JACC Heart Failure Editor's Update, October 2019
October 2019 JACC: Heart Failure—Mini-Focus Issue: Heart Failure and Pulmonary Conditions
How can we improve outcomes for patients with heart failure and chronic obstructive pulmonary disease (COPD)? This state-of-the-art review looks at diagnostic and therapeutic practices. Heart failure and COPD frequently coincide. Marco Canepa and colleagues identify gaps in diagnosis and treatment in this patient population and discuss the possible impact of using more precise tools to diagnose COPD, implementing guideline directed therapy for heart failure, and promoting better cross-discipline collaboration to decrease hospitalization and mortality.
Diagnostic and Therapeutic Gaps in Patients With Heart Failure and Chronic Obstructive Pulmonary Disease
Marco Canepa, Stephan Rosenkranz, et al.
More precise measurement of pulmonary congestion may help in guiding therapy and predicting risk. Elke Platz and colleagues examined B-line measurements obtained through lung ultrasound to determine the prognostic significance of the number of B-lines in advanced heart failure patients.
Lung Ultrasound in Acute Heart Failure: Prevalence of Pulmonary Congestion and Short- and Long-Term Outcomes
Elke Platz, John J.V. McMurray, et al.
Health related quality of life (HRQL) is of critical importance to heart failure patients and an increasingly important measure for regulators and payers. Most studies of the adverse impact of heart failure on HRQL were in HFrEF patients. Understanding HRQL and its clinical coordinates in the HFpEF patient population is particularly important because of the global burden of the disease and lack of effective therapeutic options. Alvin Chandra and colleagues add to our knowledge of this area through their analysis of data from the PARAGON-HF trial.
Health-Related Quality of Life in Heart Failure With Preserved Ejection Fraction: The PARAGON-HF Trial
Alvin Chandra, Scott D. Solomon, et al.
Neurohormonal antagonists or ICDs—which treatment option is best to prevent sudden cardiac death in heart failure patients? This Point/Counterpoint addresses both sides of this important issue. Milton Packer argues for timely comprehensive neurohormonal blockade to minimize the risk of sudden death and possibly obviate the need for an ICD while Adam DeVore and Sana Al-Khatib present the case for the multipronged approach to therapy recommended in the guidelines with the ICD continuing to play a substantial role.
ICDs Are Still an Effective Therapy to Prevent Sudden Cardiac Death in Heart Failure
Adam D. DeVore, Sana M. Al-Khatib
Heart Failure Hall of Fame—Getting to Know the Pioneers Who Inspire Us
Our Heart Failure Hall of Fame series brings information about leaders in the field of heart failure beyond their publications and extensive work. This month we feature Professor Aldo Pietro Maggioni. Professor Maggioni is Director of the Research Center of the Italian Association of Hospital Cardiologists (ANMCO), a member of the coordinating center of the GISSI studies, and author of close to 600 papers. He serves on the editorial boards of Journal of Cardiovascular Medicine, Cardiovascular Drugs and Therapeutics, International Journal of Cardiology, European Heart Journal, and European Journal of Heart Failure, and has been included in the list of the highly cited researchers over the last 15 years (2003-2018) by Thomson Reuters. His professional and research interests include clinical trial methodology, controlled evaluation of fibrinolytic and antithrombotic agents, management of acute myocardial infarction and acute/chronic heart failure, clinical epidemiology of myocardial infarction and heart failure, and appropriate use of resources in cardiovascular diseases.
What first made you interested in a career in heart failure?
- The fact that the patients with HF in the 80s were not considered very interesting by most cardiologists.
- The fact that for the first time in those years, RCTs with outcomes events as primary endpoints started to be conducted.
- The fact that during my practice, I had the opportunity to see a huge number of patients with acute and very severe chronic HF.
Which of your many accomplishments are you most proud of?
I started a registry in 1995 that is still ongoing, collecting data (in a large and representative Italian cardiology setting) describing the clinical epidemiology, the pharmacological/nonpharmacological treatments and the outcomes of patients with HF (both chronic and acute). The availability of these data gives the opportunity to measure how the patients' characteristics and morbidity/mortality are changing over time. I am very proud to see that the collaborative work of Italian cardiologists, guided by the ANMCO research center directed by me, was associated with a clear decrease in mortality and hospitalizations in patients with HF, at least of those with reduced EF.
I also had the opportunity to start and serve as the first chairman of the European registry on HF promoted by the European Society of Cardiology.
Who inspires you, in your career or otherwise?
My most important mentors have been Gianni Tognoni (for epidemiology and methodology of research) and Fausto Rovelli and Luigi Tavazzi (for the clinical research).
What is your favorite, or last book you read?
My favorite book is Six Memos for the Next Millennium (Lezioni Americane in Italian) by Italo Calvino. The last book that I read is Memory of Fire by Edoardo Galeano.
3 Things People May Not Know About Me
- I am a wine producer. I have 4 hectares of vineyards in Monferrato, Piedmont. I produce Pinot Noir, Grignolino, Barbera, and Sauvignon. This is my preferred hobby.
- I am a fan of Inter FC, the soccer team of my city. I try to never miss a game when they play in Milano. I regularly go to the stadium with my son, Paolo.
- I like to see and hear the noise of Milanese trams. They are the symbol of Milan and remind me of my father who worked as a tram driver.
Learn More about Dr. Maggioni
Professor Aldo Maggioni is Director of the Research Center of the Italian Association of Hospital Cardiologists (ANMCO) in Florence. He is also a member of the coordinating center of the GISSI studies (Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico) in collaboration with the Mario Negri Institute for Pharmacological Research in Milan.
He received his medical degree in 1974 from the University of Milan School of Medicine, Italy, where he subsequently completed his fellowship in internal medicine. He undertook a residency in cardiology at the University of Padua (1975-1978) before becoming a clinical cardiologist at the General Hospital ‘G. Fornaroli’ and progressing to Vice-Head of the Division of Cardiology at G. Fornaroli and, later, of the Division of Cardiology at the General Hospital Fatebenefratelli ed Oftalmico, both in Milan. He was Secretary of the Heart Failure Association and Scientific Coordinator of the EORP registries of the ESC (2010-2016).
Professor Maggioni’s professional and research interests include clinical trial methodology, controlled evaluation of fibrinolytic and antithrombotic agents, management of acute myocardial infarction and acute/chronic heart failure, clinical epidemiology of myocardial infarction and heart failure, and appropriateness of use of resources in cardiovascular diseases.
He has served on the steering committees, event evaluation committees, and data and safety monitoring boards of more than 60 clinical trials in the fields of arrhythmias, myocardial infarction, unstable angina, secondary prevention, stroke, diabetes, and heart failure.
Professor Maggioni is the author of close to 600 papers in peer-reviewed journals. He is also a member of the editorial boards of the following journals: Journal of Cardiovascular Medicine, Cardiovascular Drugs and Therapeutics, International Journal of Cardiology, European Heart Journal, and European Journal of Heart Failure, and has been included in the list of the highly cited researchers over the last 15 years (2003-2018) by Thomson Reuters.