Review articleUpdates in heart failure: sodium glucose co-transporter 2 inhibitors and beyond – major changes are comingCimino, Giuliana; Pancaldi, Edoardo; Tomasoni, Daniela; Lombardi, Carlo Mario; Metra, Marco; Adamo, Marianna Author Information Cardiology, ASST Spedali Civili Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy Correspondence to Marianna Adamo, MD, Piazzale Spedali Civili 1, 25123 Brescia, Italy Tel: +393897834503; e-mail: [email protected] Received 7 September, 2022 Revised 3 October, 2022 Accepted 10 October, 2022 Journal of Cardiovascular Medicine: December 2022 - Volume 23 - Issue 12 - p 761-769 doi: 10.2459/JCM.0000000000001409 Buy Metrics Abstract Prevalence of heart failure is increasing worldwide mainly due to the ageing of the population and the improvement in diagnosis and treatment. In recent years, huge progress has been made in the management of heart failure patients. A new definition of chronic heart failure based on left ventricular ejection fraction and its possible trajectories has been reported. New drug classes have been introduced for the treatment of chronic heart failure. In particular, the prognostic benefit of sodium glucose co-transporter 2 inhibitors was demonstrated across all the heart failure phenotypes. Therapies for patients with advanced heart failure (long-term mechanical circulatory supports and heart transplantation) are now indicated also in the case of mild-to-moderate symptoms but with high risk of progression. In patients with acute heart failure, monitoring of urinary sodium and the use of acetazolamide may lead to better decongestion. Importantly, pre- and postdischarge assessment should lead to optimal treatment. Devices and telemonitoring can also be of help. Cardiovascular and noncardiovascular comorbidities are major determinants of the clinical course and need proper management. This review will summarize these important advances. © 2022 Italian Federation of Cardiology - I.F.C. All rights reserved.