With Liemena Harold Adrian, Syarifah Ambami Rato Ebu General Academic Hospital, Surabaya - Indonesia and Shelley Zieroth, St. Boniface Hospital, Winnipeg - Canada.

In this episode, Liemena Harold Adrian and Shelley Zieroth discuss heart failure in post–myocardial infarction patients, covering how myocardial infarction leads to the development of heart failure despite advances in reperfusion and acute care. The conversation addresses the epidemiology and underlying pathophysiology, approaches to early prevention and screening, diagnostic tools, as well as key interventions in the acute and early post-MI phases that may alter heart failure trajectories. They outline management with guideline-directed medical therapy, review current studies on heart failure–modifying therapies (such as the DAPA-MI and EMPACT-MI trials), and address indications for advanced therapies in post-MI populations. The episode also highlights the importance of early diagnosis, prompt recognition, and key evidence gaps in the field.

Recommended readings:

• Akhtar KH, Khan MS, Baron SJ, et al. The Spectrum of Post-Myocardial Infarction Care: From Acute Ischemia to Heart Failurehttps://doi.org/10.1016/j.pcad.2024.01.017. Prog Cardiovasc Dis. (2024); 82: 15-25. DOI: 10.1016/j.pcad.2024.01.017.
• Butler J, Hammonds K, Talha KM, et al. Incident Heart Failure and Recurrent Coronary Events Following Acute Myocardial Infarctionhttps://doi.org/10.1093/eurheartj/ehae885. Eur Heart J (2025); 46: 1540-50. DOI: 10.1093/eurheartj/ehae885.
• Butler J, Jones WS, Udell JA. Empagliflozin after Acute Myocardial Infarction. N Engl J Med (2024); 390: 1455-66. DOI: 10.1056/NEJMoa2314051.
• Fioretti F, Butler J, Udell JA, et al. Empagliflozin after myocardial infarction with or without diabetes and chronic kidney disease: Insights from EMPACT-MI. ESC Heart Failure (2025); 12: 3940-3952. DOI: 10.1002/ehf2.15393.
• Hernandez AF, Udell JA, Jones WS. Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial. Circulation (2024); 149: 1627–1638. DOI: 10.1161/CIRCULATIONAHA.124.069217.
• Jenca D, Melenovsky V, Stehlik J, et al. Heart Failure after Myocardial Infarction: Incidence and Predictors. ESC Heart Failure (2021): 8: 222-237. DOI: 10.1002/ehf2.13144.
• Lala A, Beavers C, Blumer V, et al. The Continuum of Prevention and Heart Failure in Cardiovascular Medicine: A Joint Scientific Statement from the Heart Failure Society of America and The American Society for Preventive Cardiology. Journal of Cardiac Failure (2026); 32: 75-105.
• Petrie MC, Udell JA, Anker SD, et al. Empagliflozin in Acute Myocardial Infarction in Patients with and without Type 2 Diabetes: A Pre-specified Analysis of the EMPACT-MI Trial. Eur J of Heart Fail. (2025): 27: 577-588. DOI: 10.1002/ejhf.3548.
• Zieroth S, Rizi SS. Time Is of the Essence. JACC: Heart Failure (2023): 11(6): 713-714. DOI: 10.1016/j.jchf.2023.03.022

"This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsors."

With Felix Lindberg, Karolinska Institutet & Södersjukhuset Hospital, Stockholm – Sweden and Marianna Fontana, National Amyloidosis Center, University College London, London – UK.

In this episode, Felix Lindberg and Marianna Fontana discuss the evolving landscape in the treatment of cardiac amyloidosis. After exploring the pathophysiology of cardiac AL and ATTR amyloidosis and recent years' insights about the epidemiology of these conditions, they focus on the transformation that has occurred in the therapeutic options for cardiac ATTR amyloidosis. The conversation addresses the key mechanistic differences and trial data on stabilizers and silencers, how to approach patient selection for these therapies, as well as emerging therapies including anti-amyloid antibodies. The discussion also highlights the importance of early diagnosis and key red flags that should elicit suspicion of cardiac amyloidosis.

• Vutisiran in patients with transthyretin amyloidosis with cardiomyopathy. Fontana M, et al. N Engl J Med. 2025.
• Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy. Maurer M, et al. N Engl J Med. 2018.
• Efficacy and safety of acoramidis in tranthyretin amyloid cardiomyopathy. Gillmore JD, et al. N Engl J Med. 2024.
• CRISPR-Cas9 gene editing with nexiguran ziclumeran for ATTR cardiomyopathy. Fontana M, et al. N Engl J Med. 2024.
• Conventional heart failure therapy in cardiac ATTR amyloidosis. Ioannou A, et al. Eur Heart J. 2023.
• Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Gillmore JD, et al. Circulation. 2016.
• Current landscape of therapies for transthyretin amyloid cardiomyopathy. Griffin JM, et al. JACC Heart Fail. 2025.
• Transthyretin amyloid cardiomyopathy: from cause to novel treatments. Fontana M, et al. Eur Heart J. 2026.
• Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases. Garcia-Pavia P, et al. Eur Heart J. 2021.

This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Maria Tereza Sampaio de Sousa Lira, Federal University of Pernambuco - Brazil and Anja Zupan Meznar, University Medical Centre Ljubljana - Slovenia.

This episode will discuss when conduction system pacing (CSP) may be the appropriate pacing strategy for heart failure patients, particularly those with pacing-induced dyssynchrony or suspected pacing-induced cardiomyopathy (PICM).

Key talking points include:

• Clinical clues and diagnostic approach to PICM

• Differentiating PICM from other causes of LV dysfunction

• When to consider CRT upgrade in pacemaker patients

• Insights from the BUDAPEST-CRT upgrade trial

• Advantages and limitations of CSP (His-bundle and left bundle branch pacing)

• Practical take-home message for clinicians managing HF patients with pacemaker

This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsors.

With Felix Lindberg, Karolinska Institute & Karolinska University Hospital, Stockholm - Sweden, Martha Kyriakou, European University of Cyprus, Nicosia - Cyprus and Maggie Simpson, University of Edinburgh, Edinburgh - UK.

In this episode, Felix Lindberg, Martha Kyriakou, and Maggie Simpson discuss multidisciplinary care in heart failure, exploring why HF complexity and multimorbidity make coordinated, team-based management essential.

They outline the key professional roles and how they can work together to support continuity across the HF trajectory, from diagnosis and optimisation, through decompensations, and transition to advanced therapies and palliative care.

The discussion also addresses real-world gaps in implementation, and considers how the expanding roles of nurses, pharmacists, and allied professionals, alongside emerging digital tools, may shape the future of multidisciplinary HF care.

• Examining the clinical role and educational preparation of heart failure nurses across Europe. A survey of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the ESC. Hill et al. 2025. Eur J Heart Fail. DOI: 10.1002/ejhf.3519
• Multidisciplinary Care in Heart Failure Services. Sokos et al. 2023. J Card Fail. DOI: 10.1016/j.cardfail.2023.02.011
• The Core Curriculum for Cardiovascular Nurses and Allied Professionals. Neubeck et al. 2023. Eur J Cardiovasc Nurs. DOI: 10.1093/eurjcn/zvad035
• How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. Stolfo et al. 2025. Eur J Heart Fail. DOI: 10.1002/ejhf.3642
• Pharmacist- and Nurse-Led Medical Optimization in Heart Failure: A Systematic Review and Meta-Analysis. Zheng et al. 2023. J Card Fail. DOI: 10.1016/j.cardfail.2023.03.01
• Nurse-led diuretic titration via a point-of-care urinary sodium sensor in patients with acute decompensated heart failure (EASY-HF): A single-centre, randomized, open-label study. Meekers et al. 2024. Eur J Heart Fail. DOI: 10.1002/ejhf.3429
• Heart failure disease management: a systematic review of effectiveness in heart failure with preserved ejection fraction. Kalogirou et al. 2020. ESC Heart Fail. DOI: 10.1002/ehf2.12559
• What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis. Jonkman et al. 2016. J Card Fail. DOI: 10.1016/j.cardfail.2016.06.422
• Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Van Spall et al. 2017. Eur J Heart Fail. DOI: 10.1002/ejhf.765

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Tim Balthazar, University Hospital of Brussels - Belgium and Luca Fazzini, Papa Giovanni XXIII Hospital, Bergamo - Italy.

In this episode of HFA CardioTalk, Luca Fazzini interviews Tim Balthazar on the contemporary use of vasodilators and inotropic agents in heart failure. The conversation explores the gaps in current guidelines, the hemodynamic profile of patients suited for vasodilator therapy, and the rationale behind choosing specific inotropes in different clinical settings. Tim Balthazar further discusses the management of patients on chronic beta-blocker therapy presenting with signs of hypoperfusion and the challenges in designing randomized trials in this field. The discussion also touches on the role of inotropes in palliative care, as well as future perspectives and emerging pharmacological strategies.

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

In this episode, we give a wrap-up of late-breaking clinical science presented at the ESC Congress 2025 in Madrid.

First, David Berg presents the DAPA ACT HF-TIMI 68 trial, reporting on dapagliflozin in patients hospitalized for acute heart failure, along with a meta-analysis of SGLT2 inhibitors in this setting.

Next, Javed Butler highlights results of the VICTOR trial, a large phase 3 study of vericiguat in chronic heart failure with reduced ejection fraction.

Then, Andre Zimerman discusses the PhysioSync-HF trial, comparing conduction system pacing with biventricular resynchronization therapy in patients with HFrEF.

Finally, Kieran Docherty shares insights from a community-based study on the benefits of early initiation of disease-modifying therapy in suspected heart failure.

Additional information:

Topic 1:

With Gregorio Tersalvi, Mayo Clinic, Rochester, MN - USA, David Berg, Brigham and Women's Hospital, Boston - USA and Novi Yanti Sari, Siloam Hospitals Group, Jakarta - Indonesia

Results paper:

Dapagliflozin in Patients Hospitalized for Heart Failure: Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart Failure

Replay ESC Congress Hot Line: https://esc365.escardio.org/presentation/312142

Circulation. 2025 Aug 29. doi: 10.1161/CIRCULATIONAHA.125.076575.

Topic 2:

With Javed Butler, Baylor Scott & White Health, Dallas - USA and Henrike Arfsten, Medical University of Vienna, Vienna - Austria

Results papers:

Vericiguat in patients with chronic heart failure and reduced ejection fraction (VICTOR): a double-blind, placebo-controlled, randomised, phase 3 trial Lancet. 2025

Replay ESC Congress hotline: https://esc365.escardio.org/presentation/312148 doi: 10.1016/S0140-6736(25)01665-4.

Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrum: an individual participant data analysis of the VICTORIA and VICTOR trials Lancet. 2025 Aug 29:S0140-6736(25)01682-4. doi: 10.1016/S0140-6736(25)01682-4.

Topic 3:

With Andre Zimerman, Hospital Moinhos De Vento, Porto Alegre - Brazil and Floran Sahiti, University Hospital of Wurzburg, Wurzburg - Germany

Methods paper:

Conduction system pacing vs biventricular resynchronization in heart failure with reduced ejection fraction and left bundle branch block: Rationale and design of the PhysioSync-HF Trial

Am Heart J. 2025 Dec:290:38-45.

Replay ESC Congress: https://esc365.escardio.org/session/50327 doi: 10.1016/j.ahj.2025.06.002.

Topic 3:

With Kieran Docherty, University of Glasgow, Glasgow - UK and Jolie Bruno, Inserm UMR-S942, Paris - France

Results paper:

Benefit of early initiation of disease-modifying therapy in community-based patients with suspected heart failure

Eur Heart J. 2025 Aug 29:ehaf675. doi: 10.1093/eurheartj/ehaf675.

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.