • Compared to patients treated at a hospital, 84% of at-home patients completed treatment without needing to be transferred to a facility for imaging, testing or care escalation, the analysis found. At-home patients also had a slightly lower readmission rate (12.4% vs 16.9%), though researchers said this was not statistically significant.
  • Both groups had similar 30-day mortality rates, increases in GDMT scores and net changes in mean diastolic blood pressure, mean systolic blood pressure and heart rates between admission and discharge, the release said. 

    • Read the full research letter here. 


    Role Of BMP10 In Diagnosing And Predicting Outcomes In Acute Heart Failure

    Photo Credit: Raimundo79

    The following is a summary of "Diagnostic and prognostic utility of bone morphogenetic protein 10 in acute dyspnea: a cohort study," published in the December 2024 issue of Cardiology by Simonavicius et al.  

    Bone Morphogenetic Protein 10 (BMP10) is a novel atrial-specific biomarker, and the clinical utility in diagnosing and predicting outcomes in individuals with acute dyspnea remains unclear.  

    Researchers conducted a prospective study evaluating the diagnostic and prognostic accuracy of BMP10 in individuals presenting with acute dyspnea.  

    They assessed BMP10, high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute dyspnea at EDs. The final diagnosis was determined by 2 independent cardiologists blinded to BMP10 (n=933). The diagnostic accuracy for acute heart failure (AHF) was assessed using the area under the receiver operating characteristic curve (AUC), 720-day all-cause mortality, and a composite of all-cause mortality or AHF rehospitalization were measured as prognostic outcomes.  

    The results showed that individuals with AHF had higher BMP10 levels (median 3.34 ng/mL [IQR 2.55–4.35]) compared to individuals with other causes of acute dyspnea (2.04 ng/mL [1.74–2.45], P<0.001). The BMP10 had a diagnostic AUC of 0.85 (95% CI, 0.82–0.87), compared to 0.79 (95% CI, 0.76–0.82, P<0.001) for hs-cTnT and 0.91 (95% CI, 0.90–0.93, P<0.001) for NT-proBNP. Combining BMP10 with NT-proBNP resulted in an AUC of 0.92 (95% CI, 0.90–0.94), which did not improve the diagnostic accuracy compared to NT-proBNP alone, BMP10 predicted death and AHF rehospitalization, but offered no added value to NT-proBNP in prognostic models.  

    They concluded that BMP10 showed high diagnostic accuracy for AHF and was a strong predictor of death and rehospitalization but did not provide additional value over NT-proBNP.  

    Source: link.Springer.Com/article/10.1007/s00392-024-02584-2


    Top 5 Most-Read Heart Failure Articles Of 2024

    Some of the top heart failure research looked at statins and semaglutide for heart failure with preserved ejection fraction, diabetes-related heart failure risks, and the protective cardiovascular effects of COVID-19 vaccination.

    The top heart failure articles of 2024 reflect a growing focus on innovative treatments and preventative strategies to improve patient outcomes, especially for heart failure with preserved ejection fraction (HFpEF). From surgical interventions and medication breakthroughs to understanding the impacts of comorbidities and vaccination, these studies highlight the evolving landscape of heart failure care.

    Here are the 5 most-read heart failure articles of 2024. You can check out the rest of our heart failure news here.

    5. Surgery Improves Outcomes for Patients With Atrial Functional Mitral Regurgitation

    Research highlights the potential benefits of surgical intervention in AFMR over medical management alone.Image credit: totojang1977 – stock.Adobe.Com

    A study revealed that older patients with atrial functional mitral regurgitation (AFMR) who underwent mitral valve surgery had significantly better outcomes than those treated with medical therapy alone. Patients who had surgery experienced a 57% reduction in heart failure hospitalizations and mortality over nearly 3 years of follow-up. The findings emphasize the potential benefits of surgical intervention in managing AFMR, a condition often linked with atrial fibrillation and prevalent among older adults, while highlighting the need for further research to clarify its role in treatment.

    Read the article.

    4. 30-Day Atorvastatin Improved Brachial Artery FMD in Patients With HFpEF, but More Research Is Needed

    A 30-day regimen of atorvastatin improved brachial artery flow-mediated dilation (FMD), a measure of blood vessel function, in patients with HFpEF. However, the statin did not impact other factors like reactive hyperemia or blood flow during exercise, suggesting a limited scope of benefit. While these findings highlight atorvastatin's potential role in improving vascular health, the small sample size and short study duration underscore the need for further research to confirm these results and explore long-term effects.

    Read the article.

    3. Semaglutide Linked to Improved Exercise Capacity, Weight Loss in Patients With HFpEF and Obesity

    A yearlong study found that semaglutide significantly improved exercise capacity and reduced body weight by 2.9% more than placebo in patients with HFpEF and obesity. The treatment also lowered C-reactive protein levels, suggesting anti-inflammatory benefits, and led to additional health improvements such as waist circumference reduction and lower systolic blood pressure. While some adverse events—particularly gastrointestinal issues—were more common in the semaglutide group, the researchers highlighted the drug's potential as a weight-loss strategy to enhance quality of life and functional status in this population.

    Read the article.

    2. Patients With Diabetes and Heart Failure May Face Worse Outcomes, Increased HFpEF Risk

    Research from the Jordanian Heart Failure Registry revealed that patients with diabetes and heart failure are more likely to develop HFpEF and experience worse renal and lipid profiles compared with those without diabetes. HFpEF prevalence was 94.3% among patients with diabetes vs 39.5% for those without. Patients with diabetes also had significantly higher cholesterol and low-density lipoprotein levels, reduced hemoglobin levels, and more severe kidney impairment than those without diabetes.

    Read the article.

    1. Study Says COVID-19 Vaccines Can Reduce Risk of Heart Failure, Blood Clots Following Infection

    COVID-19 vaccination significantly reduced the risks of heart failure, venous thromboembolism (VTE), and arterial thrombosis/thromboembolism (ATE) following COVID-19 infection. These reductions were as high as 55% for heart failure, 78% for VTE, and 47% for ATE, all in the acute phase. This study analyzed data from over 20 million individuals across 3 countries, showing that the protective effects persisted for up to a year after infection, though trends varied slightly by condition.

    Read the article.





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