Heart Failure Congress 2026 Highlights, with Manreet Kanwar, MD

Patients with advanced heart failure who are candidates for mechanical circulatory support or transplantation are frequently referred too late for meaningful intervention, limiting the benefit of available therapies.

Data presented at the 2026 Heart Failure Association of the European Society of Cardiology (HFA ESC) Congress reinforced the urgency of earlier recognition and escalation in this population. Manreet Kanwar, MD, Professor of Medicine and Division Director of Heart Failure and Pulmonary Hypertension at the University of Chicago, spoke with HCPLive about key findings from the HFA ESC Congress held in Barcelona.

A propensity-matched analysis comparing outcomes of patients enrolled in the MOMENTUM 3 left ventricular assist device (LVAD) trial against recipients in the UNOS transplant registry drew particular attention. Prior analyses had focused on patients under age 50; this iteration examined patients aged 60 to 70 and older, a group traditionally assumed to fare better with transplant. Results showed outcomes between durable LVAD and transplant were largely comparable in this age group, a finding with direct implications for shared decision-making.

The congress also featured data on digitalis in patients hospitalized with heart failure with reduced ejection fraction (HFrEF). The trial was curtailed by the COVID-19 pandemic and did not achieve statistical significance, but a trend toward reduced morbidity and mortality was observed. Additional presentations addressed systemic inflammation as a therapeutic target in heart failure, interatrial shunts in heart failure with preserved ejection fraction (HFpEF), and remote monitoring via wearable and implantable devices for earlier disease detection and patient-directed therapy adjustment.

Kanwar identified remote monitoring as the area with the greatest near-term potential to shift outcomes. Objective, patient-transmitted data can surface deterioration before clinical signs emerge, enabling earlier intervention and potentially preventing progression to end-stage disease.

For community cardiologists, 2 clinical red flags warrant referral to an advanced heart failure center: more than 2 hospitalizations for heart failure symptoms within a year, and inability to tolerate previously stable medical therapy due to declining blood pressure or worsening renal function. Earlier referral expands access not only to LVAD and transplant evaluation, but also to clinical trials and center-specific therapies not widely available outside specialized settings.