This article provides information and a commentary on trials relevant to the pathophysiology, prevention and treatment of
heart failure, presented at the Heart Rhythm Society meeting in San Francisco, USA and the
Heart Failure Association meeting of the European Society of Cardiology which was held in Milan, Italy in June 2008. Unpublished reports should be considered as preliminary data, as analyses may change in the final publication. The ATHENA study showed that
dronedarone reduced the incidence of the composite outcome of cardiovascular hospitalisation or death, in patients with
atrial fibrillation or flutter, 29% of whom had a history of
heart failure, compared with placebo. The URGENT study demonstrated that treatment of acute
heart failure with standard
therapy, including intravenous
diuretics and
nitrates, leads to a rapid resolution of
breathlessness in the sitting position but that orthopnoea often persists. The INH study showed that a disease management programme could reduce mortality compared to usual care but not hospitalisation rates. The HEART study failed to recruit its planned number of patients, although it is the largest randomised trial of revascularisation in
heart failure reported to date. At a median follow-up of 5 years no difference in mortality was observed but the study lacked power to provide a conclusive result. The selective
myosin activator
CK-1827452 produced a concentration dependent increase in systolic ejection time, stroke volume and fractional shortening in patients with
heart failure compared to placebo.