{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T08:29:48Z","timestamp":1786350588631,"version":"build-2736575974"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum M\u00fcnster"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Chronic left ventricular heart failure (CLHF) represents a significant public health challenge globally, marked by high morbidity and mortality. CLHF is a leading cause of hospitalization, placing considerable strain on healthcare systems. This study aims to analyze in-hospital outcomes for CLHF patients in Germany over nine years (2014\u20132022), examining trends in morbidity, mortality, healthcare costs, and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      Data were sourced from the Federal Statistical Office (DESTATIS), covering 2,616,462 inpatient CLHF cases (ICD-10-GM I50.11-I50.14) in Germany from 2014 to 2022. CLHF hospitalizations increased from 288,019 in 2014 to 311,782 in 2019, then declined in 2020 but started again to rise from 2021 to 2022. The proportion of patients with advanced CLHF (NYHA stage IV) decreased slightly from 54.09% in 2014 to 50.36% in 2020 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Notable comorbidity trends included rising rates of atrial fibrillation and chronic kidney disease. Complications such as cardiogenic shock and acute kidney injury increased over time (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Despite a decrease in mortality rates from 2014 to 2019 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), in-hospital mortality rose to 8.84% in 2022 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Median revenue volume and hospitalization duration showed a pre-pandemic increase but declined in 2020.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study highlights a complex interplay of factors affecting CLHF management in Germany, as a representative example for a high-income country. While advancements in treatment have improved some outcomes, the COVID-19 pandemic significantly impacted hospitalization trends and in-hospital mortality. The findings underscore the need for ongoing improvements in CLHF management and resilient healthcare strategies to address future challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                    <jats:p>Overview of CLHF hospitalizations in Germany (2014\u20132022). Key findings include an 8.3% \nincrease in hospitalizations from 2014 to 2019, followed by a temporary drop during the COVID-19 pandemic. \nDespite this, CLHF-related mortality peaked in 2022, highlighting the ongoing burden of severe cases. Rising \ncosts and complications, alongside increasing comorbidities, emphasize the need for strengthened CLHF\nmanagement and a resilient healthcare system.\nAF: atrial fibrillation, CLHF: Chronic left ventricular heart failure; CKD: chronic kidney disease, NYHA: New \nYork Heart Association, Tsd: thousands.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-025-02679-4","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T10:10:37Z","timestamp":1748254237000},"page":"1522-1532","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evolving trends and persistent challenges in chronic left ventricular heart failure management: insights from a 9-year analysis of in-hospital outcomes in Germany"],"prefix":"10.1007","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6421-8429","authenticated-orcid":false,"given":"Anastasia Janina","family":"Hobbach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannik","family":"Feld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen Reinhard","family":"Sindermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Reinecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"issue":"6","key":"2679_CR1","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1038\/nrcardio.2016.25","volume":"13","author":"B Ziaeian","year":"2016","unstructured":"Ziaeian B, Fonarow GC (2016) Epidemiology and aetiology of heart failure. 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Reinecke reports personal fees from Daiichi Sankyo, Pfizer, MedUpdate, StreamedUp, DiaPlan, NeoVasc, Pluristem, NovoNordisk and Corvia. Furthermore, institutional grants were received from Pluristem, BMS, Pfizer, Bard and Biotronik. Dres A. Hobbach, J. Feld and J. Sindermann have no conflict of interest or financial ties to disclosure.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The investigation conforms with the principles outlined in the\n                      Declaration of Helsinki\n                      (Br Med J 1964; ii:177). Patient consent and ethical approval were waived due to the retrospective character with anonymized data of this study and all the procedures being performed were part of the routine care.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}