HFA Cardio Talk

With Floran Sahiti, University Hospital of Wurzburg, Wurzburg - Germany and Marianna Adamo, University and Civil Hospital of Brescia, Brescia – Italy.
This episode discusses the key changes in the 2026 ESC Guidelines for the management of heart failure with Marianna Adamo, one of the Task Force chairpersons.
The conversation explores the rationale for removing HFmrEF as a separate phenotype and grouping all patients with an LVEF below 50% as HFrEF. It also covers the new emphasis on stages A to D and earlier treatment to prevent symptomatic heart failure.
It also examines diagnostic updates, including age-specific NT-proBNP cut-offs and the shift from "acute" to "decompensated" heart failure. Treatment topics include the new framework of foundational, additional and guideline-directed interventional therapies, the place of semaglutide and tirzepatide in obese patients with HFpEF, and the upgrade of LVAD to a Class I recommendation.
Finally, the episode goes behind the scenes of the consensus process, highlighting which recommendations were most debated within the Task Force.
Guideline paper: Kober L, Adamo M, Ruwald AC, et al. 2026 ESC Guidelines for the management of heart failure. Eur Heart J. Published online August 28, 2026. doi:10.1093/eurheartj/ehag100
This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Gregorio Tersalvi, Mayo Clinic, Rochester, Minnesota - USA, Lars Kober and Jawad Haider Butt, Rigshospitalet - Copenhagen University Hospital, Copenhagen - Denmark, Jolie Bruno, Inselspital, Bern University Hospital, University of Bern, Bern - Switzerland, Jorg Hausleiter, LMU University Hospital, LMU Munich, Munich - Germany, Benedikt Norbert Beer, University Medical Center Hamburg-Eppendorf, Hamburg - Germany, Marianna Adamo, University and Civil Hospital of Brescia, Brescia - Italy and Novi Yanti Sari, Siloam Hospitals Group, Jakarta - Indonesia.
In this episode, we discuss the late-breaking clinical science presented at ESC Congress 2026 in Munich, Germany.
First, Jolie Bruno interviews Lars Kober and Jawad Haider Butt on hydralazine plus isosorbide dinitrate in HFrEF, covering the results of the H-HeFT trial and of the accompanying H-ISDN meta-analysis. H-HeFT compared H-ISDN with placebo in patients with symptomatic heart failure and an ejection fraction of 40% or less, while the meta-analysis pooled three placebo-controlled trials to assess the effect of H-ISDN on mortality and heart failure events.
Next, Benedikt N. Beer interviews Jorg Hausleiter, who highlights the key findings of TRIC-I-HF, a randomised, open-label trial of transcatheter tricuspid valve repair on top of medical therapy versus medical therapy alone in patients with severe tricuspid regurgitation and heart failure.
Finally, Novi Yanti Sari interviews Marianna Adamo, who co-chaired the 2026 ESC Guidelines for the management of heart failure and outlines the main novelties of the document.
This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.
Presenter: Gregorio Tersalvi, Mayo Clinic, Rochester, Minnesota - USA
Segment 1:
Title: H-HeFT: Hydralazine-Isosorbide Dinitrate in HFrEF + H-ISDN Meta-Analysis
Results paper: not yet published
Design paper: Wiggers H, Køber L, Gislason G, et al. The DANish randomized, double-blind, placebo controlled trial in patients with chronic HEART failure (DANHEART): A 2 × 2 factorial trial of hydralazine-isosorbide dinitrate in patients with chronic heart failure (H-HeFT) and metformin in patients with chronic heart failure and diabetes or prediabetes (Met-HeFT). Am Heart J. 2021;231:137-146. doi:10.1016/j.ahj.2020.09.020
Segment 2:
Title: TRIC-I-HF (TRICuspid Intervention in Heart Failure)
Results paper: Hausleiter J, Stocker TJ, Geisler T, et al. Tricuspid-Valve Intervention in Heart Failure. N Engl J Med. Published online August 30, 2026. doi:10.1056/NEJMoa2606934
Design paper: Stocker TJ, Geisler T, Rottbauer W, et al. Rationale and design of the TRIC-I-HF-DZHK24 (TRICuspid Intervention in Heart Failure) trial. Eur J Heart Fail. 2025;27(10):1895-1904. doi:10.1002/ejhf.3795
Segment 3:
Title: Highlights from the 2026 ESC Guidelines for the management of heart failure
Guideline paper: Køber L, Adamo M, Ruwald AC, et al. 2026 ESC Guidelines for the management of heart failure. Eur Heart J. Published online August 28, 2026. doi:10.1093/eurheartj/ehag100

With Daniella Motta Da Costa Dan, Rede Meridional Hospital, Vitoria - Brazil and Linda Van Laake, University Medical Center Utrecht, Utrecht - The Netherlands. 
This episode discusses recent progress across the entire heart transplantation journey, from candidate selection to long-term follow-up.
The conversation explores how clinicians should assess increasingly complex transplant candidates, including older or frail patients and those with several comorbidities. 
It also examines new strategies to expand the donor pool, with a special focus on donation after circulatory death, extended-criteria donors, hepatitis C-positive donors, machine perfusion and improved donor–recipient matching.
Finally, the episode discusses advances in post-transplant care, including personalized immunosuppression, biomarkers, donor-derived cell-free DNA, gene-expression profiling and non-invasive graft surveillance.
This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Cornelia Margineanu, University of Medicine and Pharmacy Carol Davila, Bucharest - Romania and Holger Thiele, Heart Center Leipzig at University of Leipzig, Leipzig - Germany.
In this episode, Cornelia Margineanu interviews Holger Thiele on the practical approach to temporary mechanical circulatory support in heart failure.
Specific examples and clinical scenarios in which temporary mechanical circulatory support (MCS) should be considered, as well as when patients should be referred to tertiary centres, are discussed. The differences between various MCS devices, including their advantages and limitations, are also explored, along with the key elements of patient monitoring.
This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Gregorio Sambataro and two patients: Caius and Ulrich.
Gregorio Sambataro of the European Heart Network chats with Caius and Ulrich about their personal experiences with heart disease and their thoughts on the expanding use of artificial intelligence in healthcare. The conversation delves into important themes such as trust in technology and patients' responsibility to actively participate in their own care. It also emphasises the importance of raising awareness among healthcare professionals and the general public, as well as the fact that AI should be utilised as a supplement rather than a replacement for human decision-making.
This 2026 HFA Cardio Talk podcast AI4HF is funded by the European Union's Horizon Europe Framework under Grant Agreement No 101080430.