Novel Strategies to Improve Prescription of Guideline-Directed Medical Therapy in Heart Failure.

Purpose Of Review: To examine the emerging data for novel strategies being studied to improve use and dose titration of guideline-directed medical therapy (GDMT) for patients with heart failure (HF).

Recent Findings: There is mounting evidence to employ novel multi-pronged strategies to address HF implementation gaps.

Summary: Despite high-level randomized evidence and clear national society recommendations, a large gap persists in use and dose titration of guideline-directed medical therapy (GDMT) in patients with heart failure (HF).

Device-based therapies for decompensated heart failure.

Purpose Of Review: Despite improvements in medical therapies, patients with heart failure continue to suffer significant morbidity and mortality. Acute decompensated heart failure (ADHF) remains a common and serious medical condition with a myriad of implications on patient survival and quality of life, and heart failure related readmissions persist [1-3].

Recent Findings: From the detection of prehospitalization decompensation and inpatient management of ADHF to stabilization of cardiogenic shock and durable mechanical circulatory support, device-based therapies are utilized across the spectrum of heart failure management.

Outcomes of Early Versus Delayed Transcatheter Closure of Post-Myocardial Infarction Ventricular Septal Defect.

Background: Post myocardial infarction ventricular septal defect (VSD) is a rare, but devastating complication which carries a poor prognosis if left untreated. Optimal therapy remains unclear and surgical repair is associated with high mortality.

Objective: The aim of our study is to compare 30-day survival in patients with early versus late primary transcatheter repair of post myocardial infarction ventricular septal defect.

Body surface area and medication dosing in patients with heart failure with reduced ejection fraction.

Multiple medications are proven to reduce morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), but data regarding personalized approaches to optimize medication dosing remain limited. Current treatment guidelines recommend up-titration to target or maximally tolerated doses of these medications, yet use and dosing remain suboptimal in clinical practice. Body surface area (BSA) is a readily available clinical metric, used for dosing many medications, closely associated with blood pressure, renal function, and vascular congestion, and may influence efficacy, safety, and tolerability of HFrEF medications.