Worsening Heart Failure | Episode Three

From Lab to Life

For CME Information and to Claim Your Credit: www.iridiumce.com/hf

Host:

• Dr. Bob Underwood

Guest:

• Dr. Deepak Bhatt
  • Director of Mount Sinai Heart
  • Dr. Valentin Fuster Professor of Cardiovascular Medicine at Icahn School of Medicine

Supported by:

• Independent educational grant from Merck, Sharp, and Dohme

Episode Overview:
In this episode, Dr. Bob Underwood and Dr. Deepak Bhatt discuss novel heart failure medications for both heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). They explore the latest advancements in treatment, including the four pillars of heart failure care and emerging medications like SGLT2 inhibitors and ARNI, backed by key clinical trials.

Key Takeaways:

• Four Pillars of Heart Failure Treatment:
  • The core therapies for HFrEF include beta-blockers, ACE inhibitors or ARNI, mineralocorticoid receptor antagonists (MRAs), and SGLT2 inhibitors. Each plays a distinct role in improving heart failure outcomes, reducing hospitalizations, and decreasing mortality.
• SGLT2 Inhibitors:
  • Originally developed for diabetes, SGLT2 inhibitors now show significant heart failure benefits in both HFrEF and HFpEF patients, regardless of diabetes status. Key trials, such as DAPA-HF and EMPEROR, highlight their efficacy.
• ARNI (Sacubitril/Valsartan):
  • Trials like PARADIGM-HF and PIONEER-HF established ARNI as a key therapy in reducing cardiovascular deaths and hospitalizations in patients with HFrEF, with potential benefit in those with lower ejection fractions within HFpEF.
• GLP-1 Receptor Agonists:
  • Medications like semaglutide, primarily used for diabetes and obesity, are now being investigated for their benefits in heart failure, particularly HFpEF, through trials like STEP-HFpEF, which show improvements in patient symptoms and quality of life.
• 2022 Guidelines for Heart Failure:
  • The updated AHA/ACC/HFSA guidelines emphasize the four pillars of heart failure care for HFrEF and recommend expanding SGLT2 inhibitor use for HFpEF. They highlight the importance of integrating new treatments to optimize patient outcomes.

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