🫀 What happens when long-term low-dose #digoxin is suddenly withdrawn? Blinded withdrawal analysis from the #DECISION trial presented at #HeartFailure26 by Prof. Peter van der Meer: 📍Digoxin withdrawal was associated with a ~7x increase in worsening HF events over just 6 weeks 📍14 worsening HF events occurred after digoxin withdrawal vs only 2 events in placebo withdrawal 📍Withdrawal was accompanied by: ⬆️HR,⬇️ SBP, ⬆️NT-proBNP, ⬇️eGFR 📍⚠️caution when stopping long-term low-dose digoxin in pts with HF & LVEF <=50% @escardio @HFA_President @jozinetm

What I learned the hard way in #HeartFailure care? Not every setback means failure. Sometimes the missed opportunity, rejected papers, difficult case, or moment of being overlooked becomes the experience that sharpens your clinical judgment, resilience, & purpose. In our career, growth often comes quietly: 🫀listening more carefully 🫀staying curious 🫀learning from patients & your mentors 🫀building consistency 🫀showing up again Early-career setbacks can become the foundation for future impact, if we keep going🥹❤️ Fantastic panels & sharing @KlausKWitte @ARakisheva @noshreza @corneliacrm & Floran Sahiti #HFAyoung @escardio @HFA_President @jozinetm @MarcoMetra

🫀Could RAAS inhibition improve hemocompatibility outcomes in patients supported with durable #LVAD therapy? Presented by @ameeshisath at #HeartFailure26: 📍Sustained RAAS inhibitor exposure over 2 years was associated with a 33%⬇️ in hemocompatibility-related adverse events 📍Non-surgical bleeding, particularly GI bleeding, was significantly ⬇️ with RAAS inhibition 📍Outcomes appeared independent of MAP, INR, or aspirin use 📍Combination #RAAS blockade including #MRAs on top of ACE/ARB/ARNI showed greater effectiveness than single-agent RAAS inhibition alone 📍Findings were directionally consistent across both HeartMate 3 & HeartMate II, suggesting a class-level effect rather than device-specific benefit 📍These data support neurohormonal modulation as a complementary strategy alongside LVAD technology to optimize long-term outcomes @escardio @HFA_President #MCS #GDMTworks

🫀Diuretic resistance identifies a particularly high-risk HF phenotype. Insights from a post hoc analysis of TRANSFORM-HF presented by @ambarish4786 at #HeartFailure26: 📍~1 in 5 hospitalized HF patients were classified as high risk for diuretic resistance 📍High diuretic resistance risk was associated with: - 79% higher all-cause mortality - 34% higher hospitalization risk - Less improvement in KCCQ-CSS 📍Torsemide vs Furosemide effects similar across diuretic resistance risk strata 📍Loop diuretic selection alone may not overcome the adverse prognosis associated with diuretic resistance @escardio @HFA_President #DiuresisJedi

🫀#MR in #HF is far more than “mild, moderate, severe”. ⚠️Accurate MR assessment directly influences HF management & outcomes. Excellent overview by @anatimoteo46040 at #HeartFailure26 on how we should assess secondary MR in HF: 📍Mechanism matters: Ventricular vs atrial MR, differentiate early 📍MR grading must be multiparametric, Never rely on a single number alone. 📍Secondary MR is dynamic, Severity may change after: GDMT optimization, CRT, rhythm/rate control, decongestion. ⚠️Reassess before intervention decisions. 📍Multimodality imaging matters, each provide complementary information on anatomy, mechanism, ventricular remodeling, procedural suitability 📍Heart Team discussion is essential. 📍Quantitative parameters matter most when deciding advanced therapies @escardio @EACVIPresident @VictoriaDe32503 #EchoFirst #whyCMR #YesCCT #3DEcho #HeartFailure

🫀DIGIT-HF subgroup analysis presented at #HeartFailure26 by Prof. Udo Bavendiek, explored the efficacy & safety of #digitoxin in #HFrEF according to #AFib status: 📍HFrEF➕AF represented a clinically higher-risk phenotype with more comorbidities & symptoms 📍Digitoxin ⬇️ the composite of all-cause death or first HF hospitalization irrespective of AF status 📍In AF subgroups: ARR 10.5%, NNT 10 for the primary endpoints 📍The apparent benefit seemed more pronounced in patients with AF, mainly driven by reductions in all-cause mortality @escardio @HFA_President @MarcoMetra @JBauersachsMD