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Nine contemporary therapeutic directions in heart failure
  1. Zaid Almarzooq1,
  2. Manan Pareek1,2,
  3. Lauren Sinnenberg1,
  4. Muthiah Vaduganathan1,
  5. Mandeep R. Mehra1
  1. 1 Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Department of Cardiology, North Zealand Hospital, Hillerød, Denmark
  1. Correspondence to Professor Mandeep R. Mehra, Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston MA 02115, USA; mmehra{at}


The global burden of heart failure has continued to increase dramatically with 26 million people affected and an estimated health expenditure of $31 billion worldwide. Several practice-influencing studies were reported recently, bringing advances along many frontiers in heart failure, particularly heart failure with reduced ejection fraction. In this article, we discuss nine distinct therapeutic areas that were significantly influenced by this scientific progress. These distinct areas include the emergence of sodium-glucose cotransporter-2 inhibitors, broadening the application of angiotensin-neprilysin inhibition, clinical considerations in therapy withdrawal in those patients with heart failure that ‘recover’ myocardial function, benefits of low-dose direct oral anticoagulants in sinus rhythm, targeted therapy for treating cardiac amyloidosis, usefulness of mitral valve repair in heart failure, the advent of newer left ventricular assist devices for advanced heart failure, the role of ablation in atrial fibrillation in heart failure, and finally the use of wearable defibrillators to address sudden death.

  • heart failure
  • heart failure treatment
  • left ventricular assist device
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  • ZA and MP are joint first authors.

  • Contributors This work in review represents a collective work of all the authors. ZA and MP contributed equally. All authors were involved in drafting, editing and intellectual content of this work. The corresponding author was responsible for the idea, format and overall supervision, in addition to editing and writing of key portions of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MV is supported by the KL2/Catalyst Medical Research Investigator Training award from Harvard Catalyst (NIH/NCATS Award UL 1TR002541), and serves on the advisory boards for AstraZeneca, Bayer AG and Baxter Healthcare. MP serves on an advisory board for AstraZeneca and has received speaker honoraria from AstraZeneca, Bayer and Boehringer Ingelheim. MM is a consultant for Abbott, Medtronic, Janssen (a division of Johnson and Johnson), Mesoblast, NupulseCV, Bayer, FineHeart, Xogenex and Portola.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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