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Recent advances in heart failure

Kassi, Mahwasha; Hannawi, Basharb; Trachtenberg, Barryb

Current Opinion in Cardiology: March 2018 - Volume 33 - Issue 2 - p 249–256
doi: 10.1097/HCO.0000000000000497
Special Commentaries

Purpose of review Acute heart failure continues to be a challenge as there is limited benefit of numerous agents that have been tested. Cardiac resynchronization therapy remains standard of care, yet timing and need for implantable cardiac defibrillator has been brought into question with the recent randomized trials. Several recent advances have been made towards management of heart failure both in drug and device therapy. The purpose of this review is to provide an update on the most important recent studies on heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).

Recent findings Two new drugs have been added to the armamentarium for HFrEF; ivabradine and angiotensin receptor-neprilysin inhibitors (ARNIs). Initial data from a new left ventricular assist device (LVAD) pump, the HeartMate 3 (HM III), have demonstrated no reports of pump thrombosis at 6 months, but stroke and right ventricle failure continue to be a challenge with comparable rates compared with the HeartMate II. Several large studies in HFpEF failed to show improvement in outcomes and management continues to be geared towards lifestyle modification and symptom relief.

Summary Newer therapies and devices have met with great success, yet there are several therapies that provide no benefit and even harm. A careful review of the recent literature remains instrumental to the effective management of patients with heart failure.

aMayo Clinic, Rochester, Minnesota

bDepartment of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA

Correspondence to Barry Trachtenberg, Smith 1901, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin Street, Houston, TX 77030, USA. Tel: +1 713 394 6000; e-mail: btrachtenberg@houstonmethodist.org

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