Cor Vasa 2022, 64(Suppl. 4):59-71

The year in cardiovascular medicine 2021: heart failure and cardiomyopathies

Johann Bauersachs^1*, Rudolf A. de Boer², Joann Lindenfeld³, Biykem Bozkurt⁴

¹ Department of Cardiology and Angiology, Hannover Medical Schoo, Carl-Neuberg-Straße 1, 30625 Hannover, Germany

² Department of Cardiology, University Medical Center Groningen

³ Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center

⁴ Winters Center for Heart Failure, Cardiology, Baylor College of Medicine and Michael E. DeBakey VA Medical Center

Received Date: 16 September 2021; Revision received Date: 27 October 2021; Accepted Date: 16 November 2021
Reproduced from: Bauersachs J, de Boer RA, Lindenfeld J, Bozkurt B. The year in cardiovascular medicine 2021: heart failure and cardiomyopathies. Eur Heart J 2022;43:367–376. https://doi.org/10.1093/eurheartj/ehab887, by permission of Oxford University Press on behalf of the European Society of Cardiology

In the year 2021, the universal defi nition and classifi cation of heart failure (HF) was published that defi nes HF as a clinical syndrome with symptoms and/or signs caused by a cardiac abnormality and corroborated by elevated natriuretic peptide levels or objective evidence of cardiogenic congestion. This defi nition and the classifi cation of HF with reduced ejection fraction (HFrEF), mildly reduced, and HF with preserved ejection fraction (HFpEF) is consistent with the 2021 ESC Guidelines on HF. Among several other new recommendations, these guidelines give a Class I indication for the use of the sodium–glucose co-transporter 2 (SGLT2) inhibitors dapaglifl ozin and empaglifl ozin in HFrEF patients. As the fi rst evidence-based treatment for HFpEF, in the EMPEROR-Preserved trial, empaglifl ozin reduced the composite endpoint of cardiovascular death and HF hospitalizations. Several reports in 2021 have provided novel and detailed analyses of device and medical therapy in HF, especially regarding sacubitril/valsartan, SGLT2 inhibitors, mineralocorticoid receptor antagonists, ferric carboxymaltose, soluble guanylate cyclase activators, and cardiac myosin activators. In patients hospitalized with COVID-19, acute HF and myocardial injury is quite frequent, whereas myocarditis and long-term damage to the heart are rather uncommon.

Keywords: Heart failure; Epidemiology; Imaging; Biomarkers; Pharmacotherapy; Artifi cial intelligence; SGLT-2 inhibitor; Angiotensin receptor–neprilysin inhibitors; Activators of soluble guanylate cyclase; Device therapy

Received: June 22, 2022; Revised: June 22, 2022; Accepted: July 3, 2022; Published: December 30, 2022  Show citation