Present and future of heart failure reviewed in Spain

Several prominent Spanish cardiologists have participated in a symposium on heart failure, held at SEC22 Heart Health Congress. In the meeting, moderated by Dr Román Freixa Pamias, cardiologist at Hospital de Sant Joan Despi Moises Broggi, the specialists reviewed most popular devices available for patients with heart failure, especially those with reduced ejection fraction (LVEF ≤ 40%), as well as the role of ‘the fantastic four’ in the slightly reduced IC-FE. They have also debated whether or not precision medicine is a reality at present, Saludadiario reports (link in Spanish).

To patients with HF with the reduced ejection fraction (LVEF ≤ 40%), doctors recommend to administer the four “pharmacological pillars” that have shown reductions in mortality and hospitalizations: neprilysin and angiotensin II receptor inhibitor (ARNI), beta blockers, mineralocorticoid receptor antagonists and inhibitors of sodium-glucose cotransporter 2 (iSGLT2), a treatment that must be optimized early and simultaneously. 

However, despite administering optimal medical treatment in patients with heart failure, “there is a residual risk of morbidity, mortality and hospitalization that makes the use of devices advisable”, as Dr. Román Freixa commented. The cardiologist emphasized that there is a wide variety of devices approved for the treatment and monitoring of patients with HF . At the symposium, an update was made on the indications and devices used in patients with electrical abnormalities (implantable cardioverter-defibrillator, cardiac resynchronization therapy, ablation), structural pathology (transcatheter mitral or tricuspid valve repair), devices for congestion monitoring (intrathoracic impedance, invasive monitoring), cardiac contractility modulation, autonomic modulation (baroreceptor, vagal or spinal cord stimulation) and many others under investigation.