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Current Trends and Future Challenges in Heart Failure

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 January 2026) | Viewed by 822

Special Issue Editors


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Guest Editor
The Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel
Interests: heart failure; cardiomyopathies; cardiovascular organoids; causal inference machine learning in heart failure; myocardial regeneration

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Guest Editor
Cardiology Division, Rambam Health Care Campus, Haifa, Israel
Interests: acute and chronic heart failure; cardiomupahies; acute coronary syndrom; cardiac comorbidies; tachyarrhithmias

Special Issue Information

Dear Colleagues,

Heart failure (HF) remains a prominent cause of morbidity, mortality, and healthcare resource utilization globally. Its prevalence continues to escalate due to an aging population and the increasing incidence of comorbidities such as hypertension, diabetes, obesity, and chronic kidney disease. Despite significant advancements in diagnostic tools and the expansion of guideline-directed medical therapy, including novel therapies such as Angiotensin Receptor–Neprilysin Inhibitors (ARNIs) and Sodium-Glucose Cotransporter-2 (SGLT2) inhibitors, heart failure persists as a substantial clinical and public health challenge.

This Special Issue, titled "Current Trends and Future Challenges in Heart Failure," intends to furnish a comprehensive overview of the evolving landscape of HF. Topics slated for inclusion in this issue encompass emerging pharmacologic and advanced device-based therapies, the diagnosis and treatment of cardiac amyloidosis, inflammation-targeted therapies, precision-driven strategies such as biomarker-guided care, wearable biosensors, remote hemodynamic monitoring in HF management, and the integration of digital health with artificial intelligence.

Particular emphasis will be placed on enduring gaps in care, which include multidisciplinary approaches, the management of HF with preserved ejection fraction, cardiorenal syndrome, frailty, exercise rehabilitation, and disparities in access to therapies.

We invite original research articles and state-of-the-art reviews to promote interdisciplinary collaboration and enhance patient-centered care. By addressing current evidence and identifying priorities for future investigations, this issue aims to inform both clinical practice and research innovation in the management of HF.

Dr. Oren Caspi
Dr. Robert Zukermann
Guest Editors

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Keywords

  • heart failure
  • guideline-directed therapy
  • digital health
  • biomarkers
  • multidisciplinary care
  • artificial intelligence
  • cardiorenal syndrome
  • remote hemodynamic monitoring
  • cardiac amyloidosis
  • exercise rehabilitation

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Published Papers (1 paper)

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Review

16 pages, 591 KB  
Review
Finerenone Across the Cardiovascular–Kidney–Metabolic Continuum: From Mechanistic Rationale to Clinical Positioning—A Narrative Review
by Jacek Kubica, Aldona Kubica, Jakub Ratajczak, Robert Gajda, Łukasz Szarpak and Eliano P. Navarese
J. Clin. Med. 2026, 15(9), 3486; https://doi.org/10.3390/jcm15093486 - 2 May 2026
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Abstract
The cardiovascular–kidney–metabolic (CKM) syndrome has emerged as an integrated framework linking obesity, type 2 diabetes, chronic kidney disease (CKD), and heart failure with preserved or mildly reduced ejection fraction through shared mechanisms including inflammation, oxidative stress, endothelial dysfunction, and fibrosis. Persistent mineralocorticoid receptor [...] Read more.
The cardiovascular–kidney–metabolic (CKM) syndrome has emerged as an integrated framework linking obesity, type 2 diabetes, chronic kidney disease (CKD), and heart failure with preserved or mildly reduced ejection fraction through shared mechanisms including inflammation, oxidative stress, endothelial dysfunction, and fibrosis. Persistent mineralocorticoid receptor overactivation plays a central role in this continuum, contributing to progressive cardiac and renal injury despite optimized renin–angiotensin system blockade. Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist, has therefore gained increasing attention as a targeted strategy to reduce residual cardiorenal risk. This narrative review summarizes the mechanistic rationale and clinical evidence supporting finerenone across the CKM spectrum. Experimental data indicate that finerenone attenuates inflammation, fibrosis, myocardial hypertrophy, and adverse remodeling, while proteomic and translational analyses suggest biological complementarity with sodium–glucose cotransporter 2 inhibitors. Clinically, pivotal randomized trials have demonstrated that finerenone reduces kidney disease progression and major cardiovascular events in patients with CKD and type 2 diabetes, while the FINEARTS-HF trial extended these benefits to patients with heart failure with mildly reduced or preserved ejection fraction by reducing worsening heart failure events. Additional subgroup, pooled, and meta-analytic data reinforce the consistency of these effects across a broad range of cardiorenal phenotypes. Taken together, current evidence positions finerenone as an important component of contemporary CKM management, particularly in patients with diabetic CKD and selected heart failure phenotypes. Its principal value lies in targeting residual inflammatory and fibrotic risk beyond conventional hemodynamic and metabolic control. Future progress will depend on earlier phenotype recognition, improved implementation and adherence, and wider adoption of pathway-oriented combination therapy across the cardiorenal continuum. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Heart Failure)
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