Background: Heart failure with preserved ejection fraction (HFpEF) poses global diagnostic and therapeutic challenges, with potential regional differences in clinical practice that remain underexplored. This study aimed to map physician-reported HFpEF diagnostic and management practices across Europe and the Middle East-North Africa (MENA) region to identify similarities, differences and opportunities for improved care.
Methods: An independent, academically developed survey consisting of 29 questions was designed through expert collaboration to capture detailed information on physician demographics, diagnostic strategies, screening practices, pathophysiological understanding and treatment approaches for HFpEF.
BMJ Open
August 2025
Objectives: Regional differences in heart failure with preserved ejection fraction (HFpEF) care have been reported. We aimed to assess a physician-reported HFpEF management in the Russian Federation (RF) and a variation in the diagnosis and treatment of HFpEF between the RF and the European Union (EU).
Design/settings: It is a post hoc analysis of an academic web-based international HFpEF designed as a cross-sectional survey and conducted between May 2023 and July 2023.
Card Fail Rev
June 2025
Recent advances in the pharmacological therapy of heart failure with reduced ejection fraction (HFrEF) have significantly impacted the overall survival, heart failure hospitalisations and rates of sudden cardiac death (SCD). In this context, the relevant timing of placing ICDs as primary prevention is a matter of on-going debate. This manuscript provides evidence for an updated view regarding the timing of implanting ICD in eligible patients with HFrEF receiving optimal guideline-directed medical therapy, accounting for the timing to reverse cardiac remodelling (RCR) occurrence and residual SCD risks over time.
View Article and Find Full Text PDFThe aim of this study was to evaluate the subclinical patterns and evolution of cardiac abnormalities via transthoracic echocardiography (TTE) in patients with mild initial COVID-19 illness. A total of 343 infected individuals (163 males; age 44 (interquartile range, IQR 35-52) years) years) underwent serial TTE assessments at a median of 109 (interquartile range (IQR), 77-177) and 327 (276-379) days after infection. Compared with those of non-COVID-19-infected controls (n = 94, male n = 49), baseline systolic (LVEF, TAPSE) and diastolic function (e', a', E/e') were significantly different in infected participants (p < 0.
View Article and Find Full Text PDFThe management of heart failure with preserved ejection fraction (HFpEF) remains largely unresolved due to our limited understanding of the underlying mechanisms of the pathology and the challenges in accurately phenotyping this heterogeneous syndrome. A paradigm shift is required to personalise care and unify our approaches to HFpEF patients for future clinical trials. Accordingly, we propose a staging classification for HFpEF based on the identification of the involved cardiac chambers by echocardiography.
View Article and Find Full Text PDFBeing commonly diagnosed in elderly women and associated with comorbidities as well as ageing-related cardio-vascular changes, heart failure with preserved ejection fraction (HFpEF) has been recently considered as a distinct cardiogeriatric syndrome. Frailty is another frequent geriatric syndrome. HFpEF and frailty share common underlying mechanisms, often co-exist, and represent each other's risk factors.
View Article and Find Full Text PDFLingering cardiac symptoms are increasingly recognised complications of severe acute respiratory syndrome coronavirus 2 infection, now referred to as post-acute cardiovascular sequelae of COVID-19 (PASC). In the acute phase, cardiac injury is driven by cytokine release and stems from ischaemic and thrombotic complications, resulting in myocardial necrosis. Patients with pre-existing cardiac conditions are particularly vulnerable.
View Article and Find Full Text PDFOpen Heart
August 2023
Introduction: Systemic low-grade inflammation is a fundamental pathophysiological mechanism of heart failure with preserved left ventricular ejection fraction (HFpEF). The efficacy of anti-inflammatory therapy in HFpEF is largely understudied. The aim of the study is to assess the anti-inflammatory effect of colchicine in HFpEF by looking at inflammatory biomarkers: high-sensitivity C reactive protein (hsCRP) and soluble suppression of tumorigenicity 2 (sST2).
View Article and Find Full Text PDFCritically ill COVID-19 patients have a high incidence of thromboembolic events, which significantly influence the risk of mortality. Anticoagulant therapy is generally recommended to these patients but the optimal dosing regimens require further investigations. The objective of this systematic review and meta-analysis was to assess the efficacy and safety of prophylactic, intermediate and therapeutic dose anticoagulation in COVID-19 patients admitted to the ICU.
View Article and Find Full Text PDFEur J Heart Fail
February 2023
Cardiac symptoms are increasingly recognized as late complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in previously well individuals with mild initial illness, but the underlying pathophysiology leading to long-term cardiac symptoms remains unclear. In this study, we conducted serial cardiac assessments in a selected population of individuals with Coronavirus Disease 2019 (COVID-19) with no previous cardiac disease or notable comorbidities by measuring blood biomarkers of heart injury or dysfunction and by performing magnetic resonance imaging. Baseline measurements from 346 individuals with COVID-19 (52% females) were obtained at a median of 109 days (interquartile range (IQR), 77-177 days) after infection, when 73% of participants reported cardiac symptoms, such as exertional dyspnea (62%), palpitations (28%), atypical chest pain (27%) and syncope (3%).
View Article and Find Full Text PDFAims: Women's participation is steadily growing in medical schools, but they are still not sufficiently represented in cardiology, particularly in cardiology leadership positions. We present the contemporary distribution of women leaders in cardiology departments in the World Health Organization European region.
Methods And Results: Between August and December 2020, we applied purposive sampling to collect data and analyse gender distribution of heads of cardiology department in university/third level hospitals in 23 countries: Austria, Azerbaijan, Belgium, Bosnia-Herzegovina, Croatia, France, Germany, Greece, Italy, North Macedonia, Morocco, Poland, Portugal, Russia, Serbia, Slovakia, Slovenia, Spain, Switzerland, Tunisia, Turkey, Ukraine, and the UK.
Kardiol Pol
May 2022
: COVID-19 is causing considerable morbidity and mortality worldwide. Serious respiratory complications aside, the heart is also frequently involved. The mechanisms and the extent of the myocardial injury, along with the short and long-term cardiovascular (CV) outcomes in COVID-19 survivors remain unclear.
View Article and Find Full Text PDFImportance: Coronavirus disease 2019 (COVID-19) continues to cause considerable morbidity and mortality worldwide. Case reports of hospitalized patients suggest that COVID-19 prominently affects the cardiovascular system, but the overall impact remains unknown.
Objective: To evaluate the presence of myocardial injury in unselected patients recently recovered from COVID-19 illness.
Aims: Conflicting data exist supporting differing mechanisms for sustaining ventricular fibrillation (VF), ranging from disorganized multiple-wavelet activation to organized rotational activities (RAs). Abnormal gap junction (GJ) coupling and fibrosis are important in initiation and maintenance of VF. We investigated whether differing ventricular fibrosis patterns and the degree of GJ coupling affected the underlying VF mechanism.
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