With Chris Kapelios, Onassis Cardiac Surgery Center, Athens - Greece & Gianluigi Savarese, Karolinska University Hospital, Stockholm - Sweden.

This HFA CardioTalk podcast episode addresses Clinical inertia and optimization of heart failure therapy.

The data we have on use of HF medications come from registries and may not be generalizable to unselected, real-world populations. The proportion of HFrEF patients treated with optimal medical therapy differs considerably among registries (between 70% to >90% for a beta-blocker, 60% to >90% for RASi, 15-45% for ARNI, 30-60% for MRA). It is well documented that optimal HFrEF treatment leads to better quality of life, and reduction in mortality, HF hospitalizations and healthcare costs. Clinical inertia is the lack of treatment intensification in patients not on optimized therapy. Its manifestations may differ from country to country, but it is always present, irrespective of whether the approach to HF medication initiation is sequential or in parallel. Increase of awareness, collaboration of all healthcare professionals, and use of checklists and digital tools are among the measures we can apply to tackle clinical inertia.

With Antonio Cannata, King’s College London, London - UK & Stuart Pocock, London School of Hygiene & Tropical Medicine, London - UK.

In this episode of HFA CardioTalk, Antonio Cannata interviews Stuart Pocock on how to understand randomised clinical trials. From the use of observational data to the key points in critically interpreting the results. Don’t forget: a p value is no substitute for a brain. 

With Henrike Arfsten, University of Vienna, Vienna - Austria, Juan Pablo Kaski, University College London, London - United Kingdom, Mateusz Sokolski, Wroclaw Medical University, Wroclaw - Poland, Jozine ter Maaten, University Medical Center Groningen, Groningen - the Netherlands, Peter van der Meer, University Medical Center Groningen, Groningen - the Netherlands, Antonio Cannata, King's College London, London - United Kingdom & Theresa McDonagh, King's College Hospital, London, United Kingdom.

This podcast discusses two new guidelines and the results of two hot line presentation all presented at the ESC congress 2023 in Amsterdam, the Netherlands. First, Prof. Kaski shares highlights from the new and first ESC cardiomyopathy guidelines. Second, Prof. van der Meer discusses the results from the STEP HFpEF study in which semaglutide showed beneficial effect on weight, 6MWT and a win ratio compared to placebo in patients with the obesity phenotype of HFpEF. Next, Dr. ter Maaten discusses the results of the first randomized trial investigating the effect of natriuresis guided diuretic therapy in acute heart failure, as already incorporated in the guidelines. Finally, Prof. McDonagh walks us through the update of the ESC heart failure guidelines. The podcast is concluded with a brief discussion of some HFA Young highlights at the congress. 

With Wilfred Mullens, Hospital Oost-Limburg (ZOL) and Hasselt University - Belgium & Alberto Esteban-Fernández, Hospital Universitario Severo Ochoa y Alfonso X El Sabio University - Spain. 

 This podcast addresses some of the main developments in congestion management in heart failure patients, especially those with cardiorenal syndrome. We discuss the ADVOR and CLOROTIC trials and their implications for clinical practice.

With Amitai Segev, Sheba Medical Center, Ramat Gan - Israel and Massimo Francesco Piepoli, IRCCS San Donato Polyclinic, San Donato Milanese - Italy

In this episode of HFA Cardio Talk, we dive into the world of heart failure prevention with our esteemed guest, Prof. Massimo Piepoli, an eminent figure in preventive cardiology, as he is interviewed by Dr. Amitai Segev. Join us as we discuss the importance of heart failure prevention in modern cardiology, explore practical evidence-based measures, and address key topics in the field. Tune in for an engaging and informative conversation filled with valuable insights and actionable tips for promoting cardiovascular health.

With Interviewee: Doctor Tuvia Ben Gal, Rabin Medical Center, Petah Tikva, Israel and Interviewer: Doctor Cornelia Margineanu, Emergency Institute of Cardiovascular Diseases Prof. Dr. C.C. Iliescu, Bucharest, Romania.

In this podcast, Dr Cornelia Margineanu from Bucharest, Romania interviews professor Tuvia Ben Gal from Petah Tikva, Israel on cardiac transplantation. Throughout the podcast, the expert shares a wealth of knowledge, drawing from years of experience and expertise in the field regarding indications, outcomes, specific management and also, valuable practical advice.

Interviewees: Associate Professor Jasper Brugts, Erasmus University Medical Centre of Rotterdam, The Netherlands; Professor John Cleland and Doctor Ross Campbell, University of Glasgow, United Kingdom of Great Britain & Northern Ireland; Doctor Jeroen Dauw AZ Saint-Lucas, Ghent, Belgium and Interviewers: Doctor Antonio Cannata, King's College London, United Kingdom of Great Britain & Northern Ireland; Doctor Jozine Ter Maaten, University Medical Centre Groningen, The Netherlands; Doctor Sotiria Liori, Attikon University Hospital, Athens, Greece; Doctor Francesca Musella, Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland.

This podcast discusses the results of four late breaking clinical trials presented at the Heart Failure congress 2023 in Prague, Czech. First, dr. Brugts shares the results of the MONITOR-HF trial, an open-label, randomized trial showing that haemodynamic monitoring using a cardioMEMS device, significantly improved quality of life and reduced heart failure hospitalizations in patients with moderate-to-severe heart failure. This trial was simultaneously published in the Lancet (Remote haemodynamic monitoring of pulmonary artery pressures in patients with chronic heart failure (MONITOR-HF): a randomised clinical trial - The Lancet). Second, dr. Cleland walks us through a population study from the greater Glasgow area that found that use of loop diuretics in patients without a diagnosis of heart failure was associated with poor outcomes. He consequently discusses possible explanations and clinical consequences. Third, dr. Campbell shares the results of the DAPA-RESIST trial, that found that in patients with diuretic resistance, dapagliflozin was not superior to metolazone at relieving congestion (Dapagliflozin versus metolazone in heart failure resistant to loop diuretics | European Heart Journal | Oxford Academic (oup.com)). Fourth, dr. Dauw discusses the results of the ENACT-HF trial where a strategy of natriuresis guided therapy as recommended by the HF guidelines, in an open label, sequential roll-out (first 10 patients standard of care, followed by 10-30 patients in the natriuresis arm), was shown to improve natriuresis and reduced length of hospital stay. No effect on change in congestion score or in-hospital mortality was observed. The podcast is concluded with a brief discussion of some HFA Young highlights at the congress. 

With Antonio Cannata, BHF Centre of Excellence, School of Cardiovascular and Metabolic Medicine and Science. Faculty of Life Science and Medicine, King's College London, London - UK & Mauro Giacca, King's College, BHF Centre of Excellence, School of Cardiovascular and Metabolic Medicine and Science. Faculty of Life Science and Medicine, King's College London, London - UK.

In this episode, Dr Cannata interviews Prof Giacca on the present and future perspectives of translational science in Heart Failure. A deep dive into the translational world with a view on the research of the next 30 years. 

With Sotiria Liori, Attikon University Hospital, Athens - Greece and Ovidiu Chioncel, Emergency Institute for Cardiovascular Disease - Institut De Boli Cardiovasculare C.C.Iliescu, Bucharest; University of Medicine Carol Davila, Bucharest - Romania.

In the latest episode of HFA Cardio Talk, Dr. Sotiria Liori, member of the HFA Young Committee, interviews Prof. Ovidiu Chioncel on cardiogenic shock. The podcast delves into the challenges and latest advancements in the diagnosis and management of this complex condition, providing valuable insights for clinicians and researchers. Prof. Chioncel shares his extensive knowledge on the importance of hemodynamic monitoring, the use of mechanical circulatory support devices, and other therapeutic interventions in the management of patients with cardiogenic shock. With his practical tips and tricks, Prof. Chioncel offers guidance for optimizing patient outcomes and enhancing the quality of care for this high-risk population.

With Dr. Mateusz Sokolski, Wroclaw Medical University – Poland and Prof. Finn Gustafsson, University of Copenhagen, Copenhagen - Denmark

In February´s HFA Cardio Talk, Finn Gustafsson, Professor of Cardiology at the University of Copenhagen, director of the advanced heart failure, transplantation and mechanical circulatory support program at Rigshospitalet in Copenhagen, Denmark and member of the HFA Board is interviewed by Dr. Mateusz Sokolski, from Wroclaw Medical University in Poland, member of the HFA Young Committee. The podcast is related to the HFA Advanced Heart Failure course 2023, discussing its aims and rationale. Moreover, the podcast covers challenges of the disease and provides tips and tricks for the management of patients with advanced heart failure and long-term mechanical circulatory support.