Over the last decade, the treatment of
heart failure has seen the introduction of several novel therapeutic avenues into the guidelines; however, these were mostly devoted to device
therapies. Not much has changed with regards to the pharmacological treatment of this syndrome. Serelaxin, a recombinant form of the human
peptide hormone relaxin-2, is a promising treatment candidate for patients presenting with acute
heart failure. The
Relaxin in Acute
Heart Failure (RELAX-AHF) trial has shown beneficial effects in terms of relief of
dyspnea and congestion in these patients. Even beneficial effects on short-term survival were reported. Another treatment approach to acute
heart failure was pursued in the Cardiorenal Rescue Study in Acute Decompensated
Heart Failure (CARRESS-HF) trial but the ultrafiltration used here lead to significantly worsened renal function as compared to standard pharmacologic care. Multicenter Automatic
Defibrillator Implantation Trial - Reduce Inappropriate
Therapy (MADIT-RIT) randomized patients with
heart failure with a primary preventive indication for the implantation of an
implantable cardioverter defibrillator to one of three algorithms for anti-
tachycardia pacing (
ATP) and
shock. The authors found that initiation of such
therapies only at higher heart rates than commonly used as threshold and longer time delays before the initiation of
therapy may have two big advantages: the more conservative algorithms lead to a significant reduction in the cumulative probability of first inappropriate
therapy and, even more striking, a reduced probability of death during follow-up. Biventricular versus Right Ventricular Pacing in Patients with
Left Ventricular Dysfunction and
Atrioventricular Block (BLOCK-HF) showed beneficial outcomes for
cardiac resynchronization therapy in
heart failure patients with a mere pacemaker indication. Other studies discussed here embraced the course of body wasting, particularly
cachexia, and muscle wasting in patients with
heart failure and the influence of eating behavior.