{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T16:59:48Z","timestamp":1778691588846,"version":"3.51.4"},"reference-count":98,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Heart failure (HF) is a growing issue in developed countries; it is often the result of underlying processes such as ischemia, hypertension, infiltrative diseases or even genetic abnormalities. The great majority of the affected patients present a reduced ejection fraction (\u226440%), thereby falling under the name of \u201cheart failure with reduced ejection fraction\u201d (HFrEF). This condition represents a major threat for patients: it significantly affects life quality and carries an enormous burden on the whole healthcare system due to its high management costs. In the last decade, new medical treatments and devices have been developed in order to reduce HF hospitalizations and improve prognosis while reducing the overall mortality rate. Pharmacological therapy has significantly changed our perspective of this disease thanks to its ability of restoring ventricular function and reducing symptom severity, even in some dramatic contexts with an extensively diseased myocardium. Notably, medical therapy can sometimes be ineffective, and a tailored integration with device technologies is of pivotal importance. Not by chance, in recent years, cardiac implantable devices witnessed a significant improvement, thereby providing an irreplaceable resource for the management of HF. Some devices have the ability of assessing (CardioMEMS) or treating (ultrafiltration) fluid retention, while others recognize and treat life-threatening arrhythmias, even for a limited time frame (wearable cardioverter defibrillator). The present review article gives a comprehensive overview of the most recent and important findings that need to be considered in patients affected by HFrEF. Both novel medical treatments and devices are presented and discussed.<\/jats:p>","DOI":"10.3390\/jcdd11040125","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T08:44:31Z","timestamp":1713516271000},"page":"125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Novel Medical Treatments and Devices for the Management of Heart Failure with Reduced Ejection Fraction"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7969-7428","authenticated-orcid":false,"given":"Michele","family":"Alfieri","sequence":"first","affiliation":[{"name":"Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital \u201cUmberto I-Lancisi-Salesi\u201d, 60121 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2431-3573","authenticated-orcid":false,"given":"Filippo","family":"Bruscoli","sequence":"additional","affiliation":[{"name":"Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, 63100 Ascoli Piceno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6572-4590","authenticated-orcid":false,"given":"Luca","family":"Di Vito","sequence":"additional","affiliation":[{"name":"Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, 63100 Ascoli Piceno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Di Giusto","sequence":"additional","affiliation":[{"name":"Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, 63100 Ascoli Piceno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarla","family":"Scalone","sequence":"additional","affiliation":[{"name":"Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, 63100 Ascoli Piceno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2677-9214","authenticated-orcid":false,"given":"Procolo","family":"Marchese","sequence":"additional","affiliation":[{"name":"Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, 63100 Ascoli Piceno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Delfino","sequence":"additional","affiliation":[{"name":"Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, 63100 Ascoli Piceno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Silenzi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, 63100 Ascoli Piceno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milena","family":"Martoni","sequence":"additional","affiliation":[{"name":"Medical School, Universit\u00e0 degli Studi \u201cG. d\u2019Annunzio\u201d, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Guerra","sequence":"additional","affiliation":[{"name":"Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital \u201cUmberto I-Lancisi-Salesi\u201d, 60121 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierfrancesco","family":"Grossi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, 63100 Ascoli Piceno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1038\/nrcardio.2016.25","article-title":"Epidemiology and aetiology of heart failure","volume":"13","author":"Ziaeian","year":"2016","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1007\/s40265-023-01887-4","article-title":"Guideline-Directed Medical Therapy for the Treatment of Heart Failure with Reduced Ejection Fraction","volume":"83","author":"Patel","year":"2023","journal-title":"Drugs"},{"key":"ref_3","first-page":"1167","article-title":"2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure","volume":"69","author":"Ponikowski","year":"2016","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","article-title":"Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes","volume":"373","author":"Zinman","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1056\/NEJMoa1611925","article-title":"Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes","volume":"377","author":"Neal","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1056\/NEJMoa1812389","article-title":"Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes","volume":"380","author":"Wiviott","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/dom.13126","article-title":"Why do SGLT2 inhibitors reduce heart failure hospitalization? A differential volume regulation hypothesis","volume":"20","author":"Hallow","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1038\/s41569-020-0406-8","article-title":"SGLT2 inhibitors: Mechanisms of cardiovascular benefit beyond glycaemic control","volume":"17","author":"Cowie","year":"2020","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1111\/dom.13124","article-title":"Dapagliflozin in patients with type 2 diabetes mellitus: A pooled analysis of safety data from phase IIb\/III clinical trials","volume":"20","author":"Jabbour","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/s11897-021-00529-8","article-title":"SGLT2 Inhibitors and Their Mode of Action in Heart Failure-Has the Mystery Been Unravelled?","volume":"18","author":"Pabel","year":"2021","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1002\/ejhf.1328","article-title":"Empagliflozin directly improves diastolic function in human heart failure","volume":"20","author":"Pabel","year":"2018","journal-title":"Eur. J. Heart Fail."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s10557-017-6734-1","article-title":"Empagliflozin Improves Left Ventricular Diastolic Dysfunction in a Genetic Model of Type 2 Diabetes","volume":"31","author":"Hammoudi","year":"2017","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3231","DOI":"10.1002\/jcp.26760","article-title":"Sodium-glucose cotransporter inhibitors and oxidative stress: An update","volume":"234","author":"Yaribeygi","year":"2019","journal-title":"J. Cell. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s10557-017-6725-2","article-title":"SGLT-2 Inhibition with Dapagliflozin Reduces the Activation of the Nlrp3\/ASC Inflammasome and Attenuates the Development of Diabetic Cardiomyopathy in Mice with Type 2 Diabetes. Further Augmentation of the Effects with Saxagliptin, a DPP4 Inhibitor","volume":"31","author":"Ye","year":"2017","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1002\/ejhf.1473","article-title":"Sodium-glucose co-transporter 2 inhibition with empagliflozin improves cardiac function in non-diabetic rats with left ventricular dysfunction after myocardial infarction","volume":"21","author":"Yurista","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Hou, Y.C., Zheng, C.M., Yen, T.H., and Lu, K.C. (2020). Molecular Mechanisms of SGLT2 Inhibitor on Cardiorenal Protection. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21217833"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1161\/CIRCULATIONAHA.113.005081","article-title":"Renal hemodynamic effect of sodium-glucose cotransporter 2 inhibition in patients with type 1 diabetes mellitus","volume":"129","author":"Cherney","year":"2014","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1056\/NEJMoa1911303","article-title":"Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction","volume":"381","author":"McMurray","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1001\/jamacardio.2022.3736","article-title":"Effect of Dapagliflozin on Cause-Specific Mortality in Patients with Heart Failure Across the Spectrum of Ejection Fraction: A Participant-Level Pooled Analysis of DAPA-HF and DELIVER","volume":"7","author":"Desai","year":"2022","journal-title":"JAMA Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1111\/dom.14015","article-title":"Empagliflozin reduces the risk of mortality and hospitalization for heart failure across Thrombolysis in Myocardial Infarction Risk Score for Heart Failure in Diabetes categories: Post hoc analysis of the EMPA-REG OUTCOME trial","volume":"22","author":"Verma","year":"2020","journal-title":"Diabetes Obes. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1056\/NEJMoa2022190","article-title":"Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure","volume":"383","author":"Packer","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1016\/j.jacc.2021.12.011","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"79","author":"Heidenreich","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1002\/ejhf.2720","article-title":"Soluble guanylate cyclase stimulators in patients with heart failure with reduced ejection fraction across the risk spectrum","volume":"24","author":"Butler","year":"2022","journal-title":"Eur. J. Heart Fail."},{"key":"ref_25","first-page":"359","article-title":"Vericiguat in heart failure: From scientific evidence to clinical practice","volume":"222","author":"Manzano","year":"2022","journal-title":"Rev. Clin. Esp."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.cardfail.2022.10.431","article-title":"Practical Patient Care Considerations with Use of Vericiguat after Worsening Heart Failure Events","volume":"29","author":"Rao","year":"2023","journal-title":"J. Card. Fail."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2458","DOI":"10.1111\/cts.13677","article-title":"Vericiguat, a novel sGC stimulator: Mechanism of action, clinical, and translational science","volume":"16","author":"Trujillo","year":"2023","journal-title":"Clin. Transl. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Sahana, U., Wehland, M., Simonsen, U., Schulz, H., and Grimm, D. (2023). A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241411826"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1056\/NEJMoa1915928","article-title":"Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction","volume":"382","author":"Armstrong","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1002\/ejhf.2836","article-title":"Effect of vericiguat on left ventricular structure and function in patients with heart failure with reduced ejection fraction: The VICTORIA echocardiographic substudy","volume":"25","author":"Pieske","year":"2023","journal-title":"Eur. J. Heart Fail."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4901","DOI":"10.1093\/eurheartj\/ehab670","article-title":"Corrigendum to: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gheorghiade, M., Shah, A.N., Vaduganathan, M., Butler, J., Bonow, R.O., Rosano, G.M., Taylor, S., Kupfer, S., Misselwitz, F., and Sharma, A. (2013). Recognizing hospitalized heart failure as an entity and developing new therapies to improve outcomes: Academics\u2019, clinicians\u2019, industry\u2019s, regulators\u2019, and payers\u2019 perspectives. Heart Fail. Clin., 9.","DOI":"10.1016\/j.hfc.2013.05.002"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1409077","article-title":"Angiotensin-neprilysin inhibition versus enalapril in heart failure","volume":"371","author":"McMurray","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/S0140-6736(10)61198-1","article-title":"Ivabradine and outcomes in chronic heart failure (SHIFT): A randomised placebo-controlled study","volume":"376","author":"Swedberg","year":"2010","journal-title":"Lancet"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1093\/eurheartj\/ehaa1012","article-title":"Heart failure drug treatment: The fantastic four","volume":"42","author":"Bauersachs","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1161\/CIRCULATIONAHA.120.052926","article-title":"How Should We Sequence the Treatments for Heart Failure and a Reduced Ejection Fraction?: A Redefinition of Evidence-Based Medicine","volume":"143","author":"McMurray","year":"2021","journal-title":"Circulation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1002\/ejhf.2149","article-title":"Rapid evidence-based sequencing of foundational drugs for heart failure and a reduced ejection fraction","volume":"23","author":"Packer","year":"2021","journal-title":"Eur. J. Heart Fail."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1007\/s10741-023-10325-2","article-title":"Guideline-directed medical therapy for HFrEF: Sequencing strategies and barriers for life-saving drug therapy","volume":"28","author":"Malgie","year":"2023","journal-title":"Heart Fail. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1002\/ejhf.2206","article-title":"Patient profiling in heart failure for tailoring medical therapy. A consensus document of the Heart Failure Association of the European Society of Cardiology","volume":"23","author":"Rosano","year":"2021","journal-title":"Eur. J. Heart Fail."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1002\/ejhf.1594","article-title":"Survival of patients with chronic heart failure in the community: A systematic review and meta-analysis","volume":"21","author":"Jones","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"418","DOI":"10.21037\/atm.2019.07.53","article-title":"CardioMEMS: Where we are and where can we go?","volume":"7","author":"Hana","year":"2019","journal-title":"Ann. Transl. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"263","DOI":"10.21037\/cdt-20-302","article-title":"Pathophysiology of heart failure","volume":"11","author":"Schwinger","year":"2021","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/0002-9149(79)90217-0","article-title":"Atrial reflexes and renal function","volume":"44","author":"Linden","year":"1979","journal-title":"Am. J. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1161\/01.CIR.86.6.1929","article-title":"Control of sympathetic nerve activity by vagal mechanoreflexes is blunted in heart failure","volume":"86","author":"Thames","year":"1992","journal-title":"Circulation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1161\/01.HYP.30.2.168","article-title":"Intrarenal determinants of sodium retention in mild heart failure: Effects of angiotensin-converting enzyme inhibition","volume":"30","author":"Volpe","year":"1997","journal-title":"Hypertension"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/S0140-6736(11)60101-3","article-title":"Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: A randomised controlled trial","volume":"377","author":"Abraham","year":"2011","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0140-6736(15)00723-0","article-title":"Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: Complete follow-up results from the CHAMPION randomised trial","volume":"387","author":"Abraham","year":"2016","journal-title":"Lancet"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.jchf.2015.11.011","article-title":"Interventions Linked to Decreased Heart Failure Hospitalizations During Ambulatory Pulmonary Artery Pressure Monitoring","volume":"4","author":"Costanzo","year":"2016","journal-title":"JACC Heart Fail."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/S0140-6736(21)01754-2","article-title":"Haemodynamic-guided management of heart failure (GUIDE-HF): A randomised controlled trial","volume":"398","author":"Lindenfeld","year":"2021","journal-title":"Lancet"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Writing Committee Members, and ACC\/AHA Joint Committee Members (2022). 2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure. J. Card. Fail., 28, e1\u2013e167.","DOI":"10.1016\/j.cardfail.2022.03.346"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1002\/ejhf.1943","article-title":"Pulmonary artery pressure-guided therapy in ambulatory patients with symptomatic heart failure: The CardioMEMS European Monitoring Study for Heart Failure (MEMS-HF)","volume":"22","author":"Angermann","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1002\/ejhf.1234","article-title":"Incremental benefit of drug therapies for chronic heart failure with reduced ejection fraction: A network meta-analysis","volume":"20","author":"Komajda","year":"2018","journal-title":"Eur. J. Heart Fail."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"121","DOI":"10.23736\/S0026-4806.18.05861-5","article-title":"Cardiac resynchronization therapy: A comprehensive review","volume":"110","author":"Moskovitch","year":"2019","journal-title":"Minerva Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.hfc.2021.05.005","article-title":"Cardiac Resynchronization Therapy and Cardiac Contractility Modulation in Patients with Advanced Heart Failure: How to Select the Right Candidate?","volume":"17","author":"Abraham","year":"2021","journal-title":"Heart Fail. Clin."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2217\/fca-2019-0044","article-title":"Optimizer Smart in the treatment of moderate-to-severe chronic heart failure","volume":"16","author":"Campbell","year":"2020","journal-title":"Future Cardiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s10741-020-10030-4","article-title":"Cardiac contractility modulation for patient with refractory heart failure: An updated evidence-based review","volume":"26","author":"Cappannoli","year":"2021","journal-title":"Heart Fail. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1002\/ejhf.1374","article-title":"Cardiac contractility modulation improves long-term survival and hospitalizations in heart failure with reduced ejection fraction","volume":"21","author":"Anker","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.ijcard.2015.10.208","article-title":"Cardiac contractility modulation signals improve exercise intolerance and maladaptive regulation of cardiac key proteins for systolic and diastolic function in HFpEF","volume":"203","author":"Tschope","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1038\/nrcardio.2013.114","article-title":"Cardiac contractility modulation therapy in advanced systolic heart failure","volume":"10","author":"Lyon","year":"2013","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.ijcard.2018.10.086","article-title":"Cardiac contractility modulation treatment in patients with symptomatic heart failure despite optimal medical therapy and cardiac resynchronization therapy (CRT)","volume":"277","author":"Kuschyk","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Tint, D., Florea, R., and Micu, S. (2019). New Generation Cardiac Contractility Modulation Device-Filling the Gap in Heart Failure Treatment. J. Clin. Med., 8.","DOI":"10.3390\/jcm8050588"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Marchese, P., Gennaro, F., Mazzotta, G., Acciarri, C., Amabili, S., Bonanni, C., D\u2019Antonio, A., Delfino, D., Di Vito, L., and Partemi, M. (2023). Cardiac Contractility Modulation Therapy in Patients with Amyloid Cardiomyopathy and Heart Failure, Case Report, Review of the Biophysics of CCM Function, and AMY-CCM Registry Presentation. J. Clin. Med., 12.","DOI":"10.3390\/jcm12031184"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1002\/ejhf.1349","article-title":"Cardiac contractility modulation: Mechanisms of action in heart failure with reduced ejection fraction and beyond","volume":"21","author":"Tschope","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2120","DOI":"10.1016\/j.jacc.2006.10.082","article-title":"Therapy with cardiac contractility modulation electrical signals improves left ventricular function and remodeling in dogs with chronic heart failure","volume":"49","author":"Imai","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s10741-007-9034-1","article-title":"Return to the fetal gene program protects the stressed heart: A strong hypothesis","volume":"12","author":"Rajabi","year":"2007","journal-title":"Heart Fail. Rev."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/jcp.21198","article-title":"A mechanism for stimulation of biosynthesis by electromagnetic fields: Charge transfer in DNA and base pair separation","volume":"214","author":"Blank","year":"2008","journal-title":"J. Cell. Physiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/ehf2.14575","article-title":"Enhancing myocardial function with cardiac contractility modulation: Potential and challenges","volume":"11","author":"Li","year":"2024","journal-title":"ESC Heart Fail."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.hroo.2023.06.011","article-title":"Left bundle branch area pacing vs biventricular pacing for cardiac resynchronization: A systematic review and meta-analysis","volume":"4","author":"Yousaf","year":"2023","journal-title":"Heart Rhythm O2"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1093\/europace\/euad044","article-title":"EHRA clinical consensus statement on conduction system pacing implantation: Executive summary. Endorsed by the Asia-Pacific Heart Rhythm Society (APHRS), Canadian Heart Rhythm Society (CHRS) and Latin-American Heart Rhythm Society (LAHRS)","volume":"25","author":"Burri","year":"2023","journal-title":"Europace"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.hrthm.2023.11.003","article-title":"An individualized criterion for left bundle branch capture in patients with a narrow QRS complex","volume":"21","author":"Li","year":"2024","journal-title":"Heart Rhythm"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1161\/CIRCULATIONAHA.123.067465","article-title":"Arrhythmic Risk in Biventricular Pacing Compared with Left Bundle Branch Area Pacing: Results from the I-CLAS Study","volume":"149","author":"Herweg","year":"2024","journal-title":"Circulation"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.jacep.2021.04.005","article-title":"Left Bundle Branch Pacing Optimized Cardiac Resynchronization Therapy: A Novel Approach","volume":"7","author":"Vijayaraman","year":"2021","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e004512","DOI":"10.1161\/JAHA.116.004512","article-title":"Avoiding Untimely Implantable Cardioverter\/Defibrillator Implantation by Intensified Heart Failure Therapy Optimization Supported by the Wearable Cardioverter\/Defibrillator-The PROLONG Study","volume":"6","author":"Duncker","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1007\/s00228-021-03189-8","article-title":"Effect of SAcubitril\/Valsartan on left vEntricular ejection fraction and on the potential indication for Implantable Cardioverter Defibrillator in primary prevention: The SAVE-ICD study","volume":"77","author":"Guerra","year":"2021","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1056\/NEJMoa1800781","article-title":"Wearable Cardioverter-Defibrillator after Myocardial Infarction","volume":"379","author":"Olgin","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1093\/europace\/euaa268","article-title":"Wearable cardioverter-defibrillator in patients with a transient risk of sudden cardiac death: The WEARIT-France cohort study","volume":"23","author":"Garcia","year":"2021","journal-title":"Europace"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1176710","DOI":"10.3389\/fcvm.2023.1176710","article-title":"Assessing physical activity with the wearable cardioverter defibrillator in patients with newly diagnosed heart failure","volume":"10","author":"Iliodromitis","year":"2023","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1002\/clc.23832","article-title":"Decongestive treatment adjustments in heart failure patients remotely monitored with a multiparametric implantable defibrillators algorithm","volume":"45","author":"Guerra","year":"2022","journal-title":"Clin. Cardiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1002\/clc.22638","article-title":"Trends in hospitalization for congestive heart failure, 1996\u20132009","volume":"40","author":"Munir","year":"2017","journal-title":"Clin. Cardiol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1093\/eurheartj\/eht456","article-title":"Peripheral venous congestion causes inflammation, neurohormonal, and endothelial cell activation","volume":"35","author":"Colombo","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s11897-019-0424-1","article-title":"Diuretic Resistance in Heart Failure","volume":"16","author":"Gupta","year":"2019","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1002\/ejhf.170","article-title":"Diuretic response in patients with acute decompensated heart failure: Characteristics and clinical outcome\u2014An analysis from RELAX-AHF","volume":"16","author":"Voors","year":"2014","journal-title":"Eur. J. Heart Fail."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/j.cardfail.2014.09.005","article-title":"Cardiorenal interactions in acute decompensated heart failure: Contemporary concepts facing emerging controversies","volume":"20","author":"Kazory","year":"2014","journal-title":"J. Card. Fail."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1159\/000164149","article-title":"Impact of intravenous loop diuretics on outcomes of patients hospitalized with acute decompensated heart failure: Insights from the ADHERE registry","volume":"113","author":"Peacock","year":"2009","journal-title":"Cardiology"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s10741-011-9248-0","article-title":"Treatment of congestion in heart failure with diuretics and extracorporeal therapies: Effects on symptoms, renal function, and prognosis","volume":"17","author":"Costanzo","year":"2012","journal-title":"Heart Fail. Rev."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.2215\/CJN.02910313","article-title":"Cardiorenal syndrome: Ultrafiltration therapy for heart failure\u2014Trials and tribulations","volume":"8","author":"Kazory","year":"2013","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/S0735-1097(01)01479-6","article-title":"Circulatory response to fluid overload removal by extracorporeal ultrafiltration in refractory congestive heart failure","volume":"38","author":"Marenzi","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.jacc.2006.07.073","article-title":"Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure","volume":"49","author":"Costanzo","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1056\/NEJMoa1210357","article-title":"Ultrafiltration in decompensated heart failure with cardiorenal syndrome","volume":"367","author":"Bart","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jchf.2015.08.005","article-title":"Aquapheresis versus Intravenous Diuretics and Hospitalizations for Heart Failure","volume":"4","author":"Costanzo","year":"2016","journal-title":"JACC Heart Fail."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s10741-016-9559-2","article-title":"Defining the role of ultrafiltration therapy in acute heart failure: A systematic review and meta-analysis","volume":"21","author":"Jain","year":"2016","journal-title":"Heart Fail. Rev."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/eurjpc\/zwaa015","article-title":"Sinergy between drugs and devices in the fight against sudden cardiac death and heart failure","volume":"28","author":"Boriani","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.jchf.2019.12.001","article-title":"Omecamtiv Mecarbil in Chronic Heart Failure with Reduced Ejection Fraction: Rationale and Design of GALACTIC-HF","volume":"8","author":"Teerlink","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1126\/science.1200113","article-title":"Cardiac myosin activation: A potential therapeutic approach for systolic heart failure","volume":"331","author":"Malik","year":"2011","journal-title":"Science"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"2895","DOI":"10.1016\/S0140-6736(16)32049-9","article-title":"Chronic Oral Study of Myosin Activation to Increase Contractility in Heart Failure (COSMIC-HF): A phase 2, pharmacokinetic, randomised, placebo-controlled trial","volume":"388","author":"Teerlink","year":"2016","journal-title":"Lancet"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"2793","DOI":"10.1093\/eurheartj\/ehx027","article-title":"Transitioning from usual care to biomarker-based personalized and precision medicine in heart failure: Call for action","volume":"39","author":"Voors","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1093\/eurheartj\/ehq013","article-title":"Circulating microRNA: A novel potential biomarker for early diagnosis of acute myocardial infarction in humans","volume":"31","author":"Wang","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1132680","DOI":"10.3389\/fcvm.2023.1132680","article-title":"Data processing pipeline for cardiogenic shock prediction using machine learning","volume":"10","author":"Jajcay","year":"2023","journal-title":"Front. Cardiovasc. Med."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/11\/4\/125\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:31:05Z","timestamp":1760106665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/11\/4\/125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,19]]},"references-count":98,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["jcdd11040125"],"URL":"https:\/\/doi.org\/10.3390\/jcdd11040125","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,19]]}}}