High-risk Cytomegalovirus in Heart Transplant: How Can We Improve?

Background: Cytomegalovirus (CMV) infection is associated with worse outcomes after heart transplant (HT). CMV mismatch (donor positive, recipient negative serology, D+/R-) increases the risk of infection. Guidelines recommend 3 to 6 months of antiviral prophylaxis in these patients.

Impact of natriuresis on worsening renal function during episodes of acute heart failure.

Introduction And Objectives: Worsening renal function (WRF) is a frequent complication in acute heart failure (AHF) with a controversial prognostic value. We aimed to study the usefulness of natriuresis to evaluate WRF.

Methods: We conducted an observational, prospective, multicenter study of patients with AHF who underwent a furosemide stress test.

Sex and Gender-related Disparities in Clinical Characteristics and Outcomes in Heart Transplantation.

Purpose Of Review: Limited research has been conducted on sex disparities in heart transplant (HT). The aim of this review is to analyse the available evidence on the influence of sex and gender-related determinants in the entire HT process, as well as to identify areas for further investigation.

Recent Findings: Although women make up half of the population affected by heart failure and related mortality, they account for less than a third of HT recipients.

Clinical impact of remote heart failure management using the multiparameter ICD HeartLogic alert.

Introduction And Objectives: The multiparametric implantable cardioverter-defibrillator HeartLogic index has proven to be a sensitive and timely predictor of impending heart failure (HF) decompensation. We evaluated the impact of a standardized follow-up protocol implemented by nursing staff and based on remote management of alerts.

Methods: The algorithm was activated in HF patients at 19 Spanish centers.

De Novo Donor-Specific Antibodies after Heart Transplantation: A Comprehensive Guide for Clinicians.

Antibodies directed against donor-specific human leukocyte antigens (HLAs) can be detected de novo after heart transplantation and play a key role in long-term survival. De novo donor-specific antibodies (dnDSAs) have been associated with cardiac allograft vasculopathy, antibody-mediated rejection, and mortality. Advances in detection methods and international guideline recommendations have encouraged the adoption of screening protocols among heart transplant units.

Heart failure risk scores in advanced heart failure patients: insights from the LEVO-D registry.

Aims: The prevalence of advanced heart failure (HF) is increasing due to the growing number of patients with HF and their better treatment and survival. There is a scarcity of data on the accuracy of HF web-based risk scores in this selected population. This study aimed to assess mortality prediction performance of the Meta-Analysis Global Group in Chronic HF (MAGGIC-HF) risk score and the model of the Barcelona Bio-HF Risk Calculator (BCN-Bio-HF) containing N terminal pro brain natriuretic peptide in HF patients receiving intermittent inotropic support with levosimendan as destination therapy.

Review of the allocation criteria for heart transplant in Spain in 2023. SEC-Heart Failure Association/ONT/SECCE consensus document.

Heart transplant (HT) remains the best therapeutic option for patients with advanced heart failure (HF). The allocation criteria aim to guarantee equitable access to HT and prioritize patients with a worse clinical status. To review the HT allocation criteria, the Heart Failure Association of the Spanish Society of Cardiology (HFA-SEC), the Spanish Society of Cardiovascular and Endovascular Surgery (SECCE) and the National Transplant Organization (ONT), organized a consensus conference involving adult and pediatric cardiologists, adult and pediatric cardiac surgeons, transplant coordinators from all over Spain, and physicians and nurses from the ONT.

Conduction system pacing and atrioventricular node ablation in heart failure: The PACE-FIB study design.

Aims: Atrial fibrillation (AF) worsens the prognosis of patients with heart failure (HF). Successful treatments are still very scarce for those with permanent AF and preserved (HFpEF) or mildly reduced (HFmrEF) ejection fraction. In this study, the long-term benefits and safety profile of heart rate regularization through left-bundle branch pacing (LBBP) and atrioventricular node ablation (AVNA) will be explored in comparison with pharmacological rate-control strategy.

Repetitive ambulatory levosimendan as a bridge to heart transplantation.

Introduction And Objectives: Repetitive ambulatory doses of levosimendan are an option as a bridge to heart transplantation (HT), but evidence regarding the safety and efficacy of this treatment is scarce. The objective of the LEVO-T Registry is to describe the profile of patients on the HT list receiving levosimendan, prescription patterns, and clinical outcomes compared with patients not on levosimendan.

Methods: We retrospectively reviewed all patients listed for elective HT from 2015 to 2020 from 14 centers in Spain.

Influence of the medical treatment schedule in new diagnoses patients with heart failure and reduced ejection fraction.

Aims: Heart failure (HF) guidelines recommend treating all patients with HF and reduced ejection fraction (HFrEF) with quadruple therapy, although they do not establish how to start it. This study aimed to evaluate the implementation of these recommendations, analyzing the efficacy and safety of the different therapeutic schedules.

Methods And Results: Prospective, observational, and multicenter registry that evaluated the treatment initiated in patients with newly diagnosed HFrEF and its evolution at 3 months.

Twenty-four hour ambulatory blood pressure monitoring in patients with stable heart failure. Prevalence and associated factors.

Introduction And Objectives: Hypertension is highly common in heart failure (HF). However, there is limited information on its prevalence, circadian variation, and relationship with the various HF phenotypes. The objective of this study was to describe the prevalence of hypertension and its patterns in HF.

Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry.

Aim: Patients with advanced heart failure (AHF) who are not candidates to advanced therapies have poor prognosis. Some trials have shown that intermittent levosimendan can reduce HF hospitalizations in AHF in the short term. In this real-life registry, we describe the patterns of use, safety and factors related to the response to intermittent levosimendan infusions in AHF patients not candidates to advanced therapies.

Personalized Therapy and Clinical Outcome for Heart Failure.

Heart failure (HF) is a complex clinical syndrome that results from the structural and/or functional impairment of systolic function or ventricular filling, which in turn causes elevated intracardiac pressure and/or inadequate cardiac output at rest and/or during exercise [...

Remote heart failure management using the HeartLogic algorithm. RE-HEART registry.

Introduction And Objectives: HeartLogic is a multiparametric algorithm incorporated into implantable cardioverter-defibrillators (ICD). The associated alerts predict impending heart failure (HF) decompensations. Our objective was to analyze the association between alerts and clinical events and to describe the implementation of a protocol for remote management in a multicenter registry.

Dose of furosemide before admission predicts diuretic efficiency and long-term prognosis in acute heart failure.

Aims: The outpatient diuretic dose is a marker of diuretic resistance and prognosis in chronic heart failure (HF). Still, the impact of the preadmission dose on diuretic efficiency (DE) and prognosis in acute HF is not fully known.

Methods And Results: We conducted an observational and prospective study.

Organ Donation: With Great Power Comes Great Responsibility.

Spain is a world leader in donation and transplantation. This model has been exported to other countries with favorable results. The objective of this study was to compare the actual donation intention rate with the effective donation figures, and analyze the main reasons why families decline organ donation.

Potential Role of Natriuretic Response to Furosemide Stress Test During Acute Heart Failure.

Background: Poor natriuresis has been associated with a poorer response to diuretic treatment and worse prognosis in acute heart failure. Recommendations on how and when to measure urinary sodium (UNa) are lacking. We aim to evaluate UNa quantification after a furosemide stress test (FST) capacity to predict appropriate decongestion during acute heart failure hospitalization.