ESC 2021 Prof. Carolyn Lam discusses the major changes in the 2021 ESC/HFA heart failure guidelines regarding diagnosis and treatment of patients with ejection fraction above 40%.

ESC 2021 The EMPEROR-Preserved trial showed that empagliflozin significantly reduced the risk of the primary composite endpoint of CV death or HF hospitalization by 21%, compared to placebo, in patients with HF and LVEF >40%, with and without T2DM.

ESC 2021 New concepts in the 2021 HF guidelines include a simplified treatment algorithm for HFrEF, change of the HFmrEF term to heart failure with mildly reduced ejection fraction and a treatment algorithm for HFrEF according to phenotypes.

ESC 2021 EMPEROR-Pooled was a pooled analysis of the data from EMPEROR-Reduced and EMPEROR-Preserved and showed that empagliflozin, compared to placebo, reduced HF hospitalizations by ~30% in patients with HF across a range of LVEF from <25% to <65%.

Microvascular disease (MVD) was associated with the development of HF in adults with T2DM, independently of traditional risk factors including CAD.

EMPEROR-Preserved met its primary endpoint and showed a significant risk reduction with empagliflozin for the composite endpoint of time to first event of CV death or HF hospitalization compared to placebo in adults with HFpEF, with or without T2DM.

ESC HF 2021 A subanalysis of FIDELIO-DKD showed that finerenone lowered CV and kidney outcomes compared to placebo in patients with T2DM and CKD irrespective of pre-existing HF status.

ESC HF 2021 In a nation-wide HF registry, screening for iron deficiency was performed in only 27% of patients. 19% Of patients with iron deficiency received treatment with ferric carboxymaltose.

Treatment with IV ferric carboxymaltose in patients with iron deficiency who had stabilized after acute HF led to greater improvements in health-related quality of life from week 4 to week 24 after discharge, compared to placebo.

The European Commission has extended the indication for empagliflozin and empagliflozin is now also approved for the treatment of adults with HFrEF.

ACC 2021 Ablation-based rhythm control and rate control showed no statistically significant differences in the RAFT-AF trial for the primary outcome of all-cause mortality and HF events in patients with HF and high burden AF.

ACC 2021 REHAB-HF showed that individualized physical rehabilitation intervention, compared to usual care, resulted in significant improvements in physical function, frailty status, quality of life, and depression in older patients with ADHF.