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Inconsistencies in healthcare access, varying infrastructure, resource constraints and diverse local practices as well as practical and political issues restrict the global applicability of currently available guidelines. There is a need for universal recommendations that address the unique challenges faced by patients and healthcare providers worldwide. Our iCARDIO Alliance Global Implementation Guidelines emphasize the incorporation of novel therapies, while integrating standard of care with the most up-to-date evidence to enable clinicians to optimize patient care. This document is about heart failure (HF), including acute and chronic heart failure, heart failure with reduced ejection fraction and heart failure with preserved ejection fraction as well as cardiomyopathies. Context-specific recommendations tailored to individual patient needs are highlighted providing a thorough evaluation of the risks, benefits, and overall value of each therapy, aiming to establish a standard of care that improves patient outcomes and reduces the burden of hospitalization in this susceptible population. These guidelines provide evidence-based recommendations that represent a group consensus considering the many other published guidelines that have reviewed many of the issues discussed here, but they also make new recommendations where new evidence has recently emerged. Most importantly these guidelines also provide recommendations on a number of issues where resource limitations may put constraints on the care provided to HF patients. Such "economic adjustment" recommendations aim to provide guidance for situations when "Resources are somewhat limited" or when "Resources are severely limited". Hence, this document presents not only a comprehensive but also concise update to HF management guidelines thereby aiming to provide a unified strategy for the pharmacological, non-pharmacological, invasive and interventional management of this significant global health challenge that is applicable to the needs of healthcare around the globe.
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http://dx.doi.org/10.1016/j.hlc.2025.05.094 | DOI Listing |
Clin Rheumatol
September 2025
Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55906, USA.
Objectives: IgG4-related disease (IgG4-RD) can affect multiple organ systems, with coronary artery involvement being rare. Coronary periarteritis may lead to complications such as myocardial infarction and ischemic cardiomyopathy. This case series characterizes the clinical and radiological features, complications, and treatment strategies in patients with IgG4-RD-associated coronary periarteritis.
View Article and Find Full Text PDFNat Cardiovasc Res
September 2025
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Heart failure (HF) is a growing global health issue. While most studies focus on cardiomyocytes, here we highlight the role of cardiac fibroblasts (CFs) in HF. Single-cell RNA sequencing of mouse hearts under pressure overload identified six CF subclusters, with one specific to the HF stage.
View Article and Find Full Text PDFNature
September 2025
Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA.
As a key mitochondrial Ca transporter, NCLX regulates intracellular Ca signalling and vital mitochondrial processes. The importance of NCLX in cardiac and nervous-system physiology is reflected by acute heart failure and neurodegenerative disorders caused by its malfunction. Despite substantial advances in the field, the transport mechanisms of NCLX remain unclear.
View Article and Find Full Text PDFNat Commun
September 2025
Department of Biochemistry, University of Illinois, Urbana-Champaign, IL, USA.
Individuals with progressive liver failure risk dying without liver transplantation. However, our understanding of why regenerative responses are disrupted in failing livers is limited. Here, we perform multiomic profiling of healthy and diseased human livers using bulk and single-nucleus RNA- and ATAC-seq.
View Article and Find Full Text PDFThorax
September 2025
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Introduction: Breathlessness is a common cause of hospital admission globally and is associated with high mortality, particularly in low-income countries. In sub-Saharan Africa, there is a paucity of data on breathlessness, with existing data focused on individual diseases. There is a need for patient-centred approaches to understand interactions between multiple conditions to address population needs and inform health system responses.
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