HFA Cardio Talk – Details, episodes & analysis

With Emmanouil Kampanieris, University General Hospital of Heraklion, Heraklion - Greece, and Peter Van Der Meer, University Medical Centre Groningen, Groningen - The Netherlands.

In this episode, Peter Van Der Meer and Emmanouil Kampanieris discuss peripartum cardiomyopathy, a potentially life-threatening condition that presents as heart failure with reduced ejection fraction in women in the last month of pregnancy or in the months after delivery, after other causes of heart failure have been excluded.

Peripartum Cardiomyopathy is defined as cardiomyopathy occurring towards the end of pregnancy or in the months following delivery with a left ventricular (LV) ejection fraction (EF) < 45%, when other causes for heart failure have been excluded1. Its incidence differs widely depending on the geographic area being higher in developing countries, as 1:100 pregnancies in Nigeria, while in developed countries being lower, as 1:1500 pregnancies in Germany1. Several risk factors have been associated with Peripartum Cardiomyopathy, as pre-eclampsia and many more2. More than half of the affected individuals receiving the appropriate treatment for heart failure have a full recovery in 6 months3. The role of bromocriptine as a potential specific treatment for Peripartum Cardiomyopathy remains uncertain and randomized clinical trials are needed for determining its benefits and safety 2,4. Women willing to have a subsequent pregnancy should be counseled and monitored by a multidisciplinary team experienced with Peripartum Cardiomyopathy3.

References:

1.  Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy.

2. Peripartum Cardiomyopathy: JACC State-of-the-Art Review

3. Long-term prognosis, subsequent pregnancy, contraception and overall management of peripartum cardiomyopathy: practical guidance paper from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy

4. Bromocriptine treatment and outcomes in peripartum cardiomyopathy: the EORP PPCM registry

This 2024 HFA CardioTalk podcast serie is supported by Novartis in the form of an educational grant. The discussion has not been influenced in any way by its sponsor.

With Nicolas Verheyen, Medical University of Graz, Graz - Austria, and Lars Kober, Rigshospitalet, Copenhagen University Hospital, Copenhagen - Denmark. 

In this episode of HFA CardioTalk, Nicolas Verheyen interviews Lars Kober on controversies in ICD/CRT implantation in non-ischemic cardiomyopathy for primary prevention. They focus in particular on the importance of selecting the right patients, and discuss biomarkers beyond left ventricular ejection fraction that may add value in predicting sudden death risk, and the need of randomized controlled trials with adequate endpoint selection to guide prophylactic ICD implantation.

Related scientific paper:

• 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
• 2023 ESC Guidelines for the management of cardiomyopathies
• Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure
• 2023 ESC Guidelines for the management of cardiomyopathies: Developed by the task force on the management of cardiomyopathies of the European Society of Cardiology (ESC)

This 2024 HFA CardioTalk podcast serie is supported by Novartis in the form of an educational grant. The discussion has not been influenced in any way by its sponsor.

With Antonio Cannata, King’s College London - UK and Folkert Asselbergs, Amsterdam University Medical Centre - Netherlands.

In this episode of HFA CardioTalk Antonio Cannata interviews one of the pioneer in digital medicine and artificial intelligence in cardiovascular medicine, Prof Folkert Asselbergs. Several interesting insights were discussed on the present role of AI in Heart Failure and what the future holds. 

"This 2024 HFA CardioTalk podcast series is supported by Novartis in the form of an educational grant. The discussion has not been influenced in any way by its sponsor."

With Henrike Arfsten,Medical University of Vienna - Austria & Antoni Bayes-Genis, Heart Institute, University Hospital Germans Trias and Pujol de Badalona - Spain

In this episode of HFA CardioTalk, Henrike Arfsten interviews Antoni Bayes-Genis on circulating biomarkers in heart failure. They focus in particular on natriuretic peptides and discuss the benefits of biomarkers assessment and their fundamental role in heart failure diagnosis and disease progression.

NEW! If you want to know more on this topic, access some recommended readings from the speakers:

- Bayes-Genis A, et al.; Eur J Heart Fail. 2023 Sep 15

- Mueller C, et al.; Eur J Heart Fail. 2019 Jun;21(6):715-731.

- Bayes-Genis A, et al.; Eur J Heart Fail. 2021:23,1432–1436.

- Huelsmann M, et al.; J Am Coll Cardiol. 2013 Oct 8;62(15):1365-72

- Tsutsui H, et al; Eur J Heart Fail. 2023 May;25(5):616-631.

With Chris Kapelios, Onassis Cardiac Surgery Center, Athens - Greece & Gianluigi Savarese, Karolinska University Hospital, Stockholm - Sweden.

This HFA CardioTalk podcast episode addresses Clinical inertia and optimization of heart failure therapy.

The data we have on use of HF medications come from registries and may not be generalizable to unselected, real-world populations. The proportion of HFrEF patients treated with optimal medical therapy differs considerably among registries (between 70% to >90% for a beta-blocker, 60% to >90% for RASi, 15-45% for ARNI, 30-60% for MRA). It is well documented that optimal HFrEF treatment leads to better quality of life, and reduction in mortality, HF hospitalizations and healthcare costs. Clinical inertia is the lack of treatment intensification in patients not on optimized therapy. Its manifestations may differ from country to country, but it is always present, irrespective of whether the approach to HF medication initiation is sequential or in parallel. Increase of awareness, collaboration of all healthcare professionals, and use of checklists and digital tools are among the measures we can apply to tackle clinical inertia.

With Antonio Cannata, King’s College London, London - UK & Stuart Pocock, London School of Hygiene & Tropical Medicine, London - UK.

In this episode of HFA CardioTalk, Antonio Cannata interviews Stuart Pocock on how to understand randomised clinical trials. From the use of observational data to the key points in critically interpreting the results. Don’t forget: a p value is no substitute for a brain. 

With Henrike Arfsten, University of Vienna, Vienna - Austria, Juan Pablo Kaski, University College London, London - United Kingdom, Mateusz Sokolski, Wroclaw Medical University, Wroclaw - Poland, Jozine ter Maaten, University Medical Center Groningen, Groningen - the Netherlands, Peter van der Meer, University Medical Center Groningen, Groningen - the Netherlands, Antonio Cannata, King's College London, London - United Kingdom & Theresa McDonagh, King's College Hospital, London, United Kingdom.

This podcast discusses two new guidelines and the results of two hot line presentation all presented at the ESC congress 2023 in Amsterdam, the Netherlands. First, Prof. Kaski shares highlights from the new and first ESC cardiomyopathy guidelines. Second, Prof. van der Meer discusses the results from the STEP HFpEF study in which semaglutide showed beneficial effect on weight, 6MWT and a win ratio compared to placebo in patients with the obesity phenotype of HFpEF. Next, Dr. ter Maaten discusses the results of the first randomized trial investigating the effect of natriuresis guided diuretic therapy in acute heart failure, as already incorporated in the guidelines. Finally, Prof. McDonagh walks us through the update of the ESC heart failure guidelines. The podcast is concluded with a brief discussion of some HFA Young highlights at the congress. 

With Wilfred Mullens, Hospital Oost-Limburg (ZOL) and Hasselt University - Belgium & Alberto Esteban-Fernández, Hospital Universitario Severo Ochoa y Alfonso X El Sabio University - Spain. 

 This podcast addresses some of the main developments in congestion management in heart failure patients, especially those with cardiorenal syndrome. We discuss the ADVOR and CLOROTIC trials and their implications for clinical practice.

With Amitai Segev, Sheba Medical Center, Ramat Gan - Israel and Massimo Francesco Piepoli, IRCCS San Donato Polyclinic, San Donato Milanese - Italy

In this episode of HFA Cardio Talk, we dive into the world of heart failure prevention with our esteemed guest, Prof. Massimo Piepoli, an eminent figure in preventive cardiology, as he is interviewed by Dr. Amitai Segev. Join us as we discuss the importance of heart failure prevention in modern cardiology, explore practical evidence-based measures, and address key topics in the field. Tune in for an engaging and informative conversation filled with valuable insights and actionable tips for promoting cardiovascular health.

With Interviewee: Doctor Tuvia Ben Gal, Rabin Medical Center, Petah Tikva, Israel and Interviewer: Doctor Cornelia Margineanu, Emergency Institute of Cardiovascular Diseases Prof. Dr. C.C. Iliescu, Bucharest, Romania.

In this podcast, Dr Cornelia Margineanu from Bucharest, Romania interviews professor Tuvia Ben Gal from Petah Tikva, Israel on cardiac transplantation. Throughout the podcast, the expert shares a wealth of knowledge, drawing from years of experience and expertise in the field regarding indications, outcomes, specific management and also, valuable practical advice.