1.Acute Heart Failure Across the Ejection Fraction Spectrum: Phenotypes, Management, and Outcomes From Nationwide KorHF III Registry
Huijin LEE ; Eung Ju KIM ; Seong Woo HAN ; Seong-Mi PARK ; Hyung-Seop KIM ; Myung-Chan CHO ; Hyo-Suk AHN ; Mi-Seung SHIN ; Seok-Jae HWANG ; Jin-Ok JEONG ; Dong Heon YANG ; Junho HYUN ; Jin Oh CHOI ; Hae-Young LEE ; Byung-Su YOO ; Seok-Min KANG ; Dong-Ju CHOI ; Hyun-Jai CHO ;
International Journal of Heart Failure 2026;8(1):43-55
Background and Objectives:
Clinical characteristics and outcomes in acute heart failure (AHF) vary by phenotype. We assessed phenotype-specific features, treatment patterns, and outcomes in a nationwide Korean cohort.
Methods:
The Korean Heart Failure III registry prospectively enrolled 7,351 AHF admissions at 47 hospitals. Among 6,777 patients with available left ventricular ejection fraction (EF), phenotypes were defined as heart failure with reduced EF (HFrEF, ≤40%), mildly reduced EF (HFmrEF,41–49%), or preserved EF (HFpEF, ≥50%). The primary endpoint was a 12-month composite of all-cause death or heart transplantation, evaluated from index admission and, among hospital survivors, from discharge. We used inverse probability weighting (multinomial generalized boosted models with stabilized, trimmed weights) and weighted Cox proportional-hazards models to estimate hazard ratios (HRs).
Results:
Phenotype distribution was 58.9% HFrEF, 13.6% HFmrEF, and 27.5% HFpEF. Crude 12-month composite rates from index admission were 13.4% (HFrEF), 12.7% (HFmrEF), and 16.8% (HFpEF). After weighting, from index admission, HFmrEF (HR, 0.892; 95% confidence interval [CI], 0.731–1.088) and HFpEF (HR, 1.101; 95% CI, 0.939–1.291) did not differ from HFrEF; from discharge, HFpEF had modestly higher risk (HR, 1.207; 95% CI, 1.008–1.445) whereas HFmrEF did not (HR, 1.039; 95% CI, 0.844–1.279). Hyponatremia and chronic kidney disease were consistent adverse markers, while angiotensin-converting enzyme inhibitor/ angiotensin II receptor blocker use at discharge was protective.
Conclusions
Across the EF spectrum, phenotypes showed distinct profiles and risk. Postdischarge risk was modestly higher in HFpEF, supporting phenotype-tailored care and systematic discharge optimization in Korean patients with AHF.
2.Development of Korean Standardized Heart Failure Registry: Experience From Integration of KorAHF and KorHF III
Eui-Soon KIM ; Huijin LEE ; Jong-Chan YOUN ; Byung-Su YOO ; Hae-Young LEE ; Ju-Hee LEE ; Dong-Hyuk CHO ; Mi-Hyang JUNG ; Hye Sun LEE ; Hyun-Jai CHO
International Journal of Heart Failure 2026;8(1):1-11
Heart failure (HF) prevalence and associated socio-economic costs have risen rapidly in Korea, creating urgent demand for a national, standardized prospective registry to support quality monitoring, outcome comparison, and real-world evidence. Standardized data definitions are essential for valid comparisons across studies and healthcare settings. We created a unified national HF cohort by integrating the two largest Korean registries, KorAHF (2011–2014;n=5,625) and KorHF III (2018–2023; n=7,351), yielding 12,976 hospitalized HF patients. Because heterogeneous variable definitions impeded direct comparisons, we implemented a harmonization pipeline across demographic, clinical, imaging, biomarker, therapeutic, and outcome domains, aligned with international standards and reinforced by systematic data quality checks.A multidisciplinary panel then conducted a structured decision process to produce the Korean HF Standard Dataset, a tiered and interoperable variable set spanning six domains: demographics, presentation at admission, in-hospital events and comorbidities, discharge status, outpatient follow-up, and readmission events. This integrated platform and standardized variables enable precise identification of HF patient phenotypes and prognostic factors, establishing an evidence-based foundation for disease management. This supports an analysis of temporal changes in treatment patterns and outcomes, generates data to inform future clinical practice guidelines, and provides a practical basis for planning large, continuous, prospective HF registries. Furthermore, it also facilitates pragmatic, registry-based randomized clinical trials and unmet-needs assessments that can guide national health policy. Establishing a foundation for future linkage with national health databases, this platform will allow for enhanced accuracy, comparability, and representativeness, powering quality improvement initiatives and population-level monitoring of Korea’s growing HF burden.
7.Conjugate Vertical Gaze Palsy Related to Unilateral Midbrain Infarction
Sejin PARK ; Minhee KIM ; Huijin LEE ; WooChan CHOI ; Yong-Won KIM ; Yang-Ha HWANG
Journal of the Korean Neurological Association 2024;42(4):340-343
Conjugate upward and downward gaze palsy related to unilateral midbrain infarction is a rare neurological symptom, as there were few reported cases worldwide. Here, we report a case of 55-year-old male patient presenting with conjugate vertical gaze palsy. In this case, diffusion-weighted magnetic resonance images demonstrated a localized infarction in the right rostral midbrain.
8.Conjugate Vertical Gaze Palsy Related to Unilateral Midbrain Infarction
Sejin PARK ; Minhee KIM ; Huijin LEE ; WooChan CHOI ; Yong-Won KIM ; Yang-Ha HWANG
Journal of the Korean Neurological Association 2024;42(4):340-343
Conjugate upward and downward gaze palsy related to unilateral midbrain infarction is a rare neurological symptom, as there were few reported cases worldwide. Here, we report a case of 55-year-old male patient presenting with conjugate vertical gaze palsy. In this case, diffusion-weighted magnetic resonance images demonstrated a localized infarction in the right rostral midbrain.
9.Conjugate Vertical Gaze Palsy Related to Unilateral Midbrain Infarction
Sejin PARK ; Minhee KIM ; Huijin LEE ; WooChan CHOI ; Yong-Won KIM ; Yang-Ha HWANG
Journal of the Korean Neurological Association 2024;42(4):340-343
Conjugate upward and downward gaze palsy related to unilateral midbrain infarction is a rare neurological symptom, as there were few reported cases worldwide. Here, we report a case of 55-year-old male patient presenting with conjugate vertical gaze palsy. In this case, diffusion-weighted magnetic resonance images demonstrated a localized infarction in the right rostral midbrain.
10.Feasibility and Effectiveness of a Ring-Type Blood Pressure Measurement Device Compared With 24-Hour Ambulatory Blood Pressure Monitoring Device
Huijin LEE ; Sungjoon PARK ; Hyuktae KWON ; Belong CHO ; Jin Ho PARK ; Hae-Young LEE
Korean Circulation Journal 2024;54(2):93-104
Background:
s and Objectives: This study aimed to evaluate the applicability and precision of a ring-type cuffless blood pressure (BP) measurement device, CART-I Plus, compared to conventional 24-hour ambulatory BP monitoring (ABPM).
Methods:
Forty patients were recruited, and 33 participants were included in the final analysis.Each participant wore both CART-I Plus and ABPM devices on the same arm for approximately 24 hours. BP estimation from CART-I Plus, derived from photoplethysmography (PPG) signals, were compared with the corresponding ABPM measurements.
Results:
The CART-I Plus recorded systolic blood pressure (SBP)/diastolic blood pressure (DBP) values of 131.4±14.1/81.1±12.0, 132.7±13.9/81.9±11.9, and 128.7±14.6/79.3±12.2 mmHg for 24-hour, daytime, and nighttime periods respectively, compared to ABPM values of 129.7±11.7/84.4±11.2, 131.9±11.6/86.3±11.1, and 124.5±13.6/80.0±12.2 mmHg.Mean differences in SBP/DBP between the two devices were 1.74±6.69/−3.24±6.51 mmHg, 0.75±7.44/−4.41±7.42 mmHg, and 4.15±6.15/−0.67±5.23 mmHg for 24-hour, daytime, and nighttime periods respectively. Strong correlations were also observed between the devices, with r=0.725 and r=0.750 for transitions in SBP and DBP from daytime to nighttime, respectively (both p<0.001).
Conclusions
The CART-I Plus device, with its unique ring-type design, shows promising accuracy in BP estimation and offers a potential avenue for continuous BP monitoring in clinical practice.

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