Submit to Special Issue Submit Abstract to Special Issue Review for JCM Propose a Special Issue

Journal Menu

Journal Browser

Advanced Therapy for Heart Failure and Other Combined Diseases

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

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

Deadline for manuscript submissions: 20 March 2026 | Viewed by 11385

Share This Special Issue

Special Issue Editors

Dr. Gori Mauro

E-Mail Website
Guest Editor

Cardiovascular Department, Azienda Ospedaliera Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
Interests: HFpEF; acute HF; advanced HF

Dr. Marco Marini

E-Mail Website
Guest Editor

Department of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti, 60100 Ancona, Italy
Interests: clinical cardiology; heart failure; acute myocardial infarction; cardiogenic shock

Special Issue Information

Dear Colleagues,

Heart failure (HF) is a leading cause of morbidity and mortality worldwide. Recently, novel treatment and management strategies in acute and worsening HF have been published. The addition of SGLT2 inhibitors and vericiguat to the therapeutic armamentarium of HF with reduced ejection fraction (HFrEF) has allowed for improved prognosis of HF patients. Moreover, in the last decade, therapeutic regimens have also been discovered for heart failure with preserved ejection fraction (HFpEF). However, drug implementation and titration represent major threats and challenges for contemporary health care systems. Possible reasons are patient-centered factors, such as lack of compliance; physician-centered factors, such as therapeutic inertia; and organizational issues, due to the disconnect between hospitals and primary care services or to the lack of personnel. Thus, more knowledge of the benefits of guidelines-directed medical therapies and HF management strategies is needed. The scope of the Special Issue is to provide readers with an in-depth view of the management of worsening heart failure, novel therapeutic regimens in HFrEF and HFpEF, and HF risk stratification strategies.

Dr. Gori Mauro
Dr. Marco Marini
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 250 words) can be sent to the Editorial Office for assessment.

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

heart failure with reduced and preserved ejection fraction
advanced heart failure
inotropes
acute heart failure
GDMT

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (7 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Review

16 pages, 1394 KB

Open AccessArticle

Effect of Concomitant Tricuspid Valve Repair on Clinical and Echocardiographic Outcomes in Patients Undergoing Left Ventricular Assist Device Implantation

by Olga N. Kislitsina, Sandeep N. Bharadwaj, Tingqing Wu, Rebecca Harap, Jane Kruse, Esther B. Vorovich, Jane E. Wilcox, Clyde W. Yancy, Patrick M. McCarthy and Duc T. Pham

J. Clin. Med. 2025, 14(21), 7554; https://doi.org/10.3390/jcm14217554 - 24 Oct 2025

Viewed by 606

Abstract

Objectives: The purpose of this study was to determine whether concomitant tricuspid valve repair (TVr) at the time of left ventricular assist device (LVAD) implantation improves outcomes in patients with ≥moderate tricuspid regurgitation (TR) and to evaluate the prognostic value of preoperative right ventricular (RV) strain. Methods: In a retrospective analysis of 100 LVAD recipients (44 TVr; 56 No-TVr), preoperative (preop) and postoperative (postop) clinical, echocardiographic, and hemodynamic variables, including pulmonary vascular resistance (PVR) and pulmonary artery pulsatility index (PAPI), were analyzed. RV free wall strain (RV-FWS) and RV fractional area change (RV-FAC) were measured by speckle tracking. Early right heart failure (RHF) was modeled with multivariable logistic regression, and 2-year mortality was assessed with Fine–Gray competing risk regression. Preoperative and three-month measurements were compared within each of the 100 patients. Results: Baseline invasive hemodynamics, RV-FWS, and RV-FAC were similar between the TVr and No-TVr groups. TVr at the time of LVAD implantation reduced postoperative TR grade, but it did not improve RV-FWS or RV-FAC at 3 months. The No-TVr patients were more often discharged home and had lower 30-day readmissions. PVR was comparable preoperatively and at 3 months postoperatively. In adjusted analyses, preop PVR, PAPI, and TVr were not independently associated with early RHF, whereas decreased preoperative RV-FWS and lower preop RV-FAC independently predicted higher 2-year mortality. Conclusions: In LVAD recipients with ≥moderate TR, concomitant TVr lowers postoperative TR severity but does not improve early RHF, RV strain-based remodeling, or 2-year mortality. Preoperative RV deformation metrics, rather than preoperative PVR or PAPI, independently predict survival following LVAD implantation with or without TVr. Full article

(This article belongs to the Special Issue Advanced Therapy for Heart Failure and Other Combined Diseases)

► Show Figures

Graphical abstract

16 pages, 736 KB

Open AccessArticle

Right Atrial Pressure/Pulmonary Capillary Wedge Pressure Ratio Predicts In-Hospital Mortality in Left Ventricular Assist Device Recipients

by Berhan Keskin, Aykun Hakgor, Bilge Yilmaz, Korhan Erkanli, Beytullah Cakal, Arzu Yazar, Yahya Yildiz, Bilal Boztosun and Ibrahim Oguz Karaca

J. Clin. Med. 2025, 14(13), 4784; https://doi.org/10.3390/jcm14134784 - 7 Jul 2025

Cited by 1 | Viewed by 1361

Abstract

Background/Objectives: Right ventricular failure (RVF) is a major contributor to early mortality after left ventricular assist device (LVAD) implantation. While various markers of right ventricular function and right ventriculoarterial coupling have been proposed, their value in predicting in-hospital mortality remains unclear. This study aimed to investigate the prognostic significance of the right atrial pressure/pulmonary capillary wedge pressure (RAP/PCWP) ratio—a surrogate of RV–pulmonary artery (PA) coupling—for in-hospital mortality following LVAD implantation. Methods: This retrospective single-center study included 44 patients who underwent LVAD implantation. Preoperative clinical, echocardiographic, and invasive hemodynamic parameters were collected. The optimal RAP/PCWP ratio cut-off was determined using receiver operating characteristic (ROC) analysis. Predictors of in-hospital mortality were assessed using univariate and multivariate logistic regression. Results: Patients were stratified into high (≥0.47) and low (<0.47) RAP/PCWP ratio groups. In-hospital mortality was significantly higher in the high RAP/PCWP group (46% vs. 10%, p = 0.020). The optimal cut-off for the RAP/PCWP ratio was 0.47 (AUC: 0.829). In multivariate analysis, RAP/PCWP ratio (OR: 3.48 per 0.1 increase, p = 0.020) and INTERMACS 1–2 profile (OR: 39.19, p = 0.026) were independent predictors of in-hospital mortality. Conclusions: Preoperative RAP/PCWP ratio, as a surrogate of right ventriculoarterial coupling, independently predicts in-hospital mortality following LVAD implantation. Its incorporation into preoperative assessment may enhance risk stratification and guide clinical management in this high-risk population. Full article

(This article belongs to the Special Issue Advanced Therapy for Heart Failure and Other Combined Diseases)

► Show Figures

Graphical abstract

Review

Jump to: Research

15 pages, 878 KB

Open AccessReview

Risk Stratification Tools in Acute Heart Failure and Their Roles in Personalized Follow-Up

by Vittoria Rizzello, Samuela Carigi, Renata De Maria, Maria Denitza Tinti, Raul Limonta, Francesco Orso, Matteo Bianco, Luisa De Gennaro, Maria Vittoria Matassini, Paolo Manca, Concetta Di Nora, Alessandro Navazio, Giovanna Geraci, Furio Colivicchi, Claudio Bilato, Federico Nardi, Massimo Grimaldi and Fabrizio Oliva

J. Clin. Med. 2025, 14(24), 8937; https://doi.org/10.3390/jcm14248937 - 18 Dec 2025

Viewed by 433

Abstract

Heart failure (HF) is a condition with a high clinical and healthcare burden. In Europe, the current incidence is approximately 5 per 1000 persons per year in the adult population, with a prevalence of 1–2%. Prognosis remains poor, with persistently high rates of mortality and hospitalization. The period immediately following hospital discharge is known as the “vulnerable phase,” marked by a heightened incidence of clinical events, including a 30% chance of rehospitalization and a 10% mortality risk. Effective patient management during this time is crucial and should incorporate a risk stratification process, which is vital for designing a personalized follow-up plan and ensuring optimal resource utilization. This review aims to outline the available tools for prognostic risk stratification and propose a structured follow-up model applicable at discharge from an HF hospitalization in patients with HF with reduced ejection fraction and in patients with mildly reduced/preserved ejection fraction. Full article

(This article belongs to the Special Issue Advanced Therapy for Heart Failure and Other Combined Diseases)

► Show Figures

Figure 1

19 pages, 692 KB

Open AccessReview

Finerenone: Extending MRAs Prognostic Benefit to the Recently Hospitalized and More Symptomatic Patient with HFpEF

by Maria Denitza Tinti, Luisa De Gennaro, Raul Limonta, Renata De Maria, Samuela Carigi, Matteo Bianco, Concetta Di Nora, Paolo Manca, Maria Vittoria Matassini, Vittoria Rizzello, Emilia D’Elia, Manuela Benvenuto, Marco Cittar, Geza Halasz, Massimo Iacoviello, Domenico Gabrielli, Furio Colivicchi, Claudio Bilato, Federico Nardi, Massimo Grimaldi and Fabrizio Oliva Show full author list Hide full author list

J. Clin. Med. 2025, 14(24), 8730; https://doi.org/10.3390/jcm14248730 - 10 Dec 2025

Viewed by 639

Abstract

Mineralocorticoid receptor antagonism represents a therapeutic cornerstone in patients with HFrEF. However, the efficacy of MRAs in patients HFmrEF or HFpEF remains unclear. While the TOPCAT trial did not demonstrate a statistically significant reduction in cardiovascular mortality or hospitalizations for HF in this patient population, post hoc data suggested potential clinical benefits of MRAs in specific patient subgroups. More recently, the landscape has evolved with the FINEARTS-HF trial, which generated novel evidence regarding finerenone, a non-steroidal MRA, in the HFmrEF and HFpEF cohorts. This investigation established a statistically significant decrease in the primary composite endpoint, comprising cardiovascular death and worsening heart failure events. This positive outcome was principally attributable to a lower incidence of total WHF events. Key findings also highlighted the therapy’s rapid onset of action and favorable safety profile. Notably, finerenone’s benefit was consistent across the entire LVEF spectrum and was not influenced by baseline SGLT2i use, sex, or age. Finerenone’s established indication is for patients with type 2 diabetes mellitus and chronic kidney disease to reduce heart failure risk. However, based on the findings of the FINEARTS-HF trial, finerenone may represent a novel therapeutic pillar for patients with HFpEF and HFmrEF. In this review, we aim to describe the potential benefits of MRAs in the pathophysiology of HFpEF and HFmrEF and in different patient phenotypes, the results of the FINEARTS-HF trial, and the most important subanalyses of the study. Full article

(This article belongs to the Special Issue Advanced Therapy for Heart Failure and Other Combined Diseases)

► Show Figures

Figure 1

15 pages, 1437 KB

Open AccessFeature PaperReview

SGLT2-is in Acute Heart Failure

by Matteo Bianco, Concetta Di Nora, Renata De Maria, Amir Hassan Mousavi, Samuela Carigi, Luisa De Gennaro, Paolo Manca, Maria Vittoria Matassini, Vittoria Rizzello, Maria Denitza Tinti, Giovanna Geraci, Attilio Iacovoni, Furio Colivicchi, Massimo Grimaldi and Fabrizio Oliva

J. Clin. Med. 2025, 14(21), 7799; https://doi.org/10.3390/jcm14217799 - 3 Nov 2025

Cited by 1 | Viewed by 2825

Abstract

Despite the wealth of evidence in favour of SGLT2 inhibitor use in patients with chronic heart failure, their role in the very early stages of heart failure is still unclear. While the latest update of the European Society of Cardiology guidelines on heart failure advocates the use SGLT2 inhibitors in the acute phases of heart failure based on the results of the latest trials, it does not clarify the appropriate timing to start this therapy, leaving the clinician to decide whether SGLT2 inhibitors should be started directly during hospitalization or at discharge. Conversely, the recently published focused update of the American College of Cardiology expert consensus decision pathway on the clinical assessment, management, and trajectory of patients hospitalized with heart failure clearly supports the safety and early clinical benefit use of SGLT2 inhibitors based on evidence coming from the EMPULSE and SOLOIST-WHF trials. The expert consensus decision pathway states that SGLT2 inhibitors can be initiated regardless of left ventricular ejection fraction at any time during hospitalization and places a greater emphasis on implementing the other pillars of therapy for heart failure with reduced ejection fraction after stabilization. Moreover, the results of the very recent DAPA ACT HF–TIMI 68 trial on dapagliflozin in patients with acute heart failure, although limited by a follow-up of only 2 months, did not show a reduction in mortality or heart failure hospitalizations. Based on the currently available published data, we will review what is already known about the use of these drugs in the early phases of acute heart failure and analyze their pathophysiological rationale from a practical perspective. Full article

(This article belongs to the Special Issue Advanced Therapy for Heart Failure and Other Combined Diseases)

► Show Figures

Figure 1

23 pages, 348 KB

Open AccessReview

Non-Invasive Wearable Technology to Predict Heart Failure Decompensation

by Jack Devin, Eden Powell, Dylan McGagh, Tyler Jones, Brian Wang, Pierre Le Page, Andrew J. M. Lewis, Oliver J. Rider, Andrew R. J. Mitchell and John A. Henry

J. Clin. Med. 2025, 14(20), 7423; https://doi.org/10.3390/jcm14207423 - 21 Oct 2025

Viewed by 3010

Abstract

Heart failure (HF) remains a leading cause of recurrent hospitalisations worldwide, largely driven by acute episodes of decompensation. Early identification of impending decompensation could enable timely intervention and potentially prevent costly admissions. Non-invasive wearable devices have emerged as promising tools for continuously monitoring physiological parameters and detecting early signs of deterioration. This review summarises recent advances in wearable technologies designed to predict HF decompensation and appraises their ability to generate clinically useful alerts. It will examine various modalities designed to monitor different aspects of cardiorespiratory physiology that have the potential to detect abnormalities preceding heart failure decompensation. Broadly, these devices either monitor physical activity capacity and cardiac function or monitor changes in pulmonary fluid congestion. We will also cover evidence exploring whether these devices can generate timely alerts for interventions to improve patient outcomes and reduce hospitalisations. However, despite advances in these technologies, challenges remain regarding their accuracy and usability for remote monitoring, as well as concerns with data storage, processing, patient adherence, and integration into existing healthcare workflows. While current limitations exist, previous results warrant further research into this area, with a focus on larger randomised trials, exploring both single- and multi-sensor systems, using artificial intelligence and cost-effectiveness analysis. Overall, non-invasive wearables represent an opportunity to create a more proactive approach to HF management, with the potential to shift the paradigm from reactive treatment to anticipatory care. Full article

(This article belongs to the Special Issue Advanced Therapy for Heart Failure and Other Combined Diseases)

► Show Figures

Graphical abstract

15 pages, 1044 KB

Open AccessReview

Home Inotropes in Advanced Heart Failure: A Practical Review

by Paolo Manca, Maria Vittoria Matassini, Luca Fazzini, Matteo Bianco, Concetta Di Nora, Vittoria Rizzello, Samuela Carigi, Luisa De Gennaro, Maria Denitza Tinti, Renata De Maria, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva and Mauro Gori

J. Clin. Med. 2025, 14(19), 7018; https://doi.org/10.3390/jcm14197018 - 3 Oct 2025

Cited by 1 | Viewed by 2093

Abstract

Advanced heart failure (AdHF) is a progressive condition with a high morbidity and mortality burden despite optimal medical therapy. Heart transplant (HT) and left ventricular assist device (LVAD) represent the only two life-prolonging options in AdHF. Unfortunately, only a minority of AdHF patients are eligible for these life-saving therapies, and even patients who are candidates for HT usually incur prolonged waiting list times. Intermittent or continuous home-based inotropic therapy offers a potential solution to improve quality of life, reduce recurrent hospitalizations, and maintain organ function, both for the stabilization of patients who are ultimately candidates for life-saving therapies and for palliative care in those without other therapeutic options. In this review, we summarize the current literature on the role of home inotropes in managing AdHF, emphasizing the current evidence on the most adopted agents, the practical considerations for their administration, and the possible different preferred utilization of these agents. Finally, we address gaps in the literature and outline future research directions to enhance therapeutic options and outcomes. Full article

(This article belongs to the Special Issue Advanced Therapy for Heart Failure and Other Combined Diseases)

► Show Figures

Journal Menu

Journal Browser

Advanced Therapy for Heart Failure and Other Combined Diseases

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (7 papers)

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI