HFSA 2026 Recap: 5 Key Trials to Know

The Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026 in Phoenix, Arizona, brought together some of the greatest minds in cardiology to discuss major trial readouts and new research in heart failure (HF). From new screening strategies for transthyretin amyloid cardiomyopathy (ATTR-CM) to potential new treatments for hypertrophic cardiomyopathy (HCM), a plethora of exciting new data was revealed during these 4 short days.

With all of the headlines and key clinician perspectives shared during the conference, the editorial team at HCPLive has collected 5 of the most impactful trials to come out of HFSA 2026. Catch up on any major data you may have missed during the conference below:

Ratio of sTTR and NT-proBNP Change May Predict Treatment Results in ATTR-CM

An analysis of the ATTRibute-CM trial, presented by James Januzzi, MD, chief scientific officer and C. Michael Gibson Chair in Medicine at the Baim Institute for Clinical Research and Adolph Hutter Professor of Medicine at Harvard Medical School, produced a potential new biomarker for clinical outcomes in patients with ATTR-CM. Combining early measurements of transthyretin stabilization (sTTR) with later myocardial stress markers like NT-proBNP, the new biomarker ratio was strongly associated with all-cause mortality and hospitalization risks.

ACACIA-HCM Analysis Underscores Aficamten’s Effect on nHCM Outcome Measures

Aficamten has successfully improved exercise capacity, NT-proBNP, diastolic function, and other outcome measures of nonobstructive HCM, based on a new analysis of the ACACIA-HCM trial. Presented by Martin Maron, MD, medical director of the Lahey Hospital & Medical Center, these data reflect aficamten’s direct impact on peak oxygen uptake and NYHA class improvements in patients compared to placebo. This may position aficamten as the first proven medical therapy for patients with symptomatic nHCM in over half a century.

Tovinontrine Reduces NT-proBNP in HFrEF, May Have Greater Benefit at Smaller Doses

Investigational oral phosphodiesterase 9 (PDE9) inhibitor tovinontrine has indicated its capacity to reduce NT-proBNP in patients with HF with reduced ejection fraction (HFrEF), based on results from the Cycle-1-REF trial. Additionally, a post-hoc analysis of this trial revealed a potential inverse dose-response relationship, as smaller increases in cGMP corresponded to greater NT-proBNP reductions across all 3 dose levels. These data were presented by James Udelson, MD, chief of the division of cardiology at Tufts Medical Center, in tandem with the Cycle-2-PEF trial.

Tovinontrine 50 mg Improves cGMP With Minimal Effect on NT-proBNP in HFpEF

The Cycle-2-PEF trial, presented in tandem with Cycle-1-REF by James Udelson, MD, failed to achieve its primary endpoint of reducing NT-proBNP in patients with HF with preserved ejection fraction (HFpEF). However, tovinontrine was given at a dose of 50 mg, compared to the 2.5, 25, and 50 mg doses included in Cycle-1-REF. This further reinforces the inverse dose-response relationship noted in Cycle-1-REF, as this 50 mg dose saw minimal benefits in NT-proBNP despite significantly raising cGMP.

At-Home Subcutaneous Furosemide Treatment Reduces Worsening HF Hospitalizations

Early data from the ongoing Gator SCALES-WHF trial, presented by Mustafa Ahmed, MD, assistant professor of medicine in advanced heart failure and transplantation at the University of Florida, have highlighted at-home furosemide’s capacity to replace hospital-based intravenous diuresis among patients with HF. Utilizing the Lasix ONYU device, the trial has seen 21 patients administering treatment autonomously, with substantial reductions in hospitalizations or emergency room visits for HF.