Leo M. A. Heunks, Mehmet Yilmaz, Cândida Fonseca, Gerhard Pölzl, Bojan Vrtovec, Pentti Põder, Tuvia Ben Gal, Alexandre Mebazaa, Alexander Parkhomenko, John Parissis, Sundeep Kaul, Alexandr A. Eremenko, Jacek Kubica, Visnja Ivancan, Trygve Husebye, Josep Comín-Colet, Matthias Heringlake, Vladimir Cerny, Zoltán Papp, Dimitrios Farmakis, Antoine Herpain, Veli-Pekka Harjola, Dominique Bettex, Henning Mølgaard, Piero Pollesello, Kristian Karason, Francesco Fedele, HUS Emergency Medicine and Services, Department of Diagnostics and Therapeutics, University of Helsinki, University of Zurich, Pollesello, Piero, Intensive care medicine, and ACS - Pulmonary hypertension & thrombosis
Both acute and advanced heart failure are an increasing threat in term of survival, quality of life and socio-economical burdens. Paradoxically, the use of successful treatments for chronic heart failure can prolong life but—per definition—causes the rise in age of patients experiencing acute decompensations, since nothing at the moment helps avoiding an acute or final stage in the elderly population. To complicate the picture, acute heart failure syndromes are a collection of symptoms, signs and markers, with different aetiologies and different courses, also due to overlapping morbidities and to the plethora of chronic medications. The palette of cardio-and vasoactive drugs used in the hospitalization phase to stabilize the patient’s hemodynamic is scarce and even scarcer is the evidence for the agents commonly used in the practice (e.g. catecholamines). The pipeline in this field is poor and the clinical development chronically unsuccessful. Recent set backs in expected clinical trials for new agents in acute heart failure (AHF) (omecamtiv, serelaxine, ularitide) left a field desolately empty, where only few drugs have been approved for clinical use, for example, levosimendan and nesiritide. In this consensus opinion paper, experts from 26 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Israel, Italy, The Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, Turkey, U.K. and Ukraine) analyse the situation in details also by help of artificial intelligence applied to bibliographic searches, try to distil some lesson-learned to avoid that future projects would make the same mistakes as in the past and recommend how to lead a successful development project in this field in dire need of new agents., SCOPUS: re.j, info:eu-repo/semantics/published