Moving the Needle in Medicine: Mentorship, Teams, and Heart Failure Leadership, With Robert Mentz, MD

Mentorship and team-based infrastructure may matter as much as new therapies in heart failure, where clinicians face persistent trial recruitment barriers and a thin pipeline of trainees entering the subspecialty.

On a recent episode of Moving the Needle in Medicine, host Alex Hajduczok, MD, of Oklahoma Heart Institute, spoke with Robert J. Mentz, MD, of Duke University. Mentz leads the Duke heart failure section and serves as co-editor-in-chief of the Journal of Cardiac Failure (JCF). The discussion traced his path from clinical trialist to section chief and journal editor.

Enrollment in US heart failure trials remains a structural problem, even as patients carry high residual risk despite guideline-directed medical therapy (GDMT). Eligible patients often seem plentiful until a trial opens, and junior site investigators frequently struggle to enroll. Heart Failure Collaboratory initiatives focused on recruitment and appropriate site incentivization aim to close these gaps.

Electronic consent, artificial intelligence, and electronic health record screening will likely support future enrollment, but site-level teams and skilled coordinators remain the core of successful research. Mentz argued no clinician leader can succeed without an operational partner whose skills complement their own. Neutral trials at the American Heart Association Scientific Sessions, including studies of inflammation and lipoprotein(a) modification, may inform future trial design as much as positive results.

The same mentorship model has shaped JCF, where the impact factor rose from roughly 4 in 2020 to 10.0 in its most recent release. A peer review mentorship program trains junior investigators and trainees, easing reviewer fatigue while building the next generation of reviewers. Current priorities include faster turnaround, a better author experience, and transparent policies on AI use.

Partnerships with cardiothoracic surgeons remain central to advanced heart failure care, with Duke's surgical group performing roughly 150 transplants this year. Bidirectional responsiveness, direct communication, and shared ownership of pre- and postoperative care sustain these relationships.

Workforce concerns persist, partly because early training exposure centers on transplant and ventricular assist devices rather than the full scope of heart failure management. Elevating peers, avoiding comparison, and deliberately recognizing individual successes may help counter burnout among trainees and early-career faculty. Collectively, the discussion frames mentorship and team building as practical levers for strengthening both heart failure research capacity and the subspecialty workforce.

Editors’ Note: Hajduczok reports disclosures with CVRx, Edwards Lifesciences, and Impulse Dynamics. Mentz reports disclosures with Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, and others.