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Clinical Management of Patients with Heart Failure—2nd Edition
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Clinical Management of Patients with Heart Failure—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: 13 August 2025 | Viewed by 1216

Special Issue Editor

Dr. Tudoran Cristina

E-Mail Website
Guest Editor
1. Center of Molecular Research in Nephrology and Vascular Disease, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
2. Department of Cardiology, County Emergency Hospital “Pius Brinzeu” Timisoara, Timisoara, Romania
Interests: heart failure; systemic hypertension; acute and chronic coronary syndrome; arrhythmias; management of patients with cardiovascular diseases; cardiovascular risk factors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

I am pleased to invite you to contribute to this Special Issue entitled "Clinical Management of Patients with Heart Failure—2nd Edition". For more details on the first edition, in which we published more than 15 papers, please visit: https://www.mdpi.com/journal/jcm/special_issues/91TCP5E3S2. 

Worldwide, one of the leading causes of increased morbidity and mortality is heart failure, which also leads to increased costs for the healthcare systems. It evolves with repeated episodes of decompensation, representing one of the most frequent reasons for hospitalization in the cardiology or internal medicine units, but also aggravating the course of other pathologies. Even in its more stable form, chronic heart failure may affect patients' well-being and quality of life, impacting their level of activity and reducing their possibility of self-care, also generating socio-economic consequences for the diseased persons and their families as well. The onset of heart failure is frequently subtle and unexpected, and this pathology can progress slowly, remaining unnoticed for several years. When patients seek specialized medical advice, it is often too late to obtain optimal results, because several complications and associated co-morbidities are already present, and the most appropriate recommended management must be adapted to their clinical conditions.

In the last decade, along with the progress of fundamental sciences and pharmacotherapy and the prodigious efforts of the cardiology societies and healthcare systems worldwide, new therapeutic methods have been developed, and the availability of specialized medical care for the general population has increased, leading to a better management of patients with heart failure and, in recent years, to an increase in the life expectancy of these subjects. Although a variety of new treatment options are available, starting with innovative drugs, and continuing with invasive procedures, not to forget the lifestyle change measures, selecting the most appropriate management of heart failure is difficult, raising challenges for the medical personnel and healthcare systems, while often leading to suboptimal results for the patient.

This Special Issue focuses on original articles and reviews referring to groundbreaking research regarding the clinical management of heart failure.

Dr. Tudoran Cristina
Guest Editor

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

  • acute heart failure
  • chronic heart failure
  • treatment options
  • management of heart failure
  • life style changes
  • diagnosis of heart failure

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Related Special Issue

Published Papers (3 papers)

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Research

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10 pages, 776 KiB  
Article
Guideline-Directed Medical Therapy in Sepsis Survivors with Left Ventricular Systolic Dysfunction: An Observational Study
by Thomas Oswald, Samuel Malomo, Thomas Alway, Stanislav Hadjivassilev, Steven Coombs, Susan Ellery, Joon Lee, Claire Phillips, Barbara Philips, Rachael James, David Hildick-Smith, Victoria Parish and Alexander Liu
J. Clin. Med. 2025, 14(9), 3253; https://doi.org/10.3390/jcm14093253 - 7 May 2025
Viewed by 190
Abstract
Background: Sepsis survivors can develop left ventricular systolic dysfunction (LVSD) and heart failure. These patients are often treated with guideline-directed medical therapy (GDMT) known to be effective in patients with non-sepsis-related heart failure. This study sought to assess the use of GDMT on [...] Read more.
Background: Sepsis survivors can develop left ventricular systolic dysfunction (LVSD) and heart failure. These patients are often treated with guideline-directed medical therapy (GDMT) known to be effective in patients with non-sepsis-related heart failure. This study sought to assess the use of GDMT on sepsis survivors with LVSD. Methods: Sepsis survivors with suspected myocardial injury and/or heart failure diagnosed with LVSD in a UK cardiac centre were retrospectively studied. Clinical and transthoracic echocardiography (TTE) data were recorded and analysed. Results: Of the 25 sepsis survivors (age 56 ± 11 years; 52% males), 11 (44%) had LVSD (LVEF < 50%). LV end-diastolic internal diameter (LVIDd) was similar between patients with vs. without LVSD (5.2 ± 0.8 cm vs. 4.7 ± 0.8 cm; p = 0.214). Patients with LVSD had significantly greater LV end-systolic internal diameter (LVIDs) than those without LVSD (4.0 ± 1.2 cm vs. 2.8 ± 0.6 cm; p = 0.027). Tricuspid annular plane systolic excursion (TAPSE) was similar between the two groups (2.1 ± 0.5 cm vs. 2.2 ± 0.6 cm; p = 0.910). Of the 11 patients with LVSD, nine patients underwent repeat TTE scans after 6 months [IQR 3–9], most of whom were taking GDMT. The majority (8/9) of these patients demonstrated LV systolic functional recovery (>5% LVEF increase; mean LVEF improvement 16 ± 11%) after GDMT. Reductions were seen in LVIDd (5.3 ± 0.8 cm to 5.0 ± 0.7 cm) and LVIDs (4.1 ± 1.2 cm to 3.7 ± 0.8 cm) after GDMT, though these changes did not reach statistical significance (both p > 0.05). Conclusions: GDMT appears beneficial in sepsis survivors with LV dysfunction. This finding should be validated on a larger and multi-centre basis to further affirm the value of medical therapy in post-sepsis heart failure. Full article
(This article belongs to the Special Issue Clinical Management of Patients with Heart Failure—2nd Edition)
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Review

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27 pages, 849 KiB  
Review
Historical Gaps in the Integration of Patient-Centric Self-Management Components in HFrEF Interventions: An Umbrella Narrative Review
by Pupalan Iyngkaran, Fareda Fazli, Hayden Nguyen, Taksh Patel and Fahad Hanna
J. Clin. Med. 2025, 14(8), 2832; https://doi.org/10.3390/jcm14082832 - 19 Apr 2025
Viewed by 326
Abstract
Background: Chronic disease self-management (CDSM) interventions have shown promise in improving patient outcomes in heart failure (HF), particularly for those with reduced ejection fraction (HFrEF). Patient-centric self-management programs often incorporate key components such as education, self-monitoring, and goal setting. However, the extent to [...] Read more.
Background: Chronic disease self-management (CDSM) interventions have shown promise in improving patient outcomes in heart failure (HF), particularly for those with reduced ejection fraction (HFrEF). Patient-centric self-management programs often incorporate key components such as education, self-monitoring, and goal setting. However, the extent to which these components are consistently reported and integrated into studies remains unclear. This umbrella narrative review aims to analyze systematic reviews to assess the consistency of reporting on patient-centric self-management components implemented in trials and studies. Methods: This umbrella narrative review synthesized findings from systematic reviews and meta-analyses published between 2000 and 2023 for CDSM tools in HF. Eligible studies were assessed for the presence and consistency of reporting on education, self-monitoring, and goal setting in self-management interventions for HFrEF. Data extraction focused on the frequency of reporting these components and the gaps in reporting long-term patient outcomes. Results: Among the included systematic reviews, education was the most consistently reported component (100%), while self-monitoring and goal setting were each reported in around 50% of studies. Reporting of long-term outcomes, such as mortality and quality of life, was highly variable and often absent. These inconsistencies highlight significant gaps in the evidence base for CDSM interventions. Conclusions: This review identifies gaps in the consistent reporting of key CDSM components in systematic reviews of HFrEF interventions. The inconsistent inclusion of all three components together and limited reporting of long-term outcomes may hinder the development of a robust evidence base for the adoption of these tools in HF guidelines. Future studies should prioritize comprehensive reporting to strengthen the foundation for patient-centric self-management strategies in HF care. PROSPERO registration number CRD42023431539. Full article
(This article belongs to the Special Issue Clinical Management of Patients with Heart Failure—2nd Edition)
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Other

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13 pages, 867 KiB  
Systematic Review
The Role of ARNI in Enhancing Outcomes of Cardiac Resynchronization Therapy: A Comprehensive Review
by Oana Pătru, Silvia Luca, Dragoș Cozma, Cristina Văcărescu, Simina Crișan, Mihaela Daniela Valcovici, Mirela Vîrtosu, Adrian Sebastian Zus, Constantin Tudor Luca and Simona Ruxanda Drăgan
J. Clin. Med. 2025, 14(8), 2743; https://doi.org/10.3390/jcm14082743 - 16 Apr 2025
Viewed by 372
Abstract
Background/Objectives: Cardiac resynchronization therapy (CRT) and angiotensin receptor–neprilysin inhibitors (ARNIs) are cornerstone therapies for patients with heart failure with reduced ejection fraction (HFrEF). However, nearly 30% of patients show no significant response to CRT alone. The potential of ARNI to enhance CRT outcomes—especially [...] Read more.
Background/Objectives: Cardiac resynchronization therapy (CRT) and angiotensin receptor–neprilysin inhibitors (ARNIs) are cornerstone therapies for patients with heart failure with reduced ejection fraction (HFrEF). However, nearly 30% of patients show no significant response to CRT alone. The potential of ARNI to enhance CRT outcomes—especially in non-responders—is an emerging field of interest. The objective of this review is to systematically evaluate and synthesize the available evidence on the clinical outcomes of combining CRT with ARNI therapy in patients with HFrEF. Methods: We conducted a comprehensive search of PubMed, Scopus, and Google Scholar up to September 2024, using the keywords “CRT and ARNI” and “cardiac resynchronization therapy and sacubitril/valsartan”. We included retrospective and prospective clinical studies, observational studies, and review articles reporting on patients with HFrEF treated with both CRT and ARNI. Studies not in English, animal studies, and those without full-text availability were excluded. Study selection and data extraction were performed in duplicate by independent reviewers, using PRISMA guidelines for transparency. The final selection included 8 studies published in the last four years, summarized by design, population, outcomes, and statistical significance. Results: The reviewed studies suggest that ARNI therapy, when combined with CRT, may contribute to improvements in left ventricle ejection fraction (LVEF), NYHA functional class, and ventricular remodeling, particularly in CRT non-responders. Some studies also report a potential reduction in ventricular arrhythmias and implantable cardioverter-defibrillator (ICD) interventions. However, outcomes varied across subgroups, and the influence of ARNI timing relative to CRT implantation remains inconclusive. Limitations: Heterogeneity in study designs and small sample sizes in some included studies limited the ability to conduct a meta-analysis. This review is not registered. Conclusions: ARNI therapy shows promise in enhancing CRT response in patients with HFrEF, particularly in non-responders. Further large-scale, prospective studies are needed to clarify optimal patient selection and treatment sequencing. Full article
(This article belongs to the Special Issue Clinical Management of Patients with Heart Failure—2nd Edition)
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