May 2015 at a Glance

Multicentre studies have become major tools to collect data regarding clinical characteristics, prognosis, and treatment effects in patients with heart failure (HF). This is mirrored in our current issue of the journal. Most of the data regarding cardiogenic shock have been obtained from registries of patients with myocardial infarction. CardShock is the largest European multicentre observational study including 219 patients with the whole spectrum of aetiologies of cardiogenic shock.1 Acute coronary syndrome (ACS) was the most common cause of shock (81%), and 62% of patients developed shock after admission to hospital. In-hospital mortality was 37%, lower than in other registries, and ACS aetiology, age, previous myocardial infarction, prior coronary artery bypass, confusion, low LVEF, and blood lactate levels were independently associated with increased mortality. A risk score for in-hospital mortality including these variables and estimated glomerular filtration rate (eGFR) was developed from this study.1 The International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure (REPORT-HF) is a global, prospective, observational study designed to characterize patients' clinical course during and following a HF hospitalization. This registry will be conducted at ∼300 sites located in ∼40 countries with the planned enrolment of ∼20 000 patients hospitalized for new-onset HF or decompensation of chronic HF over a 3-year period with subsequent 3 years of follow-up. Thus, both the in-hospital phase and the transition to the outpatient setting and long-term follow-up will be assessed in this study, which is probably going to be the largest registry on HF including patients from all continents. Its rationale and design are published in the current issue of our journal.2 In the Prospective comparison of Angiotensin Receptor Neprilysin Inhibitor (ARNI) with Angiotensin receptor Blocker (ARB) on Management Of heart failUre with preserved ejectioN fracTion (PARAMOUNT) study, 12 weeks treatment with LCZ696 reduced NT-proBNP to a larger extent than valsartan in patients with HF and preserved ejection fraction (HFpEF) and this effect was independent from changes in the systolic blood pressure.3, 4 In this issue of the journal, Voors et al. analyse the changes in renal function in the PARAMOUNT study and show that LCZ696 administration was associated with less decline in the eGFR and worsening of renal function, with an increase the urinary albumin to creatinine ratio, compared with placebo.5 In the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial (SHIFT) trial, ivabradine administration decreased the rate of the primary endpoint, a composite of cardiovascular death and HF hospitalization, as well as HF hospitalizations and HF deaths.6 Analysis of 24-h Holter recordings was a pre-specified substudy of this trial, and its results are shown in this issue of the journal.7 Heart rate reduction with ivabradine was similar in resting office and in 24-h, awake, and asleep recordings, with beneficial effects on HR variability and no meaningful increases in supraventricular or ventricular arrhythmias. Ivabradine administration was associated with an increased rate of episodes of heart rate reduction <40 b.p.m., but no episode of heart rate <30 b.p.m. and no RR intervals >3 s were recorded in patients on ivabradine.7

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