JACC Heart Failure Editor's Update, July 2019
July 2019 JACC: Heart Failure—Mini-Focus Issue: Transition of Care After Hospitalization
Will money motivate lower-socioeconomic status (SES) patients to participate in cardiac rehabilitation (CR)? Are the gains worth the cost? Diann Gaalema et al tested the efficacy of financial incentives among high risk cardiac Medicaid patients using an escalating cash payout schedule tied to CR session participation, and looked at changes in sociocognitive measures, fitness measures and the number of hospital contacts in the year following enrollment.
Financial Incentives to Increase Cardiac Rehabilitation Participation Among Low-Socioeconomic Status Patients: A Randomized Clinical Trial
Diann E. Gaalema, Philip A. Ades, et al.
Better information about the causes and incidence of hospitalization for heart failure patients in the final year of life can result in better and more cost-effective approaches to end of life care and palliation. Little is known about heart failure patients in the last phases of the disease. Christian Madelaire and colleagues examined hospitalization records for the final year of life of heart failure patients in Danish nationwide registries to determine the number of times these patients were hospitalized and why.
Burden and Causes of Hospital Admissions in Heart Failure During the Last Year of Life
Christian Madelaire, Morten Schou, et al.
We are excited to publish results of the first pharmacogenetically targeted, randomized controlled trial in heart failure, GENETIC-AF. This was a study of rhythm control therapy in atrial fibrillation together with beta blockers to prevent recurrent atrial fibrillation in heart failure patients, and the results point the way to further research. The study demonstrates important insights into genotype-phenotype and heart failure–atrial fibrillation interactions. An exceptional editorial by Drs. Metra and Shah helps navigate the findings of this novel trial.
Bucindolol for the Maintenance of Sinus Rhythm in a Genotype-Defined HF Population: The GENETIC-AF Trial
Jonathan P. Piccini, Stuart J. Connolly, et al.
GENETIC-AF: Digging Deeper Into Genotype-Phenotype and Heart Failure-Atrial Fibrillation Interactions
Palak Shah and Marco Metra
The sex disparities debate is revived through a study of data from REVIVAL (Registry Evaluation for Vital Information on Ventricular Assist Devices in Ambulatory Life). Garrick Stewart and colleagues compared clinical characteristics, quality of life, functional capacity, and outcomes data for women and men with ambulatory advanced heart failure.
Ambulatory Advanced Heart Failure in Women: A Report From the REVIVAL Registry
Garrick C. Stewart, Keith D. Aaronson, et al.
Heart Failure Hall of Fame—Getting to Know the Pioneers Who Inspire Us
Our series highlights leaders in the field of heart failure beyond their publications and extensive work. This month we feature Dr. Gary Francis, an internationally recognized leader and clinician scientist. His research has focused on pathophysiology, and novel therapies for heart failure. He is a past-president of the Heart Failure Society of America (HFSA); received the HFSA Lifetime Achievement Award; served as Editor-in-Chief of the Journal of Cardiac Failure and serves on the editorial boards of JACC and Circulation journals.
What first made you interested in a career in heart failure?
I became quite interested in Dr. Jay Cohn's use of nitroprusside to treat advanced heart failure in the 1970s. At the time I was working with Dr. Joe Alpert in San Diego, and we were most impressed by Dr. Cohn’s observations. This was something very "new," very different, and I was struck by the marked improvement in hemodynamics and symptom relief afforded our patients when we gained experience with "afterload reduction." I wanted to learn more. I wanted to work with Jay Cohn.
Which of your many accomplishments are you most proud of?
I was delighted to receive the ACC Distinguished Teacher Award in 2014. Teaching and mentoring have always been a high priority for me, and it was wonderful to be recognized at a national level, given all the great teachers and mentors in cardiology that the ACC has honored over the years.
Who inspires you, in your career or otherwise?
Jay Cohn was a major inspiration for me. He and his group really made research fun. The lab meetings, the manuscripts, the international travel, meeting with the great "popes of cardiology" was all very inspirational. He taught us to question dogma, to ask the right questions, to understand the physiologic mechanisms, and to do clinical studies that could possibly change practice. Through our work in Minneapolis I have met and come to know many people who have become iconic figures in the field of heart failure, and that has been the best part. More recently, Dr. Braunwald has also been very helpful and inspirational toward me. I went to him for advice when leading our large cardiology group at Minnesota. He is truly extraordinary.
What is your favorite, or last book you read?
I just finished reading Gatsby's Oxford: Scott, Zelda and the Jazz Age Invasion of Britain by Christopher A. Snyder. The book is absolutely fascinating, not so much because of F. Scott Fitzgerald's short time there, but because of the extremely detailed description of the many eccentric writers and famous professors that were at Oxford at that time (1904–1929). People remain a great interest of mine.
3 Things People May Not Know About Me
- I have 11 grandchildren that I am most proud of.
- I still read all the cardiopulmonary exercise tests at the hospital six days a week.
- I have served on 36 Data and Safety Monitoring Boards for very large, international heart failure trials, from which I've learned a great deal.
More about Dr. Francis
I was born in St. Paul, Minnesota, and spent most of my early days playing football, hockey, and baseball at the local playground. I attended college at the University of Minnesota and entered medical school early without an undergraduate degree. I was married during medical school and have been married to the same woman for 52 years. I am most grateful to my wife, Margaret, for her undying support. I trained in Chicago and San Diego and became a faculty member at UCSD and then at the University of Minnesota in 1977. I moved to Dr. Jay Cohn's lab in 1979 and worked closely with him until 1997. This proved to be a very exciting and productive time for me. I was recruited to the Cleveland Clinic in 1997 by Dr. Eric Topol. This was a very important change for me and my wife, and we were quite happy in Cleveland. I was Director of the Cardiac Intensive Care Unit and then Chief of Clinical Cardiology at the Cleveland Clinic. I returned to the University of Minnesota in 2008 where I still work. I have had the honor of closely mentoring Fellows at Minnesota and Cleveland, some of whom have gone on to very prominent academic positions. I view this as perhaps my most important accomplishment. I am also most fortunate to have worked with some of the very best clinician-scientists in the world, and for that I am most grateful. Life is really all about "the people." What happened to me is beyond my wildest expectations. It is the many colleagues that I have had the privilege to work with that have brought the most enjoyment to my career.
Call for Papers: Heart Failure in the Elderly
Heart failure is a significant global epidemic; however, in the elderly, there may be differences in treatment effects, treatment options, epidemiology, pathophysiology, risk factors, and outcomes. JACC: Heart Failure is focusing on the growing body of literature with a special issue on this topic. In line with our commitment to advance scientific understanding and patient care, we will publish a uniquely themed issue to highlight this emerging theme.
Topics spanning this theme will be considered, including epidemiology, diagnosis and prognosis, short- and long-term outcomes, clinical management, phenotyping, emerging therapies, comorbidities, the role of biomarkers, and other relevant issues.
How will this process work?
- We welcome papers addressing the broad topic of "Heart Failure in the Elderly" – these can be in the form of original research, clinical trials, meta-analysis, or position statements from societies or advocacy groups. Other formats will be considered if sufficiently rigorous and impactful.
- Interested authors should submit their papers via http://www.jaccsubmit-heartfailure.org on or before August 1, 2019. When entering manuscript information, please select "Heart Failure in the Elderly" from the "Special Issues" pull-down menu in the Keywords, Categories, Special Sections tab.
- We plan for the final publication to appear in the December 2019 issue of JACC: Heart Failure. Please see instructions to authors on the Journal webpage (http://heartfailure.onlinejacc.org).
- Accepted papers will also be displayed on the JACC: Heart Failure website in an “online before print” format.