Medscape InDiscussion: Heart Failure

Drs Michelle Kittleson and Jennifer Cowger discuss navigating the future of heart failure care through durable mechanical circulatory support, including patient selection, outcomes, and upcoming advances.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/997321. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Heart Failure https://emedicine.medscape.com/article/163062-overview

The Future of Durable Mechanical Circulatory Support: Emerging Technological Innovations and Considerations to Enable Evolution of the Field https://pubmed.ncbi.nlm.nih.gov/38431185/

Impact of 2018 Allocation System Change on Outcomes in Patients With Durable Left Ventricular Assist Device as Bridge to Transplantation: A UNOS Registry Analysis https://pubmed.ncbi.nlm.nih.gov/36973093/

OPTN Policy 6: Allocation of Hearts and Heart-Lungs https://unos.org/resources/heart-lung-toolkits/

The Impella Device: Historical Background, Clinical Applications and Future Directions https://pubmed.ncbi.nlm.nih.gov/31384109/#full-view-affiliation-1

INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) Profiling Identifies Ambulatory Patients at High Risk on Medical Therapy After Hospitalizations for Heart Failure https://pubmed.ncbi.nlm.nih.gov/27834198/

Response Shift in Patient-Reported Outcomes: Definition, Theory, and a Revised Model https://pubmed.ncbi.nlm.nih.gov/33909187/

Physiology and Clinical Utility of HeartMate Pump Parameters https://pubmed.ncbi.nlm.nih.gov/34980564/

2023 Gordon Research Seminar on Assisted Circulation (GRS): Translating Mechanical Circulatory Support from Bench to Bedside to Global Implementation https://www.grc.org/assisted-circulation-grs-conference/2023/

Drs Michelle Kittleson and Ronald Oudiz dive into everything cardiologists need to know about the diagnosis and treatment of pulmonary hypertension.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/997320). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Heart Failure https://emedicine.medscape.com/article/163062-overview

Pulmonary Arterial Hypertension https://emedicine.medscape.com/article/303098-overview

Cardiac Catheterization in Pulmonary Hypertension: Doing It Right, With a Catheter on the Left https://pubmed.ncbi.nlm.nih.gov/33224785/

How to Initiate and Uptitrate GDMT in Heart Failure: Practical Stepwise Approach to Optimization of GDMT https://pubmed.ncbi.nlm.nih.gov/36456074/

Phosphodiesterase Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK559276/

Cardiovascular Biology of Prostanoids and Drug Discovery https://pubmed.ncbi.nlm.nih.gov/32295420/

Soluble Guanylate Cyclase as an Emerging Therapeutic Target in Cardiopulmonary Disease https://pubmed.ncbi.nlm.nih.gov/21606405/

Pulmonary Hypertension Association https://phassociation.org/

Drs Michelle Kittleson and Ilan Wittstein unravel the complexities of stress cardiomyopathy, discussing the challenges in diagnosis and insights into management strategies.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/997319). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Takotsubo Cardiomyopathy: Review of Broken Heart Syndrome https://pubmed.ncbi.nlm.nih.gov/32039951

Takotsubo Cardiomyopathy Following Cardiac Surgery https://pubmed.ncbi.nlm.nih.gov/26661572/

Stress Cardiomyopathy in Critical Care: A Case Series of 109 Patients https://pubmed.ncbi.nlm.nih.gov/36331975/

Immune Checkpoint Inhibitor-Associated Myocarditis: Manifestations and Mechanisms https://pubmed.ncbi.nlm.nih.gov/33645548/

Acute Stress Cardiomyopathy: Heart of Pheochromocytoma https://pubmed.ncbi.nlm.nih.gov/32988608/

Takotsubo Cardiomyopathy: Pathophysiology and Role of Cardiac Biomarkers in Differential Diagnosis https://pubmed.ncbi.nlm.nih.gov/29081904/

Short- and Long-Term Incidence of Thromboembolic Events in Takotsubo Syndrome as Compared With Acute Coronary Syndrome https://pubmed.ncbi.nlm.nih.gov/30987433/

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/26332547/

Withdrawal of Pharmacological Treatment for Heart Failure in Patients With Recovered Dilated Cardiomyopathy (TRED-HF): An Open-Label, Pilot, Randomised Trial https://pubmed.ncbi.nlm.nih.gov/30429050/

Comparison of Complications and In-Hospital Mortality in Takotsubo (Apical Ballooning/Stress) Cardiomyopathy Versus Acute Myocardial Infarction https://pubmed.ncbi.nlm.nih.gov/32762963/

Gender Differences in Patients With Takotsubo Cardiomyopathy: Multi-Center Registry From Tokyo CCU Network https://pubmed.ncbi.nlm.nih.gov/26317750/

Drs Michelle Kittleson and Richard Cheng do a deep dive into cardiac sarcoidosis, discussing everything from diagnosis to management.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/997317). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Debating the Definition and Incidence of Isolated Cardiac Sarcoidosis https://pubmed.ncbi.nlm.nih.gov/32972559/

Cardiac Sarcoidosis — State of the Art Review https://pubmed.ncbi.nlm.nih.gov/26885492/

HRS Expert Consensus Statement on the Diagnosis and Management of Arrhythmias Associated With Cardiac Sarcoidosis https://pubmed.ncbi.nlm.nih.gov/24819193/

Abstract 11937: Genetic Cardiomyopathies Misdiagnosed as Isolated Cardiac Sarcoidosis: High-Yield Results of a Systematic Screening Strategy https://www.ahajournals.org/doi/10.1161/circ.146.suppl_1.11937

Cardiac Sarcoidosis Randomized Trial (CHASM-CS-RCT) https://classic.clinicaltrials.gov/ct2/show/NCT03593759

Rituximab for the Treatment of Refractory Cardiac Sarcoidosis: A Single-Center Experience https://pubmed.ncbi.nlm.nih.gov/34320381/

Drs Michelle Kittleson and Evan Kransdorf talk about when to test, how genetic testing should be interpreted, and what to do with the results.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/997316). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Validating an Idiopathic Dilated Cardiomyopathy Diagnosis Using Cardiovascular Magnetic Resonance: The Dilated Cardiomyopathy Precision Medicine Study https://pubmed.ncbi.nlm.nih.gov/35240856/

Prevalence and Cumulative Risk of Familial Idiopathic Dilated Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/35103767

Family Heart Talk https://dcmproject.com/family-heart-talk/

Effectiveness of the Family Heart Talk Communication Tool in Improving Family Member Screening for Dilated Cardiomyopathy: Results of a Randomized Trial https://pubmed.ncbi.nlm.nih.gov/36938756/

Rare Variant Genetics and Dilated Cardiomyopathy Severity: The DCM Precision Medicine Study https://pubmed.ncbi.nlm.nih.gov/37641966/

Standards and Guidelines for the Interpretation of Sequence Variants: A Joint Consensus Recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology https://pubmed.ncbi.nlm.nih.gov/25741868/

Implications of Genetic Testing in Dilated Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/32880476/

Clinical Risk Score to Predict Pathogenic Genotypes in Patients With Dilated Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/36109106/

Screening for Dilated Cardiomyopathy in At-Risk First-Degree Relatives https://pubmed.ncbi.nlm.nih.gov/37225358/

Drs Michelle Kittleson, Anu Lala-Trindade, and Rob Mentz kick off the new season of Medscape's heart failure podcast series by describing how they leverage social media for positive change.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/997314). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Heart Failure https://emedicine.medscape.com/article/163062-overview

Journal of Cardiac Failure https://onlinejcf.com/

Diwali https://www.britannica.com/topic/Diwali-Hindu-festival

Heart Failure Society of America (HFSA) https://hfsa.org/

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://pubmed.ncbi.nlm.nih.gov/35363499/

Medscape App https://medscape.onelink.me/U6kk/dgka5w4j

Drs Michelle Kittleson and James Fang cap off the podcast series by discussing difficult cardiac transplantation decision points, including LVADs and the latest innovations in cardiac transplantation.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982166). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Heart Failure https://emedicine.medscape.com/article/163062-overview

Heart Transplantation https://emedicine.medscape.com/article/429816-overview

Lynne Warner Stevenson, MD, FHFSA https://hfsa.org/lynne-warner-stevenson-md-fhfsa

Risk Prediction Models for Survival After Heart Transplantation: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/31733026/

Evaluation for Heart Transplantation and LVAD Implantation https://njadvancedheartfailure.com/wp-content/uploads/2022/04/Zucker-Heart-Transplantation-and-LVAD-Indications.pdf

Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/30852913/

Left Ventricular Assist Devices https://www.ncbi.nlm.nih.gov/books/NBK499841/

The Burden of Haemocompatibility With Left Ventricular Assist Systems: A Complex Weave https://pubmed.ncbi.nlm.nih.gov/28329374/

Guidance and Policy Clarifications Addressing Adult Heart Allocation Policy https://optn.transplant.hrsa.gov/media/3931/guidance_policy_clarifications_address_adult_heart_allocation_policy.pdf

Heart Transplantation From Donation After Circulatory Determined Death https://pubmed.ncbi.nlm.nih.gov/29492385/

Destination Therapy With Left Ventricular Assist Devices in Non-Transplant Centres: The Time Is Right https://pubmed.ncbi.nlm.nih.gov/32419850/

Frailty and the Selection of Patients for Destination Therapy Left Ventricular Assist Device https://pubmed.ncbi.nlm.nih.gov/22438521/

Heart Transplant Advances: Ex Vivo Organ-Preservation Systems https://pubmed.ncbi.nlm.nih.gov/36004090/

First Clinical Experience With the Novel Cold Storage Sherpapak™ System for Donor Heart Transportation https://pubmed.ncbi.nlm.nih.gov/33447411/

Is the Organ Care System (OCS) Still the First Choice With Emerging New Strategies for Donation After Circulatory Death (DCD) in Heart Transplant? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9229932/

Drs Michelle M. Kittleson and Kathryn J. Lindley discuss current approaches to treating patients with peripartum cardiomyopathy as well as patients with heart failure who want to become pregnant.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982165). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Pregnancy as an Early Cardiovascular Moment: Peripartum Cardiovascular Health https://pubmed.ncbi.nlm.nih.gov/37289905/

Considerations for Specific Cardiomyopathies During Pregnancy https://pubmed.ncbi.nlm.nih.gov/37016994/

Intersection of Heart Failure and Pregnancy: Beyond Peripartum Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/33980039/

Peripartum Cardiomyopathy: Progress in Understanding the Etiology, Management, and Prognosis https://pubmed.ncbi.nlm.nih.gov/30449378/

Thyroid Disorders in Pregnancy https://pubmed.ncbi.nlm.nih.gov/23007317/

Management of Clinical Chorioamnionitis: An Evidence-Based Approach https://pubmed.ncbi.nlm.nih.gov/33007269/

Takotsubo Cardiomyopathy: A Brief Review https://pubmed.ncbi.nlm.nih.gov/32341693/

Pheochromocytoma/Paraganglioma-Associated Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/37522121/

B-Type Natriuretic Peptide and Echocardiography Reflect Volume Changes During Pregnancy https://pubmed.ncbi.nlm.nih.gov/28195551/

Peripartum Cardiomyopathy: Challenges in Diagnosis and Management https://pubmed.ncbi.nlm.nih.gov/27276444/

Postpartum Cardiomyopathy https://www.ncbi.nlm.nih.gov/books/NBK534770/

Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/34857089/

Drs Michelle Kittleson and Bonnie Ky discuss the field of cardio-oncology and how cancer treatment-related cardiotoxicity can be prevented, detected, and treated to improve the quality of cancer survivorship.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982164). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Heart Failure https://emedicine.medscape.com/article/163062-overview

Cardio-oncology: A New and Developing Sector of Research and Therapy in the Field of Cardiology https://pubmed.ncbi.nlm.nih.gov/30073443/

Cardiovascular Effects of Neuregulin-1/ErbB Signaling: Role in Vascular Signaling and Angiogenesis https://pubmed.ncbi.nlm.nih.gov/24283954/

Heart Failure in Patients With Cancer Treated With Anthracyclines-Revisiting the Foundation of Cardio-oncology https://pubmed.ncbi.nlm.nih.gov/36735260/

2022 ESC Guidelines on Cardio-oncology Developed in Collaboration With the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS) https://pubmed.ncbi.nlm.nih.gov/36017568/

Drs Michelle Kittleson and Mark Link discuss special concerns related to arrhythmias in patients with heart failure.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982163). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure https://professional.heart.org/en/science-news/2022-guideline-for-the-management-of-heart-failure

Early Treatment of Atrial Fibrillation for Stroke Prevention Trial – EAST-AFNET 4 https://www.acc.org/latest-in-cardiology/clinical-trials/2020/08/28/16/16/east-afnet-4

Pulsed Field Ablation for the Treatment of Atrial Fibrillation: PULSED AF Pivotal Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.063988

Drs Michelle Kittleson and Carolyn Ho have a delightful discussion about effective diagnosis and management for individuals with hypertrophic cardiomyopathy.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982162). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000000937 

Hypertrophic Cardiomyopathy https://www.ahajournals.org/doi/10.1161/circresaha.117.311059

Familial Hypertrophic Cardiomyopathy https://medlineplus.gov/genetics/condition/familial-hypertrophic-cardiomyopathy/

Drs Michelle Kittleson and Mathew Maurer discuss the ins and outs of diagnosing and treating TTR amyloid cardiomyopathy.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982161). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Cardiac Amyloidosis: Evolving Diagnosis and Management: A Scientific Statement From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/32476490/

Tafamidis Treatment for Patients With Transthyretin Amyloid Cardiomyopathy https://www.nejm.org/doi/full/10.1056/NEJMoa1805689

Two Decades of Cardiac Amyloidosis: A Danish Nationwide Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543084/

Drs Michelle Kittleson and James Januzzi discuss must-know intricacies of managing subgroups of patients with HFpEF.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982160). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee https://www.jacc.org/doi/10.1016/j.jacc.2023.03.393

Heart Failure With Preserved Ejection Fraction: JACC Scientific Statement https://www.jacc.org/doi/10.1016/j.jacc.2023.01.049

Drs Michelle Kittleson and Jennifer Ho discuss the vital clues to help diagnose and precisely treat heart failure with preserved ejection fraction.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982159). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063

Heart Failure With Preserved Ejection Fraction: A Kidney Disorder? https://www.ahajournals.org/doi/full/10.1161/circulationaha.116.022249

Optimal Pharmacologic Treatment of Heart Failure With Preserved and Mildly Reduced Ejection Fraction: A Meta-analysis https://pubmed.ncbi.nlm.nih.gov/36125813/

Drs Michelle Kittleson and Jason N. Katz discuss how to navigate uncertain terrain using a few rules to balance choices, risks, and goals in managing device therapy for individuals with heart failure.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982158). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Medical Management of Advanced Heart Failure https://pubmed.ncbi.nlm.nih.gov/11829703/

William Osler https://pubmed.ncbi.nlm.nih.gov/3289809/

Escalating and De-escalating Temporary Mechanical Circulatory Support in Cardiogenic Shock: A Scientific Statement From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/35862152/

Experience With Univentricular Support in Mortally Ill Cardiac Transplant Candidates https://pubmed.ncbi.nlm.nih.gov/2306148/

Drs Michelle Kittleson and Sana Al-Khatib explore the ins and outs of complex clinical decisions regarding device placement for patients who have heart failure with reduced ejection fraction.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982150). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death https://pubmed.ncbi.nlm.nih.gov/29097296/

Optimal CRT Implantation — Where and How to Place the Left-Ventricular Lead? https://pubmed.ncbi.nlm.nih.gov/34495452/

Current Device Therapies for Sudden Cardiac Death Prevention — The ICD, Subcutaneous ICD and Wearable ICD https://pubmed.ncbi.nlm.nih.gov/30389367/

Drs Michelle M. Kittleson and Gregg Fonarow share need-to-know nuances on initiating four HFrEF therapies in select patients.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982149). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

The Use of β-Blockers in Heart Failure With Reduced Ejection Fraction https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468030/

Vericiguat in Patients With Heart Failure and Reduced Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/32222134/

Soluble Guanylate Cyclase as an Emerging Therapeutic Target in Cardiopulmonary Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103045/

Transcatheter Mitral-Valve Repair in Patients With Heart Failure https://pubmed.ncbi.nlm.nih.gov/30280640/

Drs Michelle Kittleson and Biykem Bozkurt provide game-changing updates and insights on treating heart failure with reduced ejection fraction.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982148). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://pubmed.ncbi.nlm.nih.gov/35363499/

Effects of Enalapril on Mortality in Severe Congestive Heart Failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS) https://pubmed.ncbi.nlm.nih.gov/2883575/

Prescribing SGLT2 Inhibitors in Patients With CKD: Expanding Indications and Practical Considerations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9263228/

Safety, Tolerability and Efficacy of Up-titration of Guideline-Directed Medical Therapies for Acute Heart Failure (STRONG-HF): A Multinational, Open-Label, Randomised Trial https://pubmed.ncbi.nlm.nih.gov/36356631/