Highlights include the Cardio-Oncology and Heart Failure: A Scientific Statement from the Heart Failure Society of America; original research on the use of burst steroid therapy in patients with acute HF who develop atrial fibrillation; and an update on implanted inferior vena cava sensors for accurate volume measurement.
WASHINGTON, DC (FEBRUARY 11, 2025) – Heart failure (HF) and cancer are leading causes of morbidity and mortality. Patients with cancer are at increased risk of developing HF, while HF patients have a higher risk of developing cancer. Understanding the complex interaction between these two diseases has never been more important. The Journal of Cardiac Failure (JCF) February 2025 issue, now online, highlights the associations between HF and cancer along with a new white paper on AL Amyloidosis for the Heart Failure Clinician, and a patient’s perspective on improving care.
“We’re honored to be able to share these 3 complementary articles on cardio-onc, AL amyloidosis, and a patient perspective in the February issue of the Journal. These articles highlight the position of JCF as a leader in synthesizing insights for practicing clinicians and researchers while keeping patients at the center of everything we do,” said JCF co-editor-in-chief, Robert J. Mentz, MD.
Key Highlights include:
Cardio-Oncology and Heart Failure: A Scientific Statement from the Heart Failure Society of America
Heart Failure Patients with Pro-inflammatory Activation: A Post Hoc Analysis of the CORTAHF Randomized, Open-label, Pilot Trial
Safety and Feasibility of an Implanted Inferior Vena Cava Sensor for Accurate Volume Assessment: FUTURE-HF2 Trial
Cardio-Oncology and Heart Failure: A Scientific Statement from the Heart Failure Society of America
The complexities and interactions of HF and cancer require collaboration among heart failure and oncology specialists for the optimal assessment of risk stratification, shared risk factors between cancer and HF, preventing disparities in care, monitoring and managing cardiotoxicity, and the treatment of these complex patients.
The Effects of Burst Steroid Therapy on Short-term Decongestion in Acute Heart Failure Patients with Pro-inflammatory Activation: A Post Hoc Analysis of the CORTAHF Randomized, Open-label, Pilot Trial
This secondary analysis assessed the effects of a short course of prednisone in 100 acute heart failure patients with a congestion score of 6.5 out of 9 and inflammatory activation as measured by CRP greater than 20 mg/L. The data showed that a 7-day burst of steroid administration was associated with improved symptoms and signs of congestion up to day 31 and improved measures of QoL and 90-day WHF event rates.
Current pressure-based assessments of congestion may only indirectly detect true intravascular volume status. The novel inferior vena cava (IVC)-monitoring system (FIRE1) is designed to measure the IVC area, facilitate daily monitoring, and predict congestion in HF. In this trial of 15 patients, sensor-derived IVC areas showed excellent agreement with concurrent computed tomography; the median adherence to daily readings was 98% per patient-month; and a significant improvement was seen in NYHA class while a nonsignificant improvement was observed in the Kansas City Cardiomyopathy Questionnaire.
Point and Counterpoint on the Interpretation of Clinical Trial Evidence
Read a debate on the use of diuretic treatment in patients hospitalized with worsening peripheral edema due to HF. Experts discuss whether diuresis-guided diuresis or natriuresis-guided diuresis should be the standard.
POINT: Natriuresis Guided Diuresis in Patients Admitted to Hospital with Heart Failure – Barking Up the Wrong Tree?
Randomized controlled trials (RCTs) suggest that predicting a response to diuretic treatment may be achievable without measuring urine sodium concentration. A clinical score incorporating renal function, natriuretic peptide concentration, blood pressure, presence of atrial fibrillation, previous hospitalization due to HF, and pre-admission diuretic dosage predicts diuretic efficiency in approximately 800 patients with a C-statistic of 0.9 may be beneficial.
COUNTERPOINT: Natriuresis Guided Diuresis in Patients Admitted to Hospital with Heart Failure – Barking Up the Wrong Tree? Towards Direct Insights into the Efficacy of Diuretic Therapy
If diuresis and fluid balance assessment are as straightforward as some RCTs suggest, why are decongestive outcomes so variable? Many natriuresis-guided trials also utilized diuresis as a treatment tool when either parameter was insufficient. Management need not be “natriuresis versus diuresis” but rather a combination of both.
The full line-up is as follows:
Original Research Papers
- The Effects of Burst Steroid Therapy on Short-Term Decongestion in Acute Heart Failure Patients with Pro-Inflammatory Activation: The CORTAHF Randomized, Open-Label, Pilot Trial.
- Safety and Feasibility of an Implanted Inferior Vena Cava Sensor for Accurate Volume Assessment: FUTURE HF2 Trial
- Patient Sex Impacts Volume Phenotypes and Hemodynamics in Chronic Heart Failure – A Multi-Center Analysis
- Right Ventriculoarterial Coupling Surrogates and Long-Term Survival in LVAD Recipients: Results of the ASSIST-ICD Multicentric Registry
- Clonal Hematopoiesis of Indeterminate Potential and Long-term Outcomes in Heart Transplantation
HFSA Statement
Perspectives
- POINT: Natriuresis Guided Diuresis in Patients Admitted to Hospital with Heart Failure – Barking Up the Wrong Tree?
- COUNTERPOINT: Natriuresis Guided Diuresis in Patients Admitted to Hospital with Heart Failure – Barking Up the Wrong Tree? Towards Direct Insights into the Efficacy of Diuretic Therapy
Brief Reports
- Clinical Outcomes of Chronic Intravenous Inotropic Support in Cardiac Amyloidosis
- Transplantation Outcomes in Hepatitis C Virus-Positive Donor Hearts after Circulatory Death
- The Kansas City Cardiomyopathy Questionnaire in Relation to New York Heart Association Class
Research Letter
JCF Ignite!
Patient Perspective
- An Unexpected Benefit of Adding the Patient Voice to Medical Education - Train Providers to be Better. Findings from the Amyloidosis Speakers Bureau reveal how guidance and input from patients might help budding doctors become better providers and how they could improve their relationships with their patients. The topics from patients about their diagnostic and treatment experiences had nothing to do with amyloidosis and applied to every interaction and all diseases.
View the full issue online. For interviews with authors, please contact Alyssa Altonen at aaltonen@hfsa.org.
About the Journal of Cardiac Failure
The Journal of Cardiac Failure (JCF) publishes the highest quality science in the field of heart failure with a focus on diversity, equity, and inclusion, mentorship, multidisciplinary partnerships, and patient-centeredness. Published papers span original investigator-initiated work to state-of-the-art reviews, guidelines and scientific statements, expert perspectives, early career and trainee spotlight pieces, patient and patient-partner narratives. JCF also emphasizes the power of language and prioritizes innovative approaches to dissemination of published work to reach and impact the broader heart failure community.
About the Heart Failure Society of America
The Heart Failure Society of America, Inc. (HFSA) represents the first organized effort by heart failure experts from the Americas to provide a forum for all those interested in heart function, heart failure, and congestive heart failure (CHF) research and patient care. The mission of HFSA is to provide a platform to improve and expand heart failure care through collaboration, education, innovation, research, and advocacy. HFSA members include physicians, scientists, nurses, nurse practitioners, pharmacists, trainees, other healthcare workers and patients. For more information, visit hfsa.org.
Media Contact: Alyssa Altonen, aaltonen@hfsa.org