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Tomasoni D, Adamo M, Lombardi CM, et al. Highlights in heart failure. ESC Heart Fail. 2019;6(6):1105-1127doi: 10.1002/ehf2.12555.
Tomasoni, D., Adamo, M., Lombardi, C. M., & Metra, M. (2019). Highlights in heart failure. ESC heart failure, 6(6), 1105-1127. https://doi.org/10.1002/ehf2.12555
Tomasoni, Daniela, et al. "Highlights in heart failure." ESC heart failure vol. 6,6 (2019): 1105-1127. doi: https://doi.org/10.1002/ehf2.12555
Tomasoni D, Adamo M, Lombardi CM, Metra M. Highlights in heart failure. ESC Heart Fail. 2019 Dec;6(6):1105-1127. doi: 10.1002/ehf2.12555. PMID: 31997538; PMCID: PMC6989277.
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ESC Heart Fail. 2019 Dec;6(6):1105-1127. doi: 10.1002/ehf2.12555.

Highlights in heart failure.

ESC heart failure

Daniela Tomasoni, Marianna Adamo, Carlo Mario Lombardi, Marco Metra

Affiliations

  1. Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Cardiothoracic Department, Civil Hospitals, Brescia, Italy.

PMID: 31997538 PMCID: PMC6989277 DOI: 10.1002/ehf2.12555

Abstract

Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in recent studies in patients hospitalized for acute HF. More recently, dapagliflozin and prevention of adverse-outcomes in DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HF research are summarized and reviewed in this article.

© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Keywords: HFmrEF; HFpEF; HFrEF; acute heart failure; heart failure; treatment

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