Interplay between medical and interventional therapies in valvular heart disease and heart failure: an expert opinion paper
Heart failure (HF) and valvular heart disease (VHD) often coexist and share complex pathophysiological pathways. Traditional management strategies follow a step-by-step approach, prioritizing guideline-directed medical therapy (GDMT) and reserving interventional (surgical or percutaneous) options only in case of persistent symptoms or worsening HF after GDMT. However, greater experience with the use of percutaneous procedures, even in high-risk patients, could support a more integrated approach, which exploits the synergistic effects of medical and interventional therapies to increase the tolerability of one vs the other, thereby improving quality of life and outcomes through their synergic effects. This expert opinion paper summarizes current data and evolving practices in the management of VHD in patients with HF, including secondary mitral regurgitation, aortic stenosis, aortic regurgitation, and tricuspid regurgitation.
Authors
- Mauro Riccardi (ORCID: https://orcid.org/0009-0009-3444-1916)
- Francesco Maisano (ORCID: https://orcid.org/0000-0002-3691-1709)
- Anna Sannino (ORCID: https://orcid.org/0000-0003-4275-8066)
- Henrike Arfsten (ORCID: https://orcid.org/0000-0002-5836-7759)
- Marco Metra (ORCID: https://orcid.org/0000-0001-6691-8568)
- Julia Grapsa (ORCID: https://orcid.org/0000-0003-4620-6234)
- Wilfried Müllens (ORCID: https://orcid.org/0000-0001-9995-8590)
- Matteo Pagnesi (ORCID: https://orcid.org/0000-0002-9298-7871)
- Abdelhamid Magdy
- Vassilis I. Barberis
- Nicole Karam
- Karl-Philipp Rommel (ORCID: https://orcid.org/0000-0002-2901-8138)
- Marianna Adamo
- Denisa Muraru
- Elena-Laura Antohi
Institutions
- Brigham and Women's Hospital (US)
- Cairo University (EG)
- Vita-Salute San Raffaele University (IT)
- University of Balamand (LB)
- Johannes Gutenberg University Mainz (DE)
- American Heart Institute (CY)
- San Raffaele University of Rome (IT)
- Institutul de Urgenţă pentru Boli Cardiovasculare "Prof.Dr. C.C. Iliescu" (RO)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Surgical Specialties (Canada) (CA)
- Mylan (South Africa) (ZA)
- Deutsches Herzzentrum der Charité (DE)
- German Centre for Cardiovascular Research (DE)
- IRCCS Istituto Auxologico Italiano (IT)
- Ziekenhuis Oost-Limburg (BE)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Istituti Ospitalieri di Cremona (IT)
- University of Milano-Bicocca (IT)
- Medical University of Vienna (AT)
- Charité - Universitätsmedizin Berlin (DE)
- University of Brescia (IT)
- Hasselt University (BE)
Publication Details
- Journal
- ESC Heart Failure
- Published
- 2026-01-08
- DOI
- https://doi.org/10.1093/eschf/xvaf027
- Primary Topic
- Cardiac Valve Diseases and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00