Latest news with #chronicHeartFailure
Medscape
03-07-2025
- Health
- Medscape
Influencers of COVID Vaccine Response in Dialysis Patients
TOPLINE: Among patients undergoing maintenance dialysis, chronic heart failure and hypoalbuminaemia were significantly associated with a poor humoral response at 3 months after completing three doses of the SARS-CoV-2 messenger RNA (mRNA) vaccine; however, no association was observed between haemodialysis-related variables and antibody response levels. METHODOLOGY: Researchers in France performed a retrospective observational study to identify factors associated with a poor humoral response after completion of the SARS-CoV-2 mRNA vaccination schedule (three doses) in 80 adult patients (median age, 71 years; 44% women) undergoing maintenance dialysis for more than 3 months. Anti-SARS-CoV-2 antibody levels were measured using a quantitative serology test at two timepoints: 3 months after the third dose and either 7 months after the third dose or 3 months after the fourth (second booster) dose. On the basis of antibody titres at 3 months after the third dose, the patients were classified as low responders (n = 28; anti-SARS-CoV-2 antibody level, 50-1830 AU/mL) and responders (n = 52; anti-SARS-CoV-2 antibody level > 1830 AU/mL). Data on laboratory values, dialysis parameters, history of kidney disease, chronic heart failure, and immunosuppressive treatments were extracted from medical records. The primary endpoint was the humoral immune response, evaluated using the SARS-CoV-2 antibody level at 3 months after the third dose. TAKEAWAY: Low responders were more likely to have chronic heart failure (P < .00001), worse functional abilities and well-being (P = .004), hypoalbuminaemia (P < .001), lymphopenia (P = .003), rhesus status positivity (P = .02), and no response to a hepatitis B virus vaccine (P = .02) than responders. No significant differences were observed between both groups regarding the history of kidney transplantation, use of immunosuppressive therapy, and haemodialysis parameters. In multivariate analysis, chronic heart failure (odds ratio [OR], 20.63; P < .0001) and lower serum albumin levels (OR, 0.63; P = .0004) were associated with a poor response to the SARS-CoV-2 mRNA vaccine. However, post-vaccination SARS-CoV-2 infection rates did not differ significantly between low responders and responders (P = .59). IN PRACTICE: "CHF [chronic heart failure], like CKD [chronic kidney disease], is also an immunocompromised condition, which could explain the reduced vaccine response," the authors wrote. "The French government currently recommends administering a SARS-CoV-2 vaccine booster every six months for immunocompromised patients," they added. SOURCE: This study was led by Pierre Laurent, Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, Amiens, France. It was published online on June 23, 2025, in BMC Nephrology. LIMITATIONS: The retrospective, single-centre design of the study introduced potential biases. The small patient population limited the statistical power for group comparisons and restricted the number of variables that could be included in the analysis. Moreover, the study included only patients who received SARS-CoV-2 mRNA vaccines, excluding those who initially received viral-vector-based vaccines. DISCLOSURES: This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declared having no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
17-06-2025
- Health
- Medscape
Changes in Aortic Valve Signal Heart Failure Progression
In patients with chronic heart failure (HF), the presence of aortic valve (AV) sclerosis appeared to reflect a more severe disease rather than serve as an independent prognostic factor for poor outcomes. This study suggested that its development should be viewed as a marker of disease progression. METHODOLOGY: Researchers in Italy retrospectively analysed data of 1397 patients with chronic HF (mean age, 65.2 years; 83.4% men) enrolled between September 2006 and December 2019 to determine whether AV sclerosis can predict mortality and cardiovascular outcomes. The patients had a history of HF with reduced ejection fraction or left ventricular ejection fraction < 40%, had stable HF medications for at least 3 months, could perform a cardiopulmonary exercise test, and had no planned major interventions. The presence of AV sclerosis was identified using images from transthoracic echocardiography. The 5-year outcomes of interest were all-cause mortality and cardiovascular outcomes involving a composite of cardiovascular mortality, urgent heart transplant, or implantation of the left ventricular assist device. TAKEAWAY: At baseline, 50.6% of patients had AV sclerosis; they were older and had a higher incidence of ischaemic HF and more severe HF, had worse renal function, and received more medical and device treatments than those without the condition. The presence of AV sclerosis at the time of HF diagnosis was linked to higher risks for all-cause mortality and cardiovascular outcomes; however, this association disappeared after adjusting for confounding factors. Among patients with follow-up echocardiograms, more than 40% developed AV sclerosis, particularly those older in age, with more severe HF, and with ischaemic cardiomyopathy and/or diabetes. Developing AV sclerosis during follow-up was associated with markedly higher risks for all-cause mortality (hazard ratio [HR], 3.7; P = .017) and cardiovascular outcomes (HR, 6.0; P = .020). IN PRACTICE: "Detecting the presence and new development of AV sclerosis could assist physicians in early identifying HF patients who may benefit most from closer clinical follow-up, more intensive therapy, and stricter risk factor control," the authors wrote. SOURCE: This study was led by Veronika A. Myasoedova, MD, PhD, Centro Cardiologico Monzino, Milan, Italy. It was published online on June 06, 2025, in European Heart Journal Open . LIMITATIONS: This retrospective study included only patients who could undergo cardiopulmonary exercise testing, thus limiting the generalisability of the findings to those with more advanced HF. Follow-up echocardiography was available for only 55% of patients. AV sclerosis was expressed as either present or absent without any grading. DISCLOSURES: This study received support from the Italian Ministry of Health funds and Fondazione Gigi e Pupa Ferrari Onlus. The authors declared having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
