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