Insights from late breaking clinical trials from the Heart Failure Congress 2023, Prague, Czech

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.