Integrated Multi-Omic Response to Heart Failure Reverse Remodeling with Left Ventricular Assist Device

Presenter: Xinjie Xu

This study investigated the molecular basis of reverse remodeling in advanced heart failure patients treated with left ventricular assist devices (LVADs). Using 91 human left ventricular tissue samples, researchers applied a multi-omics approach—genomics, transcriptomics, proteomics, phosphoproteomics, and radiomics—to map molecular changes.

Key findings included poor correlation between mRNA transcription and protein levels, especially for ribosome processes. Importantly, ribosome proteins (RPL19, RPS15) were linked to recovery, with restored metabolism in reverse-remodeled patients after LVAD implantation. The study identified ribosome as a predictive biomarker and therapeutic target, offering a comprehensive resource to guide personalized treatment strategies for myocardial recovery post-LVAD.

Impact of Coronary Revascularisation in Patients Undergoing Cardiovascular Magnetic Resonance for Viability Assessment

Presenter: Antoine Lequipar

This multicentric study evaluated the prognostic value of cardiovascular magnetic resonance (CMR)-guided percutaneous coronary intervention (PCI) in 6,082 patients with ischaemic cardiomyopathy (ICM) and reduced left ventricular ejection fraction (<50%). Myocardial viability was assessed using late gadolinium enhancement (LGE) transmurality.

PCI within 90 days of CMR was associated with improved survival in patients with <50% and 50–74% LGE transmurality vs. those without PCI (OR 0.58; p<0.001). PCI in patients with ≥75% myocardial LGE transmurality was not linked to better survival rates vs. those without PCI. The study supported use of CMR viability assessment to guide PCI decisions and improve long-term survival outcomes in ICM.

Assessing Impact of Home-Based Digital Cardiac Rehabilitation on Readmissions and Patient Outcomes Following Step-Down from the Acute Heart Failure Virtual Ward

Presenters: Dileep Duvva and Rajiv Sankaranarayanan

This real-world study assessed a novel digital home cardiac rehabilitation (CR) program from Heart Failure Virtual Wards (HFVW) in acute HF patients. Among 185 referred patients, 63% enrolled. Participants received wearable activity monitors, personalized dashboards, and remote mentoring.

Compared to standard care, 30- and 90-day readmission rates were significantly lower (5% vs. 21% and 9% vs. 30%, respectively; p<0.001). Patients increased daily physical activity by 31 minutes and showed improvements in quality of life (58%), mental wellbeing (74%), self-efficacy (69%), and overall scores (86%). This was the first study on the feasibility and clinical benefits of digital CR post-HFVW.

Impact of Empagliflozin on Quality-of-Life in Real-World Patients with Heart Failure: Insights from the Multinational Emp-Activity Study

Presenter: Anna Tomaszuk-Kazberuk

The Emp-Activity study evaluated real-world effects of empagliflozin (EMP) on quality of life (QoL) in 3,309 heart failure (HF) patients across six European countries.

After 24 weeks from baseline, EMP significantly improved left ventricular ejection fraction (LVEF, 42.2% vs. 44.4%), six-minute walk distance (307.1 m vs. 339.0 m), and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores (56.4 vs. 72.9). Clinically meaningful QoL improvements  (≥5 points) were observed in 73% of patients, across all HF subtypes (reduced, mildly reduced and preserved EF). These findings supported EMP’s efficacy to enhance functional capacity and QoL.

The Antifibrotic Effect of Novel Heart Failure Pharmacotherapies in Myocardial Samples of Patients Undergoing Heart Transplantation

Presenter: David Nagy

This study investigated the antifibrotic and antiremodeling effects of angiotensin receptor-neprilysin inhibitors (ARNI) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) in myocardial tissue from 93 advanced heart failure (HF) patients undergoing heart transplantation.

Patients treated with ARNI and/or SGLT2i showed significantly reduced interstitial myocardial fibrosis. As per gene expression analysis, both the therapies affected fibrosis and remodeling marker gene expressions: SGLT2i independently affected MMP9 and TIMP2, while ARNI influenced the MYH7/MYH6 ratio. These findings suggest that ARNI and SGLT2i therapies may exert direct independent myocardial antifibrotic and antiremodeling actions in HF patients undergoing heart transplantation.

MAGGIC in the Machine: Unveiling the Predictive Value of a Conventional Risk Score in the Ultra-Long LVAD Phenotype. Insights from the STELLAR Register

Presenter: Claudio Velasquez-Silva

This retrospective analysis assessed the prognostic value of MAGGIC risk score in 136 heart failure (HF) patients with ultra-long left ventricular assist device (LVAD) support.

The MAGGIC score, calculated at the 5 years (y), remained a strong predictor of mortality: higher scores (≥25) were associated with lower 1y (72.1% vs. 91.5%), 3y (38.4% vs. 76.2%), and 5y survival rates (14.3% vs. 61.3%). Each 1-point increase in score raised mortality risk by 9% (p<0.001). Patients with higher scores had distinct clinical phenotype: worse renal function, lower ejection fraction, greater hemodynamic compromise. It suggested that conventional HF risk factors remained relevant in long-term LVAD recipients.

Ref: ESC Congress 2025, 29^thAug- 1^st Sept 2025, Madrid, Spain