Cardiovascular Interventions for Heart Failure Management
Summary
Heart failure remains a leading cause of morbidity and mortality across the globe, driven by ageing populations and rising prevalence of hypertension, ischaemic heart disease and diabetes. Therapeutic strategies have evolved from conventional pharmacotherapy and device implantation to include advanced mechanical circulatory support and minimally invasive procedures. Pharmacological inotropes and vasodilators optimise cardiac output and reduce ventricular filling pressures, while implantable devices such as cardiac resynchronisation therapy systems and implantable cardioverter-defibrillators improve electromechanical synchrony and prevent sudden death. In more severe cases, mechanical circulatory support – including intra-aortic balloon pumps, percutaneous ventricular assist devices and extracorporeal membrane oxygenation – provides haemodynamic stabilisation and serves as a bridge to recovery or transplantation. In parallel, transcatheter valve repair and replacement techniques address valvular contributors to heart failure, alleviating regurgitation and stenosis without the need for open-chest surgery. Emerging approaches encompass personalised at-home telemonitoring of haemodynamic parameters, regenerative therapies and gene-based interventions aimed at remodelling failing myocardium. Collectively, these interventions form an integrated armamentarium, tailored to disease severity and patient comorbidities, with the ultimate goal of improving survival, reducing hospital admissions and preserving quality of life.
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Cardiovascular Interventions for Heart Failure Management publication trend
The graph below shows the total number of articles in cardiovascular interventions for heart failure management across all publications each year (not limited to Nature Index journals).
Technical terms
Inodilator: A pharmacological agent combining positive inotropic (increased contractility) and vasodilatory effects to improve cardiac performance and reduce afterload.
Extracorporeal membrane oxygenation (ECMO): A form of mechanical circulatory support that oxygenates and circulates blood externally, providing temporary cardiac and respiratory assistance.
Left ventricular ejection fraction (LVEF): The percentage of blood ejected from the left ventricle with each contraction, used as a key indicator of systolic function.
Cardiogenic shock: A state of critical end-organ hypoperfusion caused by primary cardiac dysfunction, often requiring urgent mechanical or pharmacological support.
Cardiac resynchronisation therapy (CRT): An implantable device therapy that delivers coordinated electrical impulses to both ventricles, restoring synchrony and improving pump efficiency.
References
- Overview of the current use of levosimendan in France: a prospective observational cohort study. Annals of Intensive Care (2023).
- Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit. Annals of Intensive Care (2019).
- Levosimendan for patients with severely reduced left ventricular systolic function and/or low cardiac output syndrome undergoing cardiac surgery: a systematic review and meta-analysis. Critical Care (2017).
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