HFA Cardio Talk

• A multidisciplinary team approach to HF

  With Felix Lindberg, Karolinska Institute & Karolinska University Hospital, Stockholm - Sweden, Martha Kyriakou, European University of Cyprus, Nicosia - Cyprus and Maggie Simpson, University of Edinburgh, Edinburgh - UK. In this episode, Felix Lindberg, Martha Kyriakou, and Maggie Simpson discuss multidisciplinary care in heart failure, exploring why HF complexity and multimorbidity make coordinated, team-based management essential. They outline the key professional roles and how they can work together to support continuity across the HF trajectory, from diagnosis and optimisation, through decompensations, and transition to advanced therapies and palliative care. The discussion also addresses real-world gaps in implementation, and considers how the expanding roles of nurses, pharmacists, and allied professionals, alongside emerging digital tools, may shape the future of multidisciplinary HF care. Proposed reading:  Examining the clinical role and educational preparation of heart failure nurses across Europe. A survey of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the ESC. Hill et al. 2025. Eur J Heart Fail. DOI: 10.1002/ejhf.3519 Multidisciplinary Care in Heart Failure Services. Sokos et al. 2023. J Card Fail. DOI: 10.1016/j.cardfail.2023.02.011 The Core Curriculum for Cardiovascular Nurses and Allied Professionals. Neubeck et al. 2023. Eur J Cardiovasc Nurs. DOI: 10.1093/eurjcn/zvad035 How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. Stolfo et al. 2025. Eur J Heart Fail. DOI: 10.1002/ejhf.3642 Pharmacist- and Nurse-Led Medical Optimization in Heart Failure: A Systematic Review and Meta-Analysis. Zheng et al. 2023. J Card Fail. DOI: 10.1016/j.cardfail.2023.03.01 Nurse-led diuretic titration via a point-of-care urinary sodium sensor in patients with acute decompensated heart failure (EASY-HF): A single-centre, randomized, open-label study. Meekers et al. 2024. Eur J Heart Fail. DOI: 10.1002/ejhf.3429 Heart failure disease management: a systematic review of effectiveness in heart failure with preserved ejection fraction. Kalogirou et al. 2020. ESC Heart Fail. DOI: 10.1002/ehf2.12559 What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis. Jonkman et al. 2016. J Card Fail. DOI: 10.1016/j.cardfail.2016.06.422 Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Van Spall et al. 2017. Eur J Heart Fail. DOI: 10.1002/ejhf.765 This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor. 

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• Heart failure in adult congenital heart disease patients

  With Sotiria Liori, Attikon University Hospital, National and Kapodistrian University of Athens - Greece and Julie De Backer, Ghent University Hospital - Belgium. In this episode, Sotiria Liori and Julie De Backer discuss heart failure in adult congenital heart disease patients — covering how congenital lesions and prior repairs shape epidemiology and mechanisms (ventricular remodeling, valvular and conduit dysfunction, arrhythmias), as well as clinical assessment with imaging, biomarkers, and hemodynamics. They outline management with guideline-directed therapy, rhythm considerations, indications for advanced therapies (MCS and transplant), and pregnancy counseling. The episode also highlights multidisciplinary care models and key evidence gaps. Proposed reading:  General Principles of Heart Failure Management in Adult Congenital Heart Disease. Tompkins R, Romfh A. Heart Failure Reviews. 2020;25(4):555-567. doi:10.1007/s10741-019-09895-x Chronic Heart Failure in Congenital Heart Disease: A Scientific Statement From the American Heart Association. Stout KK, Broberg CS, Book WM, et al. Circulation. 2016;133(8):770-801. doi:10.1161/CIR.0000000000000352. Relation Between New York Heart Association Functional Class and Objective Measures of Cardiopulmonary Exercise in Adults With Congenital Heart Disease. Das BB, Young ML, Niu J, et al. The American Journal of Cardiology. 2019;123(11):1868-1873. doi:10.1016/j.amjcard.2019.02.053.  Heart Failure and Patient-Reported Outcomes in Adults With Congenital Heart Disease from 15 Countries. Lu CW, Wang JK, Yang HL, Kovacs AH, et al; APPROACH‐IS consortium, the International Society for Adult Congenital Heart Disease (ISACHD) *.J Am Heart Assoc. 2022 May 3;11(9):e024993. doi: 10.1161/JAHA.121.024993. Epub 2022 Apr 26. Pharmacological Therapy in Adult Congenital Heart Disease: Growing Need, Yet Limited Evidence. Brida M, Diller GP, Nashat H, et al. European Heart Journal. 2019;40(13):1049-1056. doi:10.1093/eurheartj/ehy480. Advanced Heart Failure Therapies For Adults With Congenital Heart Disease: JACC State-of-the-Art Review. Givertz MM, DeFilippis EM, Landzberg MJ, et al. Journal of the American College of Cardiology. 2019;74(18):2295-2312.doi:10.1016/j.jacc.2019.09.004. A Review of Heart Transplantation for Adults With Congenital Heart Disease. McMahon A, McNamara J, Griffin M. Journal of Cardiothoracic and Vascular Anesthesia. 2021;35(3):752-762. doi:10.1053/j.jvca.2020.07.027. Heart Failure in Adult Congenital Heart Disease: From Advanced Therapies to End-of-Life Care. Crossland DS, Van De Bruaene A, Silversides CK, Hickey EJ, Roche SL. The Canadian Journal of Cardiology. 2019;35(12):1723-1739. doi:10.1016/j.cjca.2019.07.626. This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor. 

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• Inotropes and vasodilators in heart failure

  With Tim Balthazar, University Hospital of Brussels - Belgium and Luca Fazzini, Papa Giovanni XXIII Hospital, Bergamo - Italy. In this episode of HFA CardioTalk, Luca Fazzini interviews Tim Balthazar on the contemporary use of vasodilators and inotropic agents in heart failure. The conversation explores the gaps in current guidelines, the hemodynamic profile of patients suited for vasodilator therapy, and the rationale behind choosing specific inotropes in different clinical settings. Tim Balthazar further discusses the management of patients on chronic beta-blocker therapy presenting with signs of hypoperfusion and the challenges in designing randomized trials in this field. The discussion also touches on the role of inotropes in palliative care, as well as future perspectives and emerging pharmacological strategies. This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor. 

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• The future of trials in heart failure

  With Gregorio Tersalvi, Mayo Clinic, Rochester - USA, and Faiez Zannad, University of Lorraine, Nancy - France.   In this episode of HFA CardioTalk, Gregorio Tersalvi interviews Faiez Zannad on the future of trials in heart failure. Together, they explore how the landscape of heart failure trials has evolved, the major challenges in trial design today, the relevance of current and emerging outcomes, and the vision for the next decades of heart failure research. The discussion also touches on lessons learned from landmark trials and advice for young clinicians and researchers who aspire to become trialists.   Recommended readings:  Zannad F, Pitt B. The Future of Clinical Trials. Circulation 2024 Jun 4;149(23):1783-85. doi: 10.1161/CIRCULATIONAHA.123.066982.   This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.   

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• Late-breaking clinical science from ESC Congress 2025

  In this episode, we give a wrap-up of late-breaking clinical science presented at the ESC Congress 2025 in Madrid. First, David Berg presents the DAPA ACT HF-TIMI 68 trial, reporting on dapagliflozin in patients hospitalized for acute heart failure, along with a meta-analysis of SGLT2 inhibitors in this setting. Next, Javed Butler highlights results of the VICTOR trial, a large phase 3 study of vericiguat in chronic heart failure with reduced ejection fraction. Then, Andre Zimerman discusses the PhysioSync-HF trial, comparing conduction system pacing with biventricular resynchronization therapy in patients with HFrEF. Finally, Kieran Docherty shares insights from a community-based study on the benefits of early initiation of disease-modifying therapy in suspected heart failure.   Additional information: Topic 1: With Gregorio Tersalvi, Mayo Clinic, Rochester, MN - USA, David Berg, Brigham and Women's Hospital, Boston - USA and Novi Yanti Sari, Siloam Hospitals Group, Jakarta - Indonesia Results paper: Dapagliflozin in Patients Hospitalized for Heart Failure: Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart Failure Replay ESC Congress Hot Line: https://esc365.escardio.org/presentation/312142 Circulation. 2025 Aug 29. doi: 10.1161/CIRCULATIONAHA.125.076575.    Topic 2: With Javed Butler, Baylor Scott & White Health, Dallas - USA and Henrike Arfsten, Medical University of Vienna, Vienna - Austria Results papers: Vericiguat in patients with chronic heart failure and reduced ejection fraction (VICTOR): a double-blind, placebo-controlled, randomised, phase 3 trial Lancet. 2025 Replay ESC Congress hotline: https://esc365.escardio.org/presentation/312148 doi: 10.1016/S0140-6736(25)01665-4.  Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrum: an individual participant data analysis of the VICTORIA and VICTOR trials Lancet. 2025 Aug 29:S0140-6736(25)01682-4. doi: 10.1016/S0140-6736(25)01682-4.   Topic 3: With Andre Zimerman, Hospital Moinhos De Vento, Porto Alegre - Brazil and Floran Sahiti, University Hospital of Wurzburg, Wurzburg - Germany Methods paper: Conduction system pacing vs biventricular resynchronization in heart failure with reduced ejection fraction and left bundle branch block: Rationale and design of the PhysioSync-HF Trial Am Heart J. 2025 Dec:290:38-45. Replay ESC Congress: https://esc365.escardio.org/session/50327 doi: 10.1016/j.ahj.2025.06.002.   Topic 3: With Kieran Docherty, University of Glasgow, Glasgow - UK and Jolie Bruno, Inserm UMR-S942, Paris - France Results paper: Benefit of early initiation of disease-modifying therapy in community-based patients with suspected heart failure Eur Heart J. 2025 Aug 29:ehaf675. doi: 10.1093/eurheartj/ehaf675.    This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor. 

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