Heart failure in the last year: progress and perspective

ESC Heart Failure

Andrew J. S. Coats¹  Stephan vonHaehling²  Daniela Tomasoni³  Marianna Adamo³  Marco Metra³  Markus S. Anker⁴ 

[1] Centre for Clinical and Basic Research, Department of Medical Sciences IRCCS San Raffaele Pisana Rome Italy;Department of Cardiology and Pneumology University of Göttingen Medical Center Göttingen Germany;Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy;Division of Cardiology and Metabolism, Department of Cardiology (CVK) Charité–University Medicine Berlin Berlin Germany;

关键词: Heart failure;    Acute heart failure;    HfpEF;    HFrEF;    Diagnosis;    Treatment;   

DOI  :  10.1002/ehf2.13124

来源: DOAJ

【 摘 要 】

Abstract Research about heart failure (HF) has made major progress in the last years. We give here an update on the most recent findings. Landmark trials have established new treatments for HF with reduced ejection fraction. Sacubitril/valsartan was superior to enalapril in PARADIGM‐HF trial, and its initiation during hospitalization for acute HF or early after discharge can now be considered. More recently, new therapeutic pathways have been developed. In the DAPA‐HF and EMPEROR‐Reduced trials, dapagliflozin and empagliflozin reduced the risk of the primary composite endpoint, compared with placebo [hazard ratio (HR) 0.74; 95% confidence interval (CI) 0.65–0.85; P < 0.001 and HR 0.75; 95% CI 0.65–0.86; P < 0.001, respectively]. Second, vericiguat, an oral soluble guanylate cyclase stimulator, reduced the composite endpoint of cardiovascular death or HF hospitalization vs. placebo (HR 0.90; 95% CI 0.82–0.98; P = 0.02). On the other hand, both the diagnosis and treatment of HF with preserved ejection fraction, as well as management of advanced HF and acute HF, remain challenging. A better phenotyping of patients with HF would be helpful for prognostic stratification and treatment selection. Further aspects, such as the use of devices, treatment of arrhythmias, and percutaneous treatment of valvular heart disease in patients with HF, are also discussed and reviewed in this article.

【 授权许可】

Unknown