Several recent studies highlight evolving challenges and opportunities in heart failure care, particularly at the intersection of oncology, advanced imaging, and systems-based management, according to a November 2025 editorial review in the European Journal of Heart Failure. The review was led by Mert Tokcan, MD, of Saarland University Hospital.
Heart Failure in Patients with Prior Malignancy
Data from the Swedish Heart Failure Registry show that nearly one in five heart failure (HF) patients also had a history of cancer diagnosed more than 2 years prior to HF onset. Compared with patients without prior malignancy, these patients experienced higher all-cause mortality and noncardiovascular death, while rates of cardiovascular death and HF hospitalization were similar. Notably, patients with HF with reduced ejection fraction and prior malignancy were less likely to receive guideline-directed medical therapy, including device therapy. Researchers emphasized the need for integrated cardio-oncology care and improved representation of this population in HF trials.
Echocardiographic Features of Cardiac Wasting in Advanced Cancer
A prospective study of hospitalized patients with advanced cancer identified a distinct echocardiographic phenotype associated with cardiac wasting. Patients with reduced left ventricular mass demonstrated smaller chamber volumes, lower stroke volume, and reduced cardiac output, despite preserved left ventricular ejection fraction and global longitudinal strain. Clinically, these patients exhibited HF-like symptoms, hypotension, anemia, and compensatory tachycardia. The researchers suggested that longitudinal loss of left ventricular mass may represent a clinically relevant marker in cardio-oncology studies, although its prognostic role independent of systemic cachexia remains unclear.
Sacubitril/Valsartan for Prevention of Cancer Therapy–Related Cardiac Dysfunction
In a phase 2 randomized controlled trial involving patients receiving adjuvant therapy for early breast cancer, low-dose sacubitril/valsartan was associated with a lower incidence of cancer therapy–related cardiac dysfunction compared with standard care over 12 months. Outcomes were driven by prevention of subclinical declines in global longitudinal strain. Adverse events were infrequent, with hypotension leading to treatment discontinuation in a small number of patients. However, the researchers noted that larger, multicenter trials are needed to confirm these findings and define patient selection.
Hospital Volume and Outcomes in Cardiogenic Shock
A nationwide German analysis found that treatment at high-volume centers was associated with lower in-hospital mortality among patients with cardiogenic shock and those receiving mechanical circulatory support. Survival benefit increased with center experience up to defined thresholds, supporting regionalized hub-and-spoke care models for cardiogenic shock management.
Conclusion
Combined, the review noted how all of these recent studies highlight the importance of multidisciplinary care, refined phenotyping, and system-level organization to improve outcomes across diverse HF populations.