Advances in Diagnosis and Treatment of Acute and Chronic Heart Failure: A Comprehensive Review

TL;DR

This paper reviews recent advances in diagnosing and treating heart failure, focusing on new biomarkers, imaging, and personalized therapies to improve patient outcomes.

Contribution

The paper provides a comprehensive review of novel biomarkers, imaging techniques, and treatment strategies for heart failure.

Findings

Novel biomarkers may improve risk assessment beyond traditional natriuretic peptides.

Imaging advances allow better structural and functional assessment of heart failure.

Guideline-directed medical therapy and adjunctive treatments have reduced hospitalizations and mortality.

Abstract

Heart failure (HF) remains a major cause of morbidity and mortality worldwide, with its prevalence continuing to rise due to an aging population and the increasing burden of cardiometabolic diseases. Advances in understanding HF pathophysiology—neurohormonal, inflammatory, and metabolic mechanisms—have led to significant improvements in diagnosis and management, emphasizing earlier detection and patient-centered approaches. Novel biomarkers have the potential to enhance risk assessment beyond traditional natriuretic peptides. Imaging advances can enhance structural and functional assessment, enabling more accurate phenotyping, disease characterization, and risk stratification. Recent advances and real-world data have been used to implement and optimize guideline-directed medical therapy (GDMT) for HF to reduce HF hospitalizations and cardiovascular mortality across the spectrum of HF etiologies. Adjunctive therapies are reserved for select patients with persistent symptoms or high-risk features despite optimal GDMT. Device- and transcatheter-based interventions include established and emerging technologies that address persistent symptoms, structural abnormalities, and hemodynamic abnormalities despite optimal GDMT, thereby expanding treatment options for high-risk patients. Collectively, these advancements highlight a paradigm shift toward precise, personalized approaches to HF management, thereby improving long-term outcomes across the spectrum of HF etiologies.