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European Journal of Heart Failure consensus statement. Heart failure pharmacotherapy for patients with heart failure with reduced ejection fraction and concomitant atrial fibrillation: Review of evidence and call to action

2025-10-22Journal article Open access
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datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg17:Parcerias para a Implementação dos Objetivos
dc.contributor.authorLuedde, Mark
dc.contributor.authorAgewall, Stefan
dc.contributor.authorAmbrosio, Giuseppe
dc.contributor.authorBayes‐Genis, Antoni
dc.contributor.authorBorghi, Claudio
dc.contributor.authorCerbai, Elisabetta
dc.contributor.authorDan, Gheorghe A.
dc.contributor.authorDrexel, Heinz
dc.contributor.authorFerdinandy, Péter
dc.contributor.authorGrove, Erik Lerkevang
dc.contributor.authorKaski, Juan Carlos
dc.contributor.authorKlingenberg, Roland
dc.contributor.authorMorais, João
dc.contributor.authorParker, William
dc.contributor.authorPetrie, Mark
dc.contributor.authorRocca, Bianca
dc.contributor.authorSemb, Anne Grete
dc.contributor.authorSenni, Michele
dc.contributor.authorSohns, Christian
dc.contributor.authorSulzgruber, Patrick
dc.contributor.authorTamargo, Juan
dc.contributor.authorMetra, Marco
dc.contributor.authorBöhm, Michael
dc.contributor.authorDobrev, Dobromir
dc.contributor.authorSossalla, Samuel
dc.date.accessioned2025-11-27T15:59:39Z
dc.date.available2025-11-27T15:59:39Z
dc.date.issued2025-10-22
dc.descriptionOpen Access funding enabled and organized by Projekt DEAL.
dc.descriptionReview article
dc.description.abstractHeart failure (HF) and atrial fibrillation (AF) are major global health challenges with rising prevalence and significant morbidity, mortality, and healthcare burden. Despite advances in HF management, AF remains a critical comorbidity that worsens outcomes and requires ad hoc treatment strategies, increasing the risk of non-adherence and side effects. While rhythm control strategies in AF have gained attention for their prognostic benefits in HF, the pharmacological treatment of HF in patients with AF, including the benefit of rhythm versus rate control, remains underexplored. The relationship between HF and AF lacks sufficient evidence and targeted research to assess the optimal treatment strategies. This narrative review critically examines current HF pharmacotherapy in the context of AF, focusing on the four cornerstone treatments and modifiers of prognosis for HF with reduced ejection fraction: beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/sacubitril-valsartan, aldosterone antagonists, and sodium–glucose co-transporter 2 inhibitors. Although these therapies are well-established in HF patients, their efficacy in patients with concomitant AF requires further prospective investigation. The unique challenges posed by AF, including arrhythmia-induced remodelling and cardiomyopathy, necessitate a more individually tailored treatment. We also highlight critical knowledge gaps and the need for dedicated clinical trials specifically assessing HF therapies in AF subgroups, such as paroxysmal, long-standing persistent and permanent AF, and the benefit of heart rate and rhythm control strategies. The future of precision medicine in HF-AF management lies in bridging these evidence gaps through targeted research and interdisciplinary collaboration.eng
dc.description.sponsorshipProf. Sossalla is funded by the Deutsche Forschungsgemeinschaft (DFG) through projects 471241922, 549060740, the CRC 1213 project B10N, the F. Thyssen Foundation (Az 10.19.2.026MN), and the Excellence Cluster Cardio Pulmonary Institute (CPI). Prof. Böhm is supported by the Deutsche Forschungsgemeinschaft (German Research Foundation; TTR 219, project number 322900939). Prof. Dobrev is supported by the Deutsche Forschungsgemeinschaft (Research Training Group 2989, project 517043330), National Institutes of Health (R01HL131517, R01HL136389, R01HL163277, R01HL160992, R01HL165704, R01HL164838, and R01HL176651), and European Union (large-scale integrative project MAESTRIA, No. 965286; DD). M.C. Petrie: Research funding – Boehringer Ingelheim, Roche, SQ Innovations, AstraZeneca, Novartis, Novo Nordisk, Medtronic, Boston Scientific, Pharmacosmos.
dc.identifier.citationLuedde, M., Agewall, S., Ambrosio, G., Bayes-Genis, A., Borghi, C., Cerbai, E., Dan, G.A., Drexel, H., Ferdinandy, P., Grove, E.L., Kaski, J.C., Klingenberg, R., Morais, J., Parker, W., Petrie, M.C., Rocca, B., Semb, A.G., Senni, M., Sohns, C., Sulzgruber, P., Tamargo, J., Metra, M., Böhm, M., Dobrev, D. and Sossalla, S. (2025), European Journal of Heart Failure consensus statement. Heart failure pharmacotherapy for patients with heart failure with reduced ejection fraction and concomitant atrial fibrillation: Review of evidence and call to action. Eur J Heart Fail. https://doi.org/10.1002/ejhf.70069
dc.identifier.doi10.1002/ejhf.70069
dc.identifier.eissn1879-0844
dc.identifier.issn1388-9842
dc.identifier.urihttp://hdl.handle.net/10400.8/14759
dc.language.isoeng
dc.peerreviewedyes
dc.publisherWiley
dc.relation.hasversionhttps://onlinelibrary.wiley.com/doi/10.1002/ejhf.70069?af=R
dc.relation.ispartofEuropean Journal of Heart Failure
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectAtrial fibrillation
dc.subjectCardiovascular pharmacotherapy
dc.subjectHeart failure
dc.titleEuropean Journal of Heart Failure consensus statement. Heart failure pharmacotherapy for patients with heart failure with reduced ejection fraction and concomitant atrial fibrillation: Review of evidence and call to actioneng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleEuropean Journal of Heart Failure
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameMorais
person.givenNameJoão
person.identifier.ciencia-id3614-652A-118E
person.identifier.orcid0000-0003-3406-2878
relation.isAuthorOfPublication3bc0f910-a460-461f-863a-1ca701ee597f
relation.isAuthorOfPublication.latestForDiscovery3bc0f910-a460-461f-863a-1ca701ee597f

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