Dear Colleagues,

Heart failure (HF) represents a complex clinical syndrome. The symptoms and signs of HF are due to underlying cardiac disorders that result in structural and functional abnormalities.

It is important to identify the etiology of HF so that the most appropriate clinical and therapeutic approach can be used.

Pharmacological therapy including sodium-glucose co-transporter-2 (SGLT2i) and angiotensin receptor-neprilysin inhibitor (ARNi) is recommended for patients with reduced ejection fraction HF (HFrEF). Interventions using devices should also be considered.

HF with mildly reduced ejection fraction (HFmrEF) is particularly complex and heterogeneous, and the approach to be taken remains controversial.

HF with preserved ejection fraction (HFpEF) is a leading cause of morbidity, mortality, and hospitalization. SGLT2i was recently shown to reduce the risk of cardiovascular events, particularly hospitalization due to HF.

Updates on rare diseases such as amyloidosis and Anderson-Fabry disease, as well as other cardiomyopathies that cause HF, will also be reviewed.

Atrial fibrillation (AF) has been reported to be very frequent in patients with HF. Conversely, HF is also likely to occur in patients with AF. AF is the most common supraventricular arrhythmia and its prevalence increases with age and with the presence of comorbidities. The prevalence of AF has risen significatively over the past few decades due to increases in overall lifespan and in the incidence of comorbidities. This has caused several issues with its management in terms of the therapeutic strategy (pharmacological or interventional strategy, anticoagulation therapy) and in the management of particular categories of patients with specific considerations, such as cancer patients. Additionally, it has been shown that women are more prone to develop AF due to sex-specific risk factors. Therefore, both traditional risk factors and gender-specific conditions such as pregnancy, hormonal status, and menopause should be carefully evaluated in relation to AF.

This special issue will focus on the pathophysiology, diagnosis, classification, treatment, and management of patients with HFrEF, HFmrEF, and HFpEF, as well as the clinical and therapeutic aspects of AF and AF management in all populations.

Fabiana Lucà, MD, PhD
Guest Editor