THE FUTURE OF HEART FAILURE MANAGEMENT: EMERGING THERAPIES AND TECHNOLOGIES
Main Article Content
Keywords
Abstract
Background: Heart failure (HF) While traditional treatments are still a major worldwide burden for mortality and morbidity, innovative treatment and diagnosis methods are urgently needed. Conventional therapies, as applied in the conventional medical model, though able to provide symptomatic relief, are often unable to reverse the disease process, let alone slow it in the worst-case scenario. Objective: Through this systematic review, the effectiveness, safety, and clinical relevance of advanced pharmacological, medical device, and point-of-care technologies for effectively managing heart failure will be assessed. Methods: To supplement the literature review, an electronic search was conducted in Pubmed, Cochrane Database, and Scopus with data collected from the past decade regarding PRISMA guidelines. Regarding inclusion criteria, systematic review and meta-analysis studies build on randomized controlled trials, prospective and retrospective cohort studies, case-control studies, and systematic reviews of novel pharmacological treatments, innovative and sophisticated device-based therapy, and novel diagnostics. Results: The new pharmacological agents, the SGLT2 inhibitors, and the ARNi particularly, were shown to have reduced hospitalization and mortality rates as was noticeable from conventional therapies. Technology-based therapies such as CRT, ICD, LVAD, and wearable technology gave patients better chances of survival, better quality of life, and a better opportunity for additional monitoring, especially for those with advanced HF. New technology like biomarkers, cardiac MRI, and innovative, AI-based tools offered essential findings and high sensitivity and specificity of diagnosis and risk assessment. Conclusion: The study implies that new commodity therapies and technologies carry a future capacity in heart failure. SGLT2 inhibitors, ARNi, CRT, ICDs, and advanced diagnostic methods make HF management more individualized and effective by providing patient-centered increases in outcomes, quality of life, and efficiency of available resources.
References
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27. Liu, P., & Xing, L. (2022). [Retracted] Effect of ICD/CRT‐D Implantation on Adverse Events and Readmission Rate in Patients with Chronic Heart Failure (CHF). Computational and mathematical methods in medicine, 2022(1), 8695291.
28. Luo, S., Long, Y., Xiao, W., Wang, X., Chen, R., Guo, Q., ... & Chen, M. (2020). Risk of bias assessments and reporting quality of systematic reviews and randomized controlled trials examining acupuncture for depression: An overview and meta‐epidemiology study. Journal of Evidence‐Based Medicine, 13(1), 25-33.
29. March, K. L., Peters, M. J., Finch, C. K., Roberts, L. A., McLean, K. M., Covert, A. M., & Twilla, J. D. (2022). Pharmacist transition-of-care services improve patient satisfaction and decrease hospital readmissions. Journal of Pharmacy Practice, 35(1), 86-93.
30. Mentz, R. J., Whellan, D. J., Reeves, G. R., Pastva, A. M., Duncan, P., Upadhya, B., ... & Kitzman, D. W. (2021). Rehabilitation intervention in older patients with acute heart failure with preserved versus reduced ejection fraction. Heart Failure, 9(10), 747-757.
31. Miftode, R. S., Constantinescu, D., Cianga, C. M., Petris, A. O., Timpau, A. S., Crisan, A., ... & Serban, I. L. (2021). A novel paradigm based on ST2 and its contribution towards a multimarker approach in the diagnosis and prognosis of heart failure: A prospective study during the pandemic storm. Life, 11(10), 1080.
32. Monami, M., Candido, R., Pintaudi, B., Targher, G., & Mannucci, E. (2021). Improvement of glycemic control in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Nutrition, Metabolism and Cardiovascular Diseases, 31(9), 2539-2546.
33. Morin, O., Vallières, M., Braunstein, S., Ginart, J. B., Upadhaya, T., Woodruff, H. C., ... & Lambin, P. (2021). An artificial intelligence framework integrating longitudinal electronic health records with real-world data enables continuous pan-cancer prognostication. Nature Cancer, 2(7), 709-722.
34. Nakimuli-Mpungu, E., Musisi, S., Wamala, K., Okello, J., Ndyanabangi, S., Birungi, J., ... & Mills, E. J. (2020). Effectiveness and cost-effectiveness of group support psychotherapy delivered by trained lay health workers for depression treatment among people with HIV in Uganda: a cluster-randomised trial. The Lancet Global Health, 8(3), e387-e398.
35. Nayak, A., Hicks, A. J., & Morris, A. A. (2020). Understanding the complexity of heart failure risk and treatment in black patients. Circulation: Heart Failure, 13(8), e007264.
36. Njoroge, J. N., & Teerlink, J. R. (2021). Pathophysiology and therapeutic approaches to acute decompensated heart failure. Circulation research, 128(10), 1468-1486.
37. Poorcheraghi, H., Negarandeh, R., Pashaeypoor, S., & Jorian, J. (2023). Effect of using a mobile drug management application on medication adherence and hospital readmission among elderly patients with polypharmacy: a randomized controlled trial. BMC Health Services Research, 23(1), 1192
38. Popa, I. P., Haba, M. Ș. C., Mărănducă, M. A., Tănase, D. M., Șerban, D. N., Șerban, L. I., ... & Tudorancea, I. (2022). Modern approaches for the treatment of heart failure: recent advances and future perspectives. Pharmaceutics, 14(9), 1964.
39. Rahimi, K., Bidel, Z., Nazarzadeh, M., Copland, E., Canoy, D., Ramakrishnan, R., ... & Davis, B. R. (2021). Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. The Lancet, 397(10285), 1625-1636.
40. Roger, V. L. (2021). Epidemiology of heart failure: a contemporary perspective. Circulation research, 128(10), 1421-1434.
41. Santema, B. T., Ouwerkerk, W., Tromp, J., Sama, I. E., Ravera, A., Regitz-Zagrosek, V., ... & Voors, A. A. (2019). Identifying optimal doses of heart failure medications in men compared with women: a prospective, observational, cohort study. The Lancet, 394(10205), 1254-1263.
42. Shi, Y. L., Zhao, J., Ai, F. L., Wang, Y. T., Hu, K. R., Wang, X. W., ... & Wan, X. (2022). Evaluating the quality of case-control studies involving the association between tobacco exposure and diseases in a Chinese population based on the Newcastle-Ottawa Scale and Post-hoc Power. Biomed Environ Sci, 35(9), 861-866.
43. Starr, J. A., Pinner, N. A., Lisenby, K. M., & Osmonson, A. (2021). Impact of SGLT2 inhibitors on cardiovascular outcomes in patients with heart failure with reduced ejection fraction. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 41(6), 526-536.
44. Tabucanon, T., Wilcox, J., & Tang, W. W. (2020). Does weight loss improve clinical outcomes in overweight and obese patients with heart failure?. Current Diabetes Reports, 20, 1-12.
45. Tamargo, J., Caballero, R., & Mosquera, E. D. (2023). Sex and gender differences in the treatment of arterial hypertension. Expert review of clinical pharmacology, 16(4), 329-347.
46. Valentí, V., Ramos, J., Pérez, C., Capdevila, L., Ruiz, I., Tikhomirova, L., ... & Salazar, R. (2020). Increased survival time or better quality of life? Trade-off between benefits and adverse events in the systemic treatment of cancer. Clinical and Translational Oncology, 22, 935-942.
47. Wahlström, M. (2018). Effects of MediYoga among patients with paroxysmal atrial fibrillation.
48. Wong, W. M., Chan, D. N., Choi, K. C., Choy, Y. P., & So, W. K. (2023). A multi-modal intervention for managing the fatigue–sleep disturbance–depressed mood symptom cluster in breast cancer patients undergoing chemotherapy: A pilot study. Asia-Pacific Journal of Oncology Nursing, 10(8), 100269.
49. Zhang, W., Zhang, S., Deng, Y., Wu, S., Ren, J., Sun, G., ... & Cai, J. (2021). Trial of intensive blood-pressure control in older patients with hypertension. New England Journal of Medicine, 385(14), 1268-1279.
2. An, S., & Song, R. (2020). Effects of health coaching on behavioral modification among adults with cardiovascular risk factors: Systematic review and meta-analysis. Patient Education and Counseling, 103(10), 2029-2038.
3. Badrić, M., Roca, L., & Krošnjar, N. (2023). The relationship between the quality of life and cardiorespiratory fitness. SPORTS SCIENCE AND HEALTH, 26(2), 208-214.
4. Bozkurt, B., Coats, A. J., Tsutsui, H., Abdelhamid, M., Adamopoulos, S., Albert, N., ... & Zieroth, S. (2021). Universal definition and classification of heart failure: a report of the heart failure society of America, heart failure association of the European society of cardiology, Japanese heart failure society and writing committee of the universal definition of heart failure. Journal of cardiac failure, 27(4), 387-413.
5. Butler, J., Brown, M., Prokocimer, P., Humphries, A. C., Pope, S., Wright, O., ... & Muresan, B. (2024). The role of cardiac acoustic biomarkers in monitoring patients with heart failure: A systematic literature review. ESC Heart Failure.
6. Carroll, A. M., Farr, M., Russell, S. D., Schlendorf, K. H., Truby, L. K., Gilotra, N. A., ... & Devore, A. D. (2023). Beyond Stage C: Considerations in the Management of Patients With Heart Failure Progression and Gaps in Evidence. Journal of cardiac failure, 29(5), 818-831.
7. Chaudhary, P., & Wainford, R. D. (2021). Association of urinary sodium and potassium excretion with systolic blood pressure in the Dietary Approaches to Stop Hypertension Sodium Trial. Journal of human hypertension, 35(7), 577-587.
8. Cicero, A. F., Colletti, A., von Haehling, S., Vinereanu, D., Bielecka-Dabrowa, A., Sahebkar, A., ... & Banach, M. (2020). Nutraceutical support in heart failure: a position paper of the International Lipid Expert Panel (ILEP). Nutrition research reviews, 33(1), 155-179.
9. Faghy, M. A., Yates, J., Hills, A. P., Jayasinghe, S., da Luz Goulart, C., Arena, R., ... & Ashton, R. E. (2023). Cardiovascular disease prevention and management in the COVID-19 era and beyond: an international perspective. Progress in Cardiovascular Diseases, 76, 102-111.
10. Fibbi, G., Sato, R., Vatic, M., Genreith, F. P., & von Haehling, S. (2024). Pharmacological management of heart failure: a patient-centered approach. Expert Opinion on Pharmacotherapy, (just-accepted).
11. Filippini, T., Malavolti, M., Whelton, P. K., Naska, A., Orsini, N., & Vinceti, M. (2021). Blood pressure effects of sodium reduction: dose–response meta-analysis of experimental studies. Circulation, 143(16), 1542-1567.
12. Finocchiaro, G., Sheikh, N., Biagini, E., Papadakis, M., Sinagra, G., Pelliccia, A., ... & Olivotto, I. (2020). The electrocardiogram in the diagnosis and management of patients with hypertrophic cardiomyopathy. Heart Rhythm, 17(1), 142-151.
13. Giovanni, A., Enrico, A., Aime, B., Michael, B., Marianne, B., Jonathan, C., ... & Mayowa, O. (2020). Global Burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. Journal of the American College of Cardiology, 76(25), 2982-3021.
14. Grisorio, L., Bongianino, R., Gianeselli, M., & Priori, S. G. (2024). Gene therapy for cardiac diseases: methods, challenges, and future directions. Cardiovascular research, cvae207.
15. Gunnell, K. E., Belcourt, V. J., Tomasone, J. R., & Weeks, L. C. (2022). Systematic review methods. International Review of Sport and Exercise Psychology, 15(1), 5-29.
16. Guo, Y., & Albright, D. (2018). The effectiveness of telehealth on self-management for older adults with a chronic condition: a comprehensive narrative review of the literature. Journal of telemedicine and telecare, 24(6), 392-403.
17. Heidenreich, F., & Weber-Stein, F. (2022). The Politics of Digital Pharmacology: Exploring the Craft of Collective Care (p. 126). transcript Verlag.
18. Heidenreich, P. A., Fonarow, G. C., Opsha, Y., Sandhu, A. T., Sweitzer, N. K., Warraich, H. J., ... & Ng, T. (2022). Economic issues in heart failure in the United States. Journal of cardiac failure, 28(3), 453-466.
19. Hemdan, M., Ali, M. A., Doghish, A. S., Mageed, S. S. A., Elazab, I. M., Khalil, M. M., ... & Amin, A. S. (2024). Innovations in Biosensor Technologies for Healthcare Diagnostics and Therapeutic Drug Monitoring: Applications, Recent Progress, and Future Research Challenges. Sensors (Basel, Switzerland), 24(16), 5143.
20. Hernandez, M., Sullivan, R. D., McCune, M. E., Reed, G. L., & Gladysheva, I. P. (2022). Sodium-glucose cotransporter-2 inhibitors improve heart failure with reduced ejection fraction outcomes by reducing edema and congestion. Diagnostics, 12(4), 989.
21. Hilty, D. M., Armstrong, C. M., Luxton, D. D., Gentry, M. T., & Krupinski, E. A. (2021). A scoping review of sensors, wearables, and remote monitoring for behavioral health: uses, outcomes, clinical competencies, and research directions. Journal of Technology in Behavioral Science, 6, 278-313.
22. Karlström, P., Pivodic, A., Dahlström, U., & Fu, M. (2024). Modern heart failure treatment is superior to conventional treatment across the left ventricular ejection spectrum: real-life data from the Swedish Heart Failure Registry 2013–2020. Clinical Research in Cardiology, 1-14.
23. Kawamura, A., Inagaki, J., Umemoto, S., Kajiya, K., Kishi, H., Mitarai, M., ... & Kobayashi, S. (2020). Dietary adherence, self-efficacy, and health behavior change of WASHOKU-modified DASH diet: a sub-analysis of the DASH-JUMP study. Current Hypertension Reviews, 16(2), 128-137.
24. Koutentakis, M., Kuciński, J., Świeczkowski, D., Surma, S., Filipiak, K. J., & Gąsecka, A. (2023). The Ketogenic Effect of SGLT-2 Inhibitors—Beneficial or Harmful?. Journal of cardiovascular development and disease, 10(11), 465.
25. Kruik-Kollöffel, W. J., van der Palen, J., Doggen, C. J., van Maaren, M. C., Kruik, H. J., Heintjes, E. M., ... & Linssen, G. C. (2020). Heart failure medication after a first hospital admission and risk of heart failure readmission, focus on beta-blockers and renin-angiotensin-aldosterone system medication: A retrospective cohort study in linked databases. Plos one, 15(12), e0244231.
26. Kunhoth, J., Subramanian, N., & Bouridane, A. (2022). Commercial Non‐Invasive and Invasive Devices for Heart Failure Prediction: A Review. Predicting Heart Failure: Invasive, Non‐Invasive, Machine Learning and Artificial Intelligence Based Methods, 243-268.
27. Liu, P., & Xing, L. (2022). [Retracted] Effect of ICD/CRT‐D Implantation on Adverse Events and Readmission Rate in Patients with Chronic Heart Failure (CHF). Computational and mathematical methods in medicine, 2022(1), 8695291.
28. Luo, S., Long, Y., Xiao, W., Wang, X., Chen, R., Guo, Q., ... & Chen, M. (2020). Risk of bias assessments and reporting quality of systematic reviews and randomized controlled trials examining acupuncture for depression: An overview and meta‐epidemiology study. Journal of Evidence‐Based Medicine, 13(1), 25-33.
29. March, K. L., Peters, M. J., Finch, C. K., Roberts, L. A., McLean, K. M., Covert, A. M., & Twilla, J. D. (2022). Pharmacist transition-of-care services improve patient satisfaction and decrease hospital readmissions. Journal of Pharmacy Practice, 35(1), 86-93.
30. Mentz, R. J., Whellan, D. J., Reeves, G. R., Pastva, A. M., Duncan, P., Upadhya, B., ... & Kitzman, D. W. (2021). Rehabilitation intervention in older patients with acute heart failure with preserved versus reduced ejection fraction. Heart Failure, 9(10), 747-757.
31. Miftode, R. S., Constantinescu, D., Cianga, C. M., Petris, A. O., Timpau, A. S., Crisan, A., ... & Serban, I. L. (2021). A novel paradigm based on ST2 and its contribution towards a multimarker approach in the diagnosis and prognosis of heart failure: A prospective study during the pandemic storm. Life, 11(10), 1080.
32. Monami, M., Candido, R., Pintaudi, B., Targher, G., & Mannucci, E. (2021). Improvement of glycemic control in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Nutrition, Metabolism and Cardiovascular Diseases, 31(9), 2539-2546.
33. Morin, O., Vallières, M., Braunstein, S., Ginart, J. B., Upadhaya, T., Woodruff, H. C., ... & Lambin, P. (2021). An artificial intelligence framework integrating longitudinal electronic health records with real-world data enables continuous pan-cancer prognostication. Nature Cancer, 2(7), 709-722.
34. Nakimuli-Mpungu, E., Musisi, S., Wamala, K., Okello, J., Ndyanabangi, S., Birungi, J., ... & Mills, E. J. (2020). Effectiveness and cost-effectiveness of group support psychotherapy delivered by trained lay health workers for depression treatment among people with HIV in Uganda: a cluster-randomised trial. The Lancet Global Health, 8(3), e387-e398.
35. Nayak, A., Hicks, A. J., & Morris, A. A. (2020). Understanding the complexity of heart failure risk and treatment in black patients. Circulation: Heart Failure, 13(8), e007264.
36. Njoroge, J. N., & Teerlink, J. R. (2021). Pathophysiology and therapeutic approaches to acute decompensated heart failure. Circulation research, 128(10), 1468-1486.
37. Poorcheraghi, H., Negarandeh, R., Pashaeypoor, S., & Jorian, J. (2023). Effect of using a mobile drug management application on medication adherence and hospital readmission among elderly patients with polypharmacy: a randomized controlled trial. BMC Health Services Research, 23(1), 1192
38. Popa, I. P., Haba, M. Ș. C., Mărănducă, M. A., Tănase, D. M., Șerban, D. N., Șerban, L. I., ... & Tudorancea, I. (2022). Modern approaches for the treatment of heart failure: recent advances and future perspectives. Pharmaceutics, 14(9), 1964.
39. Rahimi, K., Bidel, Z., Nazarzadeh, M., Copland, E., Canoy, D., Ramakrishnan, R., ... & Davis, B. R. (2021). Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. The Lancet, 397(10285), 1625-1636.
40. Roger, V. L. (2021). Epidemiology of heart failure: a contemporary perspective. Circulation research, 128(10), 1421-1434.
41. Santema, B. T., Ouwerkerk, W., Tromp, J., Sama, I. E., Ravera, A., Regitz-Zagrosek, V., ... & Voors, A. A. (2019). Identifying optimal doses of heart failure medications in men compared with women: a prospective, observational, cohort study. The Lancet, 394(10205), 1254-1263.
42. Shi, Y. L., Zhao, J., Ai, F. L., Wang, Y. T., Hu, K. R., Wang, X. W., ... & Wan, X. (2022). Evaluating the quality of case-control studies involving the association between tobacco exposure and diseases in a Chinese population based on the Newcastle-Ottawa Scale and Post-hoc Power. Biomed Environ Sci, 35(9), 861-866.
43. Starr, J. A., Pinner, N. A., Lisenby, K. M., & Osmonson, A. (2021). Impact of SGLT2 inhibitors on cardiovascular outcomes in patients with heart failure with reduced ejection fraction. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 41(6), 526-536.
44. Tabucanon, T., Wilcox, J., & Tang, W. W. (2020). Does weight loss improve clinical outcomes in overweight and obese patients with heart failure?. Current Diabetes Reports, 20, 1-12.
45. Tamargo, J., Caballero, R., & Mosquera, E. D. (2023). Sex and gender differences in the treatment of arterial hypertension. Expert review of clinical pharmacology, 16(4), 329-347.
46. Valentí, V., Ramos, J., Pérez, C., Capdevila, L., Ruiz, I., Tikhomirova, L., ... & Salazar, R. (2020). Increased survival time or better quality of life? Trade-off between benefits and adverse events in the systemic treatment of cancer. Clinical and Translational Oncology, 22, 935-942.
47. Wahlström, M. (2018). Effects of MediYoga among patients with paroxysmal atrial fibrillation.
48. Wong, W. M., Chan, D. N., Choi, K. C., Choy, Y. P., & So, W. K. (2023). A multi-modal intervention for managing the fatigue–sleep disturbance–depressed mood symptom cluster in breast cancer patients undergoing chemotherapy: A pilot study. Asia-Pacific Journal of Oncology Nursing, 10(8), 100269.
49. Zhang, W., Zhang, S., Deng, Y., Wu, S., Ren, J., Sun, G., ... & Cai, J. (2021). Trial of intensive blood-pressure control in older patients with hypertension. New England Journal of Medicine, 385(14), 1268-1279.