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Publications

Journal Article Ahead of print

PubMed: 42216242 DOI: 10.1093/eurheartj/ehag362

Prevention of heart failure.

Eur Heart J

Authors: Massimo Piepoli, Giuseppe Rosano, Ana Abreu, Marianna Adamo, Andrea Attanasio, Ovidiu Chioncel, Alain Cohen-Solal, Gerasimos Filippatos, Eva Gerdts, Andreas Gevaert, Martin Halle, Pardeep Jhund, Donata Kurpas, Brenda Moura, Gianfranco Parati, Mark C Petrie, Eduard Shantsila, Maggie Simpson, Isabella Sudano, Maryia Tokmakova, Daniela Tomasoni, Izabella Uchmanowicz, Maurizio Volterrani, Marco Metra

Affiliations

  • Department of Biomedical Science for Health, University of Milan, Milan, Italy.
  • Cardiology University Department, IRCCS Policlinico San Donato, Piazza Edmondo Malan, Milan 20097, Italy.
  • IRCCS San Raffaele, Rome, Italy.
  • Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open University of Rome, Rome, Italy.
  • Cardiology Department, Cardiac Rehabilitation Centre, Hospital Universitário Santa Maria (ULSSM), Centro Académico Medicina de Lisboa (CAML), Lisbon, Portugal.
  • Faculty of Medicine from University of Lisbon (FMUL), Instituto de Saúde Ambiental (ISAMB)/TERRA, Instituto Medicina Preventiva e Saúde Pública (IMPSP), Centro Cardiovascular da Universidade de Lisboa (CCUL), Lisbon, Portugal.
  • Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, ASST Spedali Civili, University of Brescia, Brescia, Italy.
  • Emergency Institute for Cardiovascular Diseases 'Prof. C.C. Iliescu', Bucharest, Romania.
  • Paris Cite University, INSERM U942 MASCOT Lariboisiere Hospital AP-HP, Paris, France.
  • Department of Cardiology, Attikon University Hospital, Scholl of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Department of Clinical Science, Centre for Research on Cardiac Disease in Women, University of Bergen, Bergen, Norway.
  • Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium.
  • Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium.
  • Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, TUM University Hospital, Technical University of Munich, Munich, Germany.
  • BHF Glasgow Cardiovascular Research Center, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland, UK.
  • Division of Research Methodology, Department of Nursing Faculty of Nursing and Midwifery, Wroclaw Medical University WrocÅ‚aw, Poland.
  • Armed Forces Hospital, Faculty of Medicine, University of Porto, Porto, Portugal.
  • Istituto Auxologico Italiano, IRCCS, Dept. of Cardiology, Ospedale San Luca, Milano, Italy.
  • Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
  • School of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
  • Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom.
  • Edinburgh Medical School, University of Edinburgh, Edinburgh, UK.
  • Cardiology Section, First Department of Internal Diseases, Medical University of Plovdiv, Clinic of Cardiology, UMHAT 'Sv. Georgi' EAD, Plovdiv, Bulgaria.
  • Division of Cardiology, First Department of Internal Diseases, Medical University of Plovdiv, Clinic of Cardiology, Universitetska Mnogoprofilna Bolnitsa Za Aktivno Lechenie Sveti Georgi Enolichno Aktsionerno Druzhestvo Plovdiv, Bulgaria.
  • Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, Wroclaw, Poland.
  • Centre for Cardiovascular Health, Edinburgh Napier University, Edinburgh, UK.
  • IRCCS San Raffaele Roma, Rome, Italy.
  • Department of Human Science and Promotion of Quality of Life, San Raffaele Open University, Rome, Italy.

Abstract

Heart failure (HF) remains a major cause of morbidity, mortality and costs for the healthcare systems worldwide, despite advances in diagnostic and therapeutic strategies. The enhancement of preventive measures is now a priority, but effective prevention requires a multidisciplinary strategy addressing a broad spectrum of comorbidities and risk factors. It must also consider the changes in the prevailing phenotype of the patients with HF with a lower impact of coronary artery disease and the increasing role of renal and metabolic conditions leading mostly to HF with preserved ejection fraction. Prevention of HF must take into consideration arterial hypertension, chronic kidney disease, diabetes mellitus, sedentary lifestyle, obesity, dyslipidemia, female-specific risk factors, as well as adverse effects of chemotherapy and radiotherapy. Other key factors include infections and the protective role of vaccination, and environmental and socio-economic determinants of health. In 2022, a position paper of the Heart Failure Association and the European Association of Preventive Cardiology of the ESC was published as a complete overview on this topic and as a compendium to the 2021 ESC Guidelines on HF. However, since then, significant evidence has emerged regarding the potential to prevent HF, particularly in the context of metabolic disorders, diabetes and kidney diseases. This scientific statement aims to provide an updated perspective, highlighting the importance of a holistic and tailored approach to managing the multifaceted contributors to this syndrome.

MeSH

Diabetes Mellitus, Kidney Diseases, Heart Failure, Heart, Kidney, Cardiology, Risk Factors, Primary Prevention