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Acute and Chronic Heart Failure: Clinical Updates and Perspectives—2nd Edition

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

Deadline for manuscript submissions: 20 January 2027 | Viewed by 2300

Editors


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Guest Editor
Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Interests: heart failure; cardiogenic shock; ischemic heart disease; percutaneous coronary interventions; structural heart dis-ease; percutaneous ventricular assist devices
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Guest Editor
Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
Interests: transcatheter aortic valve implantation; percutaneous coronary interventions; heart failure
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to this Special Issue entitled “Acute and Chronic Heart Failure: Clinical Updates and Perspectives—2nd Edition”. In our previous Special Issue, entitled “Acute and Chronic Heart Failure: Clinical Updates and Perspectives”, we published high-quality original research articles and review papers covering a wide range of topics. This second edition represents the continuation of this series.

Heart failure (HF) represents a twenty-first century cardiovascular epidemic, with over 25 million cases worldwide. The increase in HF cases is partly ascribable to the "paradoxical" advancement of treatments for cardiovascular diseases, with a consequent reduction in mortality and higher incidence of cardiac dysfunction among survivors, partly due to the increase in the longevity of the general population. The prognosis of patients with HF remains poor, with one in nine patients dying one year after diagnosis and about one half dying within five years; moreover, despite appropriate medical treatment, many patients face frequent hospitalization and a reduced quality of life. Furthermore, even when symptoms are controlled, subclinical disease progression can occur due to the underlying neurohormonal imbalance.

In recent decades, several advancements have been made in HF treatment. Pharmacological therapy, alongside well-established therapies, has seen the introduction of new molecules. These molecules have now largely entered clinical practice and are recognized in international guidelines, such as valsartan/sacubitril, SGLT2 inhibitors, and more recent drugs such as vericiguat. Furthermore, device-based therapy has seen a significant improvement, with the development of more efficient systems of cardiac pacing and resynchronization therapy, as well as the production of continuously more efficient and less invasive percutaneous assist devices to improve outcomes and enable survival, even in the patients with the most critical conditions.

Despite these advancements, the prognosis and quality of life for patients with HF often remain poor, and there is an urgent need for further studies. Therefore, the aim of this Special Issue is to provide insights into the latest advancements in all aspects of heart failure treatment in both acute and chronic settings. In particular, original research articles and valuable reviews concerning the newest progress in HF are welcome.

Dr. Luigi Cappannoli
Dr. Cristina Aurigemma
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-anonymized 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

  • acute heart failure
  • chronic heart failure
  • devices
  • drug therapy
  • percutaneous ventricular assist devices
  • cardiogenic shock
  • arrhythmias
  • ischemic heart disease

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Related Special Issue

Published Papers (3 papers)

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Research

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11 pages, 864 KB  
Article
Transaxillar Impella Implantation: Learning Curve Analysis and the Role of Mentorship in Accelerating Proficiency
by Serena Boeddu, Marcin P. Szczechowicz, Kálmán Benke, Fabio Abbondanza, Anna Hoffmeister, Viktor Banhegyi, Givi Damenija, Gábor Szabó and Gábor Veres
J. Clin. Med. 2026, 15(13), 5154; https://doi.org/10.3390/jcm15135154 - 2 Jul 2026
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Abstract
Objectives: Transaxillar Impella 5.0/5.5 implantation is a hybrid surgical and fluoroscopy-guided procedure. We evaluated the learning curve using radiation exposure as a marker of procedural efficiency and assessed whether structured mentorship accelerates procedural proficiency. Methods: This retrospective single-center study included consecutive transaxillar Impella [...] Read more.
Objectives: Transaxillar Impella 5.0/5.5 implantation is a hybrid surgical and fluoroscopy-guided procedure. We evaluated the learning curve using radiation exposure as a marker of procedural efficiency and assessed whether structured mentorship accelerates procedural proficiency. Methods: This retrospective single-center study included consecutive transaxillar Impella 5.0/5.5 implantation attempts by two surgeons. Surgeon A adopted the technique independently, whereas Surgeon B was trained under direct proctorship. The primary endpoint was radiation exposure (dose–area product), and the secondary endpoint was fluoroscopy time. Temporal trends were analyzed by regression, and CUSUM plots were generated. Results: Of 104 procedures, 14 were excluded (12 transaortic, 2 unsuccessful). Ninety procedures were analyzed (74 Surgeon A, 16 Surgeon B). In Surgeon A, radiation exposure decreased significantly with increasing case number. In Surgeon B, no significant association between case number and radiation exposure was observed. Fluoroscopy time was not associated with case number in either group. CUSUM analysis suggested an early increase followed by stabilization in Surgeon A, whereas no clear pattern was observed in Surgeon B. The between-surgeon interaction was not statistically significant. ECMELLA configuration was the only independent predictor of increased radiation exposure, whereas device type, surgery type, and patient age were not significant predictors. Conclusions: Transaxillar Impella implantation appears to have a measurable early learning phase. Structured mentorship may attenuate the early learning phase, although this finding remains exploratory. Full article
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10 pages, 226 KB  
Article
Performances of Clinical, Biological and Echographic Signs to Assess Right Atrial Pressure in Pulmonary Hypertension
by Magali Croquette, Etienne-Marie Jutant, Elisa Larrieu-Ardilouze and Jean-Eudes Trihan
J. Clin. Med. 2026, 15(12), 4704; https://doi.org/10.3390/jcm15124704 - 17 Jun 2026
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Abstract
Background/Objectives: Right heart failure remains the leading cause of death in pulmonary hypertension. Early detection of right-sided congestion is crucial but relies largely on clinical signs with limited diagnostic accuracy. We performed a post hoc analysis of the CODOVEIN study to evaluate the [...] Read more.
Background/Objectives: Right heart failure remains the leading cause of death in pulmonary hypertension. Early detection of right-sided congestion is crucial but relies largely on clinical signs with limited diagnostic accuracy. We performed a post hoc analysis of the CODOVEIN study to evaluate the diagnostic performance of clinical and non-invasive parameters for predicting elevated right atrial pressure (RAP). Methods: This post hoc analysis included patients from a prospective cross-sectional study who underwent right heart catheterization. Clinical signs, echocardiographic parameters, venous Doppler indices, and NT-proBNP levels were assessed within four hours before catheterization. Patients were stratified according to invasively measured RAP. Diagnostic performances were evaluated using sensitivity, specificity, predictive values, likelihood ratios, and ROC curves. Results: Several clinical and imaging parameters were associated with increasing RAP. Among non-invasive markers, the femoral venous stasis index (FVSI) and inferior vena cava (IVC) collapsibility assessed in transverse view showed the best discriminative ability for detecting RAP > 14 mmHg. FVSI demonstrated the highest positive likelihood ratio (>11) and an excellent negative predictive value (>0.98), outperforming other clinical and echocardiographic markers. Conclusions: In patients with pulmonary hypertension, FVSI provides robust non-invasive identification of right atrial pressure elevation and may complement traditional clinical assessment for the early detection of right-sided congestion. Full article
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Review

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15 pages, 820 KB  
Review
Mechanical Support in Myocardial Infarction Complicated by Cardiogenic Shock: What Have We Learned from Trials?
by Cristina Aurigemma, Norman Mangner, Vasileios Panoulas and Jacob Eifer Møller
J. Clin. Med. 2026, 15(12), 4453; https://doi.org/10.3390/jcm15124453 - 9 Jun 2026
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Abstract
Cardiogenic shock (CS) is the most lethal complication of acute myocardial infarction (AMI), with a 30-day mortality of approximately 40–50% despite early revascularization. Temporary mechanical circulatory support (tMCS) devices, including the intra-aortic balloon pump (IABP), microaxial flow pumps (MAFP) and veno-arterial extracorporeal membrane [...] Read more.
Cardiogenic shock (CS) is the most lethal complication of acute myocardial infarction (AMI), with a 30-day mortality of approximately 40–50% despite early revascularization. Temporary mechanical circulatory support (tMCS) devices, including the intra-aortic balloon pump (IABP), microaxial flow pumps (MAFP) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO), are used as adjunctive therapy in refractory shock, but evidence of a survival benefit is limited and often conflicting. The IABP-SHOCK II trial found no 30-day mortality reduction with IABP, supporting a Class III (no benefit) recommendation, whereas the DanGer Shock trial reported a 12.7% absolute mortality reduction at 180 days with the MAFP Impella CP in highly selected patients. In contrast, the ECLS-SHOCK and ECMO-CS trials showed no improvement in survival with early VA-ECMO and noted high complication rates. Real-world data reveal significant disparities between trial populations and clinical practice, highlighting limitations of current evidence, since many AMI-CS patients are older, in more advanced shock or have multiple comorbidities and would not meet typical randomized controlled trial (RCT) inclusion criteria. In clinical practice, in-hospital mortality with IABP or VA-ECMO often exceeds 50–60%. Given the heterogeneity of AMI-CS, rapid identification of appropriate tMCS candidates and personalized therapy are essential. Management guided by individual patient profile, hemodynamic stage and neurological status, supported by multidisciplinary shock teams, may improve timely triage, device selection and outcomes. This review emphasizes the need for individualized, protocol-driven care within structured shock systems to optimize tMCS use in AMI-CS. Full article
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