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Clinical Update on the Diagnosis and Treatment of Heart Failure
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Clinical Update on the Diagnosis and Treatment of Heart Failure

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

Deadline for manuscript submissions: 30 August 2025 | Viewed by 4509

Special Issue Editors

Dr. Giulia Nardi

E-Mail Website
Guest Editor
Division of Structural Interventional Cardiology, Careggi University Hospital, 50134 Florence, Italy
Interests: interventional cardiology; intravascular imaging; coronary calcified lesions; complex high risk PCI; structural heart interventions; mechanical circulatory support
Dr. Alessio Mattesini

E-Mail Website
Guest Editor Assistant
Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy
Interests: interventional cardiology; intravascular imaging; complex high risk PCI; drug-coated balloon angioplasty

Special Issue Information

Dear Colleagues,

Heart failure (HF) is a clinical syndrome resulting from structural and/or functional abnormalities of the heart and has a high prevalence in Western countries, significantly impacting their healthcare systems. With the aging of the population, the incidence of HF is growing, and despite significant advances in pharmacological therapy and device management, morbidity and mortality remain high, contributing to elevated healthcare costs. Etiological diagnosis and classification are crucial for understanding the underlying causes of HF and targeting treatments for each HF phenotype.

Despite recent innovations, the treatment and management of HF remain challenging and require a multidisciplinary team of physicians with expertise in clinical cardiology, imaging, intensive care, interventional cardiology, arrhythmology, and cardiac stimulation. The combination of both pharmacological and interventional treatments is essential to significantly reducing major cardiovascular events in these patients.

Currently, several novel and existing technologies are available for HF treatment, allowing multiple therapeutic strategies. Innovations in pharmacology and percutaneous technologies include soluble guanylate cyclase stimulators, selective cardiac myosin activators, transcatheter treatment of valvular disease, atrial flow regulator devices, left ventricle remodeling systems, cardiac resynchronization therapy, and contractility modulation.

This Special Issue aims to provide a focused update on new clinical data and perspectives in the field of heart failure, encompassing diagnosis, management, innovative treatments, and novel technologies. It will serve as a forum for high-quality original research and review articles, showcasing the latest clinical advances and future perspectives in HF management.

Dr. Giulia Nardi
Dr. Alessio Mattesini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ejection fraction
  • acute heart failure
  • multidisciplinary management
  • right heart failure
  • left ventricle remodeling systems
  • HF percutaneous treatment; pharmacotherapy
  • HF prevention
  • cardiomyopathies

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Published Papers (3 papers)

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Research

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12 pages, 1015 KiB  
Article
Impact of Remote Dielectric Sensing on Predicting Worsening Heart Failure During Hospitalization for Heart Failure
by Teruhiko Imamura, Yu Nomoto, Toshihide Izumida, Nikhil Narang and Koichiro Kinugawa
J. Clin. Med. 2024, 13(21), 6427; https://doi.org/10.3390/jcm13216427 - 26 Oct 2024
Viewed by 984
Abstract
Background: A remote dielectric sensing (ReDS) system quickly quantifies pulmonary congestion. Nonetheless, its efficacy in predicting an in-hospital increase in plasma B-type natriuretic peptide levels, the potential surrogate of worsening heart failure, remains undetermined. Methods: Patients who underwent ReDS measurement on admission during [...] Read more.
Background: A remote dielectric sensing (ReDS) system quickly quantifies pulmonary congestion. Nonetheless, its efficacy in predicting an in-hospital increase in plasma B-type natriuretic peptide levels, the potential surrogate of worsening heart failure, remains undetermined. Methods: Patients who underwent ReDS measurement on admission during their hospitalization in the general wards for heart failure between 2021 and 2022 were eligible. The impact of the baseline ReDS value, completely blinded to the attending clinicians, on the in-hospital increase in plasma B-type natriuretic peptide levels of >100 pg/mL from index admission was evaluated. Results: A total of 147 patients admitted with acute-on-chronic heart failure (median age: 79 years; 76 men) were included. The median ReDS value on admission was 28% (25%, 34%). Eighteen patients experienced the primary outcome: plasma B-type natriuretic peptide levels increasing from 461 (207, 790) pg/mL (baseline) to 958 (584, 1290) pg/mL (maximum) (p < 0.001). The ReDS value on admission was an independent predictor of the primary outcome, with an adjusted odds ratio of 1.07 (95% confidence interval: 1.01–1.14; p = 0.028) with an optimal cutoff of 32%. Conclusions: The ReDS system could be a promising tool for predicting in-hospital worsening heart failure in patients hospitalized for heart failure when measured upon admission. The clinical implication of ReDS-guided management of heart failure during index hospitalization requires further studies. Full article
(This article belongs to the Special Issue Clinical Update on the Diagnosis and Treatment of Heart Failure)
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9 pages, 2231 KiB  
Article
Examination of the Suitability of Vericiguat in Non-Heart Failure with Preserved Ejection Fraction Patients with Improved Ejection Fraction
by Haruyuki Kinoshita, Hiroshi Sugino, Kento Fujita, Yoji Sumimoto, Kenji Masada, Takashi Shimonaga, Akiyo Suga, Mayumi Toko, Kaori Taniyasu, Saki Ushirozako, Yumiko Katayama, Chiemi Hirahara and Masahiro Takada
J. Clin. Med. 2024, 13(17), 5264; https://doi.org/10.3390/jcm13175264 - 5 Sep 2024
Viewed by 2143
Abstract
Background/Objectives: Vericiguat has been shown to reduce cardiovascular mortality and hospitalisation for heart failure in patients with reduced ejection fraction. While Vericiguat is considered one of the standard treatments for heart failure, it is unclear under which conditions Vericiguat would be most [...] Read more.
Background/Objectives: Vericiguat has been shown to reduce cardiovascular mortality and hospitalisation for heart failure in patients with reduced ejection fraction. While Vericiguat is considered one of the standard treatments for heart failure, it is unclear under which conditions Vericiguat would be most effective. With a focus on the prognosis and improved EF of heart failure, we aimed to investigate in which cases Vericiguat is suitable for use in addition to standard cardioprotective drugs. Methods: We prospectively compared echocardiograms taken before and after the administration of Vericiguat in 46 patients with non-dialysis and without heart failure with preserved ejection fraction (non-HFpEF) (left ventricle ejection fraction [LVEF] < 50%) who were able to continue Vericiguat in addition to other standard heart failure drugs (the “Fantastic Four”) for more than 6 months at our hospital. Patients who showed an improvement of 10 points or more in LVEF were defined as improved EF+. Results: LVEF improved significantly from 38 [33–45]% at the time of administration to 46 [35–54.5]% at 6 months (p < 0.001). When comparing patients with and without improved EF, a significant difference was observed in the Hb (OR = 1.66, 95%CI = 1.12–2.83, p = 0.028), early introduction (OR = 12.5, 95%CI = 1.58–149, p = 0.025), and initiation of Vericiguat after the administration of the Fantastic Four (OR = 9.79, 95%CI = 1.71–100.2, p = 0.022). Conclusions: In this study, the early administration of Vericiguat, haemoglobin value, and initiation of Vericiguat after the introduction of the Fantastic Four were identified as independent factors for eligibility in non-dialysis, non-HFpEF patients who were able to continue GDMT treatment for more than 6 months after adding Vericiguat. Full article
(This article belongs to the Special Issue Clinical Update on the Diagnosis and Treatment of Heart Failure)
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Review

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11 pages, 655 KiB  
Review
Heart Rate Reduction and the Prognosis of Heart Failure Focused on Ivabradine
by Shunsuke Kiuchi and Takanori Ikeda
J. Clin. Med. 2025, 14(4), 1074; https://doi.org/10.3390/jcm14041074 - 7 Feb 2025
Viewed by 1091
Abstract
Cardioprotective medications referred to as the fantastic four are used to treat heart failure (HF). Additionally, ivabradine can also be used if the heart rate (HR) is elevated. An elevated HR is a prognostic factor in HF patients, as well as in the [...] Read more.
Cardioprotective medications referred to as the fantastic four are used to treat heart failure (HF). Additionally, ivabradine can also be used if the heart rate (HR) is elevated. An elevated HR is a prognostic factor in HF patients, as well as in the general population. In both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), an elevated HR is associated with all-cause mortality, whereas cardiovascular death is only associated with the former. In addition, previous clinical trials revealed that ivabradine was useful only in HFrEF but not in HFpEF. Therefore, ivabradine is indicated for patients only with HFrEF. Moreover, ivabradine increases the stroke volume by ensuring an effective diastolic time as a result of the decreased HR. Including this effect, the introduction of ivabradine allowed for the discontinuation of dobutamine infusion used in HF patients and the uptitration of β-blockers in other reports. Additionally, ivabradine improves exercise tolerance and the subjective symptoms of HF. However, the effects of ivabradine on exercise tolerance remain poorly understood, and prospective clinical trials are underway. While these beneficial effects have been reported, side effects such as photopsia and atrial fibrillation have also been reported. It is important to use ivabradine appropriately in conjunction with standard HF treatment, including quadruple therapy. Full article
(This article belongs to the Special Issue Clinical Update on the Diagnosis and Treatment of Heart Failure)
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