This is a synopsis of presentations made at the American College of Cardiology (ACC) in 2001 summarising recent research developments relating to
heart failure. Clinical studies of particular interest to physicians with an interest in
heart failure and its prevention are reviewed. The COPERNICUS trial lends further support to the use of the beta-blocker,
carvedilol, in severe
heart failure and the CAPRICORN trial to its use in patients with post-
infarction left ventricular systolic dysfunction. The MIRACLE study reinforces the evidence from three smaller trials that cardiac resynchronisation
therapy is an effective treatment for the relief of symptoms in patients with severe
heart failure and cardiac dyssynchrony. The STAF trial casts further doubt on the wisdom of
cardioversion as a routine strategy for the management of chronic
atrial fibrillation. The RITZ-2 trial suggests that an intravenous, non-selective
endothelin antagonist is effective in improving haemodynamics and symptoms and possibly in reducing morbidity in severe
heart failure. Observational studies in
heart failure suggest that a moderate excess of body fat and elevated blood
cholesterol may be desirable in patients with
heart failure, challenging the current non-evidenced-based vogue for
cholesterol lowering
therapy in
heart failure. The RENAISSANCE and RECOVER outcome studies of
etanercept, a tumour
necrosis factor (
TNF) receptor analogue that blocks the effect of TNF, were stopped because of lack of evidence of benefit shortly after the ACC.