Heart Failure

Heart failure deaths increasingly occur at home or in hospice, but racial, sex, and regional disparities persist in end-of-life care.

Martha Gulati, MD, explains how bias and underrepresentation in research lead to misdiagnosis of HFpEF in women and delays in care.

AHA 2025 highlights included new guidelines and targeted approaches advancing heart failure and cardiovascular care.

Guideline-recommended HF therapies do not improve major outcomes in Chagas disease, though sacubitril/valsartan improved NT-proBNP levels, new data show.

Non-DNMT3A CHIP subtypes raised heart failure risk in a recent analysis, offering new insights for prevention and targeted management.

Scientists restored the CCNA2 gene in adult human heart cells, enabling them to divide and form new functional cardiomyocytes—advancing heart repair therapies.

Panelists discuss their excitement about the evolution of heart failure as a distinct specialty with multiple effective therapeutic options, the convergence of previously siloed medical disciplines around shared evidence-based therapies that treat root causes of multiple comorbidities, and emerging technologies like clinical decision support systems and remote patient monitoring to improve population health management and prevent hospitalizations.

Panelists discuss how payers typically require step therapy with SGLT2 inhibitors before approving nonsteroidal MRAs due to cost considerations, while acknowledging the need for head-to-head trials to determine incremental benefits, though early clinical experience suggests good tolerability and the potential for combination therapy initiation rather than sequential treatment approaches.

Panelists discuss how nonsteroidal MRAs like finerenone differ mechanistically from steroidal MRAs by lacking steroid rings (reducing steroid-related adverse effects like gynecomastia), having different mineralocorticoid receptor binding patterns, shorter half-lives, and potentially lower hyperkalemia risk, with strong evidence supporting their use in heart failure with preserved ejection fraction and additive benefits when combined with SGLT2 inhibitors.

Guideline-directed medical therapy used with remote monitoring can potentially reduce hospitalization in patients with heart failure with ejection fraction.

Panelists discuss how mineralocorticoid receptor antagonists (MRAs) remain underutilized despite being foundational therapy for heart failure with reduced ejection fraction due to clinician fears of hyperkalemia and renal dysfunction, while new nonsteroidal MRAs like finerenone show promise across the ejection fraction spectrum with potentially improved adverse effect profiles, though questions remain about their incremental benefit over traditional steroidal MRAs given their substantially higher cost.

Panelists discuss how GLP-1 receptor agonists show promising benefits for patients with HFpEF, particularly those with obesity-related disease, through significant weight loss and improved functional capacity, while their role in HFrEF remains more cautious due to concerns about increased heart rate and potential arrhythmic risks, though observational data suggest additive benefits when combined with SGLT2 inhibitors.

Aggressive lifestyle and risk factor control after ablation significantly lowers atrial fibrillation recurrence and improves heart health.

Increases in global temperatures may exacerbate cardiovascular mortality risk in older patients with heart failure.

Heart rate variability (HRV) biofeedback may be a potential intervention for patients with coronary artery disease.

Papillary muscle scarring (papSCAR) was found to be associated with increased risk of cardiac death in patients with dilated cardiomyopathy

A retrospective multicenter study found that patients with heart failure discharged by noon had higher short- and long-term mortality and increased early readmission rates compared with afternoon discharges.

Stephen Greene, MD, discusses the future and practical implications of optimizing quadruple foundational therapies for patients with heart failure.

The American Heart Association (AHA) launched a news initiative to address challenges with in-hospital care for patients with different types of heart failure.

The transthyretin cardiac amyloidosis (ATTR-CA) variant is more prevalent in Black individuals, increasing the need for more research to assess hereditary links and early prevention awareness.

Social determinants of health were associated with a younger age of first hospitalization for heart failure in Black and Hispanic patients when compared with Asian and White patients.

A new study evaluated real-world data on the efficacy of GLP-1s in patients with obesity and heart failure with preserved ejection fraction (HFpEF), confirming findings from prior research.

In an observational extension of the myPACE clinical trial, researchers found that a personalized accelerated pacing in patients with heart failure with preserved ejection fraction (HFpEF) and a preexisting physiological pacer saw a slower trend in adverse cardiac events and overall improved health status.

The analysis highlighted a shift in heart failure diagnoses, with hypertensive heart disease with and without chronic kidney disease as prevalent diagnoses, underlining coding variability and implications for research.

Clinical trial results establish the safety and efficacy of finerenone to help preserve potassium levels and reduce sodium in patients on diuretics with heart failure and mildly reduced ejection fraction or preserved ejection fraction.