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Welcome and introduction

Frank Ruschitzka (Switzerland) and Michele Senni (Italy)

Frank Ruschitzka and Michele Senni introduce the symposium, discuss the inclusion of new treatments in the 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, and show a video of Martin Cowie and Aldo Maggioni describing their perspectives on the clinical unmet needs in heart failure treatment.



Welcome and introduction - Frank Ruschitzka and Michele Senni

Welcome and introduction - Frank Ruschitzka and Michele Senni

Frank Ruschitzka: Good afternoon, everybody. We are having a full house and that was expected, with a breakthrough therapy to be discussed the day after it has been appreciated in the new guidelines and you have seen that yesterday here.

I just see friends with whom I ran a session right now, so I see Linda and others and I felt like Sunday morning it was Church, it was a Church Mass because some of my friends, the electrophysiologists kept telling us ‘I believe! I believe!’ I said ‘Okay. We in heart failure, we know!’

We in heart failure have eight life-saving therapies, Michele. Let’s help me – ACEs, beta blockers, MRAs, now LCZ and we are not only drugs and devices, only we bring them together. Take the chip out of your head that devices are not part of ?ICD/CET/ELVET, that’s eight, so that’s great.

We wanted the test of time and benefit in an adequately powered randomised clinical trial. I don’t recall in the last decade or so in medicine having seen a more convincing and really, really powerful message delivering trial than Paradigm. That’s what we want to discuss now, how we bring this into clinical practice. This is why we are here today and I will leave it now to Michele.


Welcome and introduction

Michele Senni

Welcome to this symposium. It is a great pleasure to be here above all with Frank. We will make this symposium very interactive and I think is the aim at this time during the lunch we need someone that moves your heart.

I think we can move to the first speaker after some slides that I have to show you.


This is the programme of course.


Please mute your mobile phone.


If you have a question you can fill out these cards and give us just to read and we will try to answer.

Evaluation form

Then at the end, please give us the evaluation form of this symposium just to have your opinion.

Now let me show this movie.



Martin Cowie: I think there are some very clear needs that have not been met as yet for heart failure patients. One of them is about the transition periods, coming from living at home with a crisis into hospital and then also the transition back into the community quite often things are not done as properly as they should be.

Also I think the other unmet need is that if you are young you tend to get very good treatment for heart failure, but the older you are the less likely you are to get access to even treatments we have known that have worked for many years, so I think for me equity and also the transition periods are two very clear unmet needs.

Aldo Maggioni: In my opinion the unmet needs in heart failure treatment are mainly two. One is the treatment of patients with heart failure but with preserved ejection fraction and the other very important unmet need is the treatment of a patient with acute heart failure, for whom the mortality rate is still unacceptably high.

Martin Cowie: Both physicians and patients are looking for new developments in heart failure because patients still have symptoms, we know they are at risk of hospitalisation and that their life expectancy is reduced. It’s fantastic when new developments come along, whether they be drugs or devices or new ways of working that can make sure that patients have a better deal and actually live longer with better quality of life.

Aldo Maggioni: I think that there are several studies of course and new drugs are explored to treat the patient with acute heart failure and we have also in recent years regarding treatment for chronic heart failure.

I think that integrating this new treatment in the current available treatments, the outcome of the patient could be some way improved in the next five years.

Martin Cowie: I think the key priority is that for each physician looking after heart failure patients, they have to think about what they are responsible for, what’s working and what’s not working. To try to make sure the whole pathway is working efficiently and quickly for their patients, so that everybody gets access to rapid diagnosis and then goes on to good treatment which is modernised to reflect 2016 standards for heart failure.

Also they are encouraged to self-monitor and self-manage their heart failure so they feel empowered and involved in this and it is a partnership between the patient and their healthcare advisers.

Aldo Maggioni: The first priority in my opinion, is to apply in clinical practice what we have already available because we know that unfortunately even if we have very good treatments for heart failure, not always these treatments are applied, they are applied discontinuously and not always the possibility to obtain favourable results is achieved.

Martin Cowie: In the next five years I think it is quite clear what is going to be the major impact on improving treatment and that is giving access to new developments in both devices and drug therapy, making sure that we deliver that to everybody with heart failure, not just the young people with heart failure.

It is about equity of access to new developments and I think with the things that have been announced in the last 12 months or so, we have new techniques, we have new drugs and we have new treatments for our patients. That is going to drive improvement and better outcomes for our patients in the next five years.

Aldo Maggioni: To improve the care of heart failure patients besides applying appropriately the guidelines, what is really important is to have a multidisciplinary approach because we know that the patients with heart failure die not only from cardiovascular causes and they are hospitalised not only for cardiovascular causes. It is really necessary to have a multidisciplinary approach, in order to contain the overall burden of the disease.

Martin Cowie: One of the very important things we can do in day-to-day practice is to think every time we see a patient with heart failure as a physician or as a nurse ‘Is this patient’s treatment the best it should be, 2016 standards, not 2010 standards or earlier?’ We have to think all the time what are the patient’s problems, what are their priorities, what should we be doing, how can we make it happen, so that every encounter with somebody with heart failure should be used to optimise their treatment and care and their experience of that care.

[Video ends]

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