On 31 August, at this year’s European Society of Cardiology (ESC) conference, during a late-breaking science session on the topic of “Chronic Heart Failure,” Dr. Deborah Belfort presented findings of the CATHEDRAL-HF trial. Belfort focused on beta blocker, carvedilol, to highlight the progress made in the management of heart failure (HF) with improved ejection fraction (EF).

The CATHEDRAL-HF trial was an open-label randomised clinical trial to investigate carvedilol as single maintenance therapy for HF with improved EF. The findings presented at ESC showed that discontinuation of HF treatment while maintaining carvedilol could be safe in HF with improved EF regarding left ventricular EF, mortality, and hospitalisation. Exploratory outcomes at 52 weeks showed no hospitalisations, deaths, and ventricular arrhythmias, and left ventricular EF was lower in both control and intervention groups. Belfort emphasised further studies with larger sample sizes and longer follow-ups are necessary to confirm trial findings.

Belfort also presented limitations of the CATHEDRAL-HF trial, highlighting it was a small sample size and carvedilol was the only beta-blocker used in the study.

Key opinion leaders interviewed by GlobalData emphasised that a large proportion of chronic HF patients are taking suboptimal doses of relevant medications, leading to a worsening of symptoms and disease progression. Factors that contribute to this issue are not simply patient compliance and cost, but also difficulty in balancing comorbidities and adverse effects associated with the optimal dose of certain HF therapies.

HF is defined as a clinical syndrome with signs and symptoms caused by a structural or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels or objective evidence of pulmonary or systemic congestion. HF is a lifelong condition in which the heart muscle cannot pump enough blood to meet the body’s need for oxygen. Sudden or acute HF often occurs due to allergic reactions, blood clots in the lungs, severe infections, use of certain medicines, and viruses that attack the heart muscle.