HFA Cardio Talk

With Felix Lindberg, Karolinska Institutet & Södersjukhuset Hospital, Stockholm – Sweden and Marianna Fontana, National Amyloidosis Center, University College London, London – UK.
In this episode, Felix Lindberg and Marianna Fontana discuss the evolving landscape in the treatment of cardiac amyloidosis. After exploring the pathophysiology of cardiac AL and ATTR amyloidosis and recent years' insights about the epidemiology of these conditions, they focus on the transformation that has occurred in the therapeutic options for cardiac ATTR amyloidosis. The conversation addresses the key mechanistic differences and trial data on stabilizers and silencers, how to approach patient selection for these therapies, as well as emerging therapies including anti-amyloid antibodies. The discussion also highlights the importance of early diagnosis and key red flags that should elicit suspicion of cardiac amyloidosis.
Suggested reading:
Vutisiran in patients with transthyretin amyloidosis with cardiomyopathy. Fontana M, et al. N Engl J Med. 2025.

Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy. Maurer M, et al. N Engl J Med. 2018.

Efficacy and safety of acoramidis in tranthyretin amyloid cardiomyopathy. Gillmore JD, et al. N Engl J Med. 2024.

CRISPR-Cas9 gene editing with nexiguran ziclumeran for ATTR cardiomyopathy. Fontana M, et al. N Engl J Med. 2024.

Conventional heart failure therapy in cardiac ATTR amyloidosis. Ioannou A, et al. Eur Heart J. 2023.

Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Gillmore JD, et al. Circulation. 2016.

Current landscape of therapies for transthyretin amyloid cardiomyopathy. Griffin JM, et al. JACC Heart Fail. 2025.

Transthyretin amyloid cardiomyopathy: from cause to novel treatments. Fontana M, et al. Eur Heart J. 2026.

Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases. Garcia-Pavia P, et al. Eur Heart J. 2021.

This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Maria Tereza Sampaio de Sousa Lira, Federal University of Pernambuco - Brazil and Anja Zupan Meznar, University Medical Centre Ljubljana - Slovenia.
This episode will discuss when conduction system pacing (CSP) may be the appropriate pacing strategy for heart failure patients, particularly those with pacing-induced dyssynchrony or suspected pacing-induced cardiomyopathy (PICM).
Key talking points include:
Clinical clues and diagnostic approach to PICM

Differentiating PICM from other causes of LV dysfunction

When to consider CRT upgrade in pacemaker patients

Insights from the BUDAPEST-CRT upgrade trial

Advantages and limitations of CSP (His-bundle and left bundle branch pacing)

Practical take-home message for clinicians managing HF patients with pacemaker

This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsors.

With Felix Lindberg, Karolinska Institute & Karolinska University Hospital, Stockholm - Sweden, Martha Kyriakou, European University of Cyprus, Nicosia - Cyprus and Maggie Simpson, University of Edinburgh, Edinburgh - UK.
In this episode, Felix Lindberg, Martha Kyriakou, and Maggie Simpson discuss multidisciplinary care in heart failure, exploring why HF complexity and multimorbidity make coordinated, team-based management essential.
They outline the key professional roles and how they can work together to support continuity across the HF trajectory, from diagnosis and optimisation, through decompensations, and transition to advanced therapies and palliative care.
The discussion also addresses real-world gaps in implementation, and considers how the expanding roles of nurses, pharmacists, and allied professionals, alongside emerging digital tools, may shape the future of multidisciplinary HF care.
Proposed reading: 
Examining the clinical role and educational preparation of heart failure nurses across Europe. A survey of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the ESC. Hill et al. 2025. Eur J Heart Fail. DOI: 10.1002/ejhf.3519

Multidisciplinary Care in Heart Failure Services. Sokos et al. 2023. J Card Fail. DOI: 10.1016/j.cardfail.2023.02.011

The Core Curriculum for Cardiovascular Nurses and Allied Professionals. Neubeck et al. 2023. Eur J Cardiovasc Nurs. DOI: 10.1093/eurjcn/zvad035

How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. Stolfo et al. 2025. Eur J Heart Fail. DOI: 10.1002/ejhf.3642

Pharmacist- and Nurse-Led Medical Optimization in Heart Failure: A Systematic Review and Meta-Analysis. Zheng et al. 2023. J Card Fail. DOI: 10.1016/j.cardfail.2023.03.01

Nurse-led diuretic titration via a point-of-care urinary sodium sensor in patients with acute decompensated heart failure (EASY-HF): A single-centre, randomized, open-label study. Meekers et al. 2024. Eur J Heart Fail. DOI: 10.1002/ejhf.3429

Heart failure disease management: a systematic review of effectiveness in heart failure with preserved ejection fraction. Kalogirou et al. 2020. ESC Heart Fail. DOI: 10.1002/ehf2.12559

What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis. Jonkman et al. 2016. J Card Fail. DOI: 10.1016/j.cardfail.2016.06.422

Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Van Spall et al. 2017. Eur J Heart Fail. DOI: 10.1002/ejhf.765

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Sotiria Liori, Attikon University Hospital, National and Kapodistrian University of Athens - Greece and Julie De Backer, Ghent University Hospital - Belgium.
In this episode, Sotiria Liori and Julie De Backer discuss heart failure in adult congenital heart disease patients — covering how congenital lesions and prior repairs shape epidemiology and mechanisms (ventricular remodeling, valvular and conduit dysfunction, arrhythmias), as well as clinical assessment with imaging, biomarkers, and hemodynamics. They outline management with guideline-directed therapy, rhythm considerations, indications for advanced therapies (MCS and transplant), and pregnancy counseling. The episode also highlights multidisciplinary care models and key evidence gaps.
Proposed reading: 
General Principles of Heart Failure Management in Adult Congenital Heart Disease. Tompkins R, Romfh A. Heart Failure Reviews. 2020;25(4):555-567. doi:10.1007/s10741-019-09895-x
Chronic Heart Failure in Congenital Heart Disease: A Scientific Statement From the American Heart Association. Stout KK, Broberg CS, Book WM, et al. Circulation. 2016;133(8):770-801. doi:10.1161/CIR.0000000000000352.
Relation Between New York Heart Association Functional Class and Objective Measures of Cardiopulmonary Exercise in Adults With Congenital Heart Disease. Das BB, Young ML, Niu J, et al. The American Journal of Cardiology. 2019;123(11):1868-1873. doi:10.1016/j.amjcard.2019.02.053.
 Heart Failure and Patient-Reported Outcomes in Adults With Congenital Heart Disease from 15 Countries. Lu CW, Wang JK, Yang HL, Kovacs AH, et al; APPROACH‐IS consortium, the International Society for Adult Congenital Heart Disease (ISACHD) *.J Am Heart Assoc. 2022 May 3;11(9):e024993. doi: 10.1161/JAHA.121.024993. Epub 2022 Apr 26.
Pharmacological Therapy in Adult Congenital Heart Disease: Growing Need, Yet Limited Evidence. Brida M, Diller GP, Nashat H, et al. European Heart Journal. 2019;40(13):1049-1056. doi:10.1093/eurheartj/ehy480.
Advanced Heart Failure Therapies For Adults With Congenital Heart Disease: JACC State-of-the-Art Review. Givertz MM, DeFilippis EM, Landzberg MJ, et al. Journal of the American College of Cardiology. 2019;74(18):2295-2312.doi:10.1016/j.jacc.2019.09.004.
A Review of Heart Transplantation for Adults With Congenital Heart Disease. McMahon A, McNamara J, Griffin M. Journal of Cardiothoracic and Vascular Anesthesia. 2021;35(3):752-762. doi:10.1053/j.jvca.2020.07.027.
Heart Failure in Adult Congenital Heart Disease: From Advanced Therapies to End-of-Life Care. Crossland DS, Van De Bruaene A, Silversides CK, Hickey EJ, Roche SL. The Canadian Journal of Cardiology. 2019;35(12):1723-1739. doi:10.1016/j.cjca.2019.07.626.
This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Tim Balthazar, University Hospital of Brussels - Belgium and Luca Fazzini, Papa Giovanni XXIII Hospital, Bergamo - Italy.
In this episode of HFA CardioTalk, Luca Fazzini interviews Tim Balthazar on the contemporary use of vasodilators and inotropic agents in heart failure. The conversation explores the gaps in current guidelines, the hemodynamic profile of patients suited for vasodilator therapy, and the rationale behind choosing specific inotropes in different clinical settings. Tim Balthazar further discusses the management of patients on chronic beta-blocker therapy presenting with signs of hypoperfusion and the challenges in designing randomized trials in this field. The discussion also touches on the role of inotropes in palliative care, as well as future perspectives and emerging pharmacological strategies.
This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.