Finerenone is known to reduce the risk of worsening heart failure (HF) events and cardiovascular (CV) death in patients with HF with mildly reduced or preserved ejection fraction.

Coronary artery disease remains a common cause of morbidity and mortality for patients with heart failure, both in the acute and chronic settings. The management decisions for these patients are complex and are often driven by the clinical setting (ie, acute vs chronic disease) and predominant symptoms (angina vs heart failure). However, there remain significant gaps in the knowledge/evidence around optimal timing and implementation of medical therapy and the role and selection of patients for revascularization. Suggested considerations for clinical practice are provided based on the current body of evidence with emphasis on ongoing gaps in knowledge for future clinical research in this area.

Heart failure with preserved ejection fraction (HFpEF) has risen to become the most common form of heart failure (HF) worldwide. The pathophysiology of HFpEF is complex and intimately tied to cardiac-metabolic-kidney abnormalities, spanning cardiac, vascular, and noncardiovascular organ systems. Large-scale prospective phenotyping studies that comprehensively examine these abnormalities in the same patient are not available, an evidence gap recognized by a NHLBI (National Heart, Lung, and Blood Institute)-assembled working group of experts as a major bottleneck impeding new therapeutic innovations. Here, we present the rationale and design for the HeartShare/AMP-HF (Accelerating Medicines Partnership-Heart Failure) program, supported through the NHLBI, the FNIH (Foundation for the National Institutes of Health), the U.S. FDA (Food and Drug Administration), and multiple industry and nonprofit partners.

Despite the goal of the 2018 revision to the heart allocation policy to reduce reliance on exception requests through improved granularity in status criteria, there has been a dramatic rise in exception requests.

Recognizing the lack of disease monitoring recommendations in transthyretin amyloid cardiomyopathy (ATTR-CM), international experts convened in 2021 to propose criteria for monitoring disease progression. Data have since been published demonstrating the prognostic value of certain parameters in ATTR-CM. Additionally, increased awareness and advances in diagnostic methods have led to a shift toward diagnosis at earlier stages of disease. In light of these developments, international experts with experience in treating ATTR-CM reviewed the available data, considered the feasibility of implementing evaluations in clinical practice, and proposed an update to the 2021 criteria. The criteria, with meaningful thresholds and monitoring frequency recommendations, are specifically designed to measure disease progression in patients with ATTR-CM, rather than to define progression of amyloid deposition. It remains unknown whether disease progression is an indicator for modifications to ATTR-CM treatment. Future studies should investigate whether changes in ATTR-CM disease-modifying treatment improve outcomes in patients demonstrating disease progression.

Limited data exist on trends and differential heart failure (HF) hospitalization rates, particularly when appropriate statistical age standardization is applied.