With Giulia Bruno, Hospital Limerick, Limerick - Ireland and Piotr Ponikowski, Wroclaw Medical University, Wroclaw - Poland.

In this episode, Giulia Bruno is joined by Piotr Ponikowski to explore the complex interplay between valvular heart disease and heart failure. As our understanding of secondary mitral and tricuspid regurgitation evolves, new questions are emerging around prognosis, optimal timing of intervention, and the role of transcatheter therapies.

Together, they discuss how to approach management in these patients, the importance of guideline-directed medical therapy, and whether treating the valve can truly improve outcomes. This conversation highlights the challenges, current evidence, and future directions shaping this rapidly evolving field.

Recommended readings:

• 2025 ESC/EACTS Guidelines for the management of valvular heart disease: Developed by the task force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). https://doi.org/10.1093/eurheartj/ehaf194
• 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC. https://doi.org/10.1093/eurheartj/ehad195
• 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. https://doi.org/10.1093/eurheartj/ehab086
• Coats AJ et al. The management of secondary mitral regurgitation in patients with heart failure: a joint position statement from the HFA, EACVI, EHRA, and EAPCI of the ESC. European Heart Journal. 2021. https://doi.org/10.1093/eurheartj/ehab086
• Stone GW et al. Transcatheter Mitral-Valve Repair in Patients with Heart Failure. NEJM. 2018 (COAPT). DOI: 10.1056/NEJMoa1806640
• Stone GW et al. Five-Year Follow-up after Transcatheter Repair of Secondary Mitral Regurgitation. NEJM. 2023. DOI: 10.1056/NEJMoa2300213
• Sorajja P et al. Transcatheter Repair for Patients with Tricuspid Regurgitation. NEJM. 2023 (TRILUMINATE Pivotal). DOI: 10.1056/NEJMoa2300525
• Iliadis C et al. Acute heart failure and valvular heart disease: a scientific statement of the HFA, ACVC and EAPCI of the ESC. European Journal of Heart Failure. 2023. https://doi.org/10.1002/ejhf.70043

This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.