Vol 8, No 2 (2023)
Invited editorial
Published online: 2023-06-29

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Treatment of heart failure patients — in search of new solutions to difficult problems

Aldona Kubica1
Medical Research Journal 2023;8(2):89-90.


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Medical Research Journal 2023;
Volume 8, Number 2, 89–90,
Copyright © 2023 Via Medica,
ISSN 2451-2591, e-ISSN 2451-4101

Treatment of heart failure patients — in search of new solutions to difficult problems

Aldona Kubica
Department of Cardiach Rehabilitation and Health Promotion, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

Corresponding author:

Aldona Kubica,
Department of Cardiach Rehabilitation
and Health Promotion, Collegium Medicum,
Nicolaus Copernicus University,
Bydgoszcz, Poland;
e-mail: akubica@cm.umk.pl

The 2021 Guidelines of European Society of Cardiology (ESC) for the diagnosis and treatment of acute and chronic heart failure (HF) defined three major goals of treatment: (1) reduction in mortality, (2) prevention of recurrent hospitalizations due to worsening HF, and (3) improvement in clinical status, functional capacity, and quality of life. To achieve these goals a new simplified treatment algorithm has been introduced [1]. The cornerstone of management is therapy with angiotensin-converting enzyme inhibitors (ACE-I) or an angiotensin receptor-neprilysin inhibitor (ARNI), beta-blockers (BB), mineralocorticoid receptor antagonists (MRA) and sodium-glucose co-transporter 2 inhibitors (SGLT2-I), unless the drugs are contraindicated or not tolerated (class I of recommendations) [1–4]. Moreover, importance of multidisciplinary team management, education, self-care, lifestyle advice, exercise training, follow-up, and monitoring to improve therapeutic effectiveness has been highlighted [1, 3]. Adequate patient education and lifestyle advice are pivotal for successful treatment of HF allowing the patients to understand what is beneficial, to embrace the concept of self-monitoring, to accept therapeutic plans and improve adherence to treatment [1, 5–9]. Education to improve self-care should be tailored to each individual patient and based on scientific evidence or expert opinion [1, 10–13]. The guidelines encourage application of either home-based and/or clinic-based programmes leaving space for the use of already known as well as new tools and methods to improve clinical outcomes of HF patients.

In the current issue of Medical Research Journal Kolasa et al. [14] present the rationale and design of a randomized trial of the original mindfulness-based heart training for patients with heart failure (MIND-HF trial). The study is aimed to examine the feasibility and acceptability of online-delivered Mindfulness Based Heart Training (MBHT) in comparison to psychoeducational intervention in HF patients. The efficacy, safety and adherence to these interventions will also be assessed. This novel, exciting idea of using MBHT in patients with HF deserves attention, although the relatively small study population and short follow-up period limit the relevance of the expected results. The researchers should be congratulated on the idea, but also suggested at this stage of the study to consider increasing the number of patients to be enrolled and extending the follow-up period [14].

Previously, our research group proposed the use of original diagnostic tools to assess readiness for hospital discharge, adherence to therapeutic recommendations and functioning in chronic disease in patients with HF [15–22].

In conclusion, it also seems worth considering to combine efforts in a large multicenter study using both new therapeutic and diagnostic tools in patients with heart failure.


  1. McDonagh TA, Metra M, Adamo M, et al. ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021; 42(36): 35993726, doi: 10.1093/eurheartj/ehab368, indexed in Pubmed: 34447992.
  2. Kubica J. Heart failure treatment according to the 2021 European Society of Cardiology Guidelines experiences with SGLT2 inhibitors have changed the treatment strategy. Medical Research Journal. 2021; 6(3): 163165, doi: 10.5603/mrj.2021.0046.
  3. Kubica J, Kubica A, Grzelakowska K, et al. Inhibitors of sodium-glucose transport protein 2: A new multidirectional therapeutic option for heart failure patients. Cardiol J. 2023; 30(1): 143149, doi: 10.5603/CJ.a2021.0133, indexed in Pubmed: 34708866.
  4. Kubica J. Dapagliflozin a key pawn on the new guidelines chessboard. Medical Research Journal. 2021; 6(4): 342350, doi: 10.5603/mrj.a2021.0056.
  5. Kubica A. Adherence to medication in elderly patients. Medical Research Journal. 2023; 1(8): 9394, doi: 10.5603/mrj.a2023.0015.
  6. Kubica A, Kubica J. Functioning in chronic disease a key factor determining adherence to heart failure treatment. Medical Research Journal. 2022; 7(4): 277279, doi: 10.5603/mrj.2022.0059.
  7. Pietrzykowski Ł, Kasprzak M, Michalski P, et al. The influence of patient expectations on adherence to treatment regimen after myocardial infarction. Patient Educ Couns. 2022; 105(2): 426431, doi: 10.1016/j.pec.2021.05.030, indexed in Pubmed: 34059362.
  8. Pietrzykowski Ł, Michalski P, Kosobucka A, et al. Medication adherence and its determinants in patients after myocardial infarction. Sci Rep. 2020; 10(1): 12028, doi: 10.1038/s41598-020-68915-1, indexed in Pubmed: 32694522.
  9. Kubica A, Obońska K, Fabiszak T, et al. Adherence to antiplatelet treatment with P2Y12 receptor inhibitors. Is there anything we can do to improve it? A systematic review of randomized trials. Curr Med Res Opin. 2016; 32(8): 14411451, doi: 10.1080/03007995.2016.1182901, indexed in Pubmed: 27112628.
  10. Michalski P, Kasprzak M, Kosobucka-Ozdoba A, et al. The impact of knowledge on the functioning of patients with coronary artery disease. Medical Research Journal. 2022; 7(3): 223227, doi: 10.5603/mrj.a2022.0039.
  11. Michalski P, Kosobucka A, Pietrzykowski Ł, et al. Effectiveness of therapeutic education in patients with myocardial infarction. Medical Research Journal. 2018; 2(3): 8996, doi: 10.5603/mrj.2017.0011.
  12. Kubica A, Pietrzykowski Ł. The therapeutic plan implementation in patients discharged from the hospital after myocardial infarction. Medical Research Journal. 2021; 6(2): 7982, doi: 10.5603/mrj.a2021.0024.
  13. Michalski P, Kasprzak M, Siedlaczek M, et al. The impact of knowledge and effectiveness of educational intervention on readiness for hospital discharge and adherence to therapeutic recommendations in patients with acute coronary syndrome. Medical Research Journal. 2020, doi: 10.5603/mrj.a2020.0023.
  14. Kolasa J, Woźniak M, Cyrkot T, et al. Rationale and design of Mind-HF: randomized trial of the original Mindfulness-Based Heart Training for patients with heart failure. Medical Research Journal. 2023, doi: 10.5603/mrj.a2023.0021.
  15. Buszko K, Obońska K, Michalski P, et al. The Adherence Scale in Chronic Diseases (ASCD). The power of knowledge: the key to successful patient health care provider cooperation. Medical Research Journal. 2016; 1(1): 3742, doi: 10.5603/mrj.2016.0006.
  16. Kubica A, Kosobucka A, Michalski P, et al. The Adherence in Chronic Diseases Scale a new tool to monitor implementation of a treatment plan. Folia Cardiol. 2017; 12: 1926, doi: 10.5603/FC.2016.0000.
  17. Kosobucka A, Pietrzykowski Ł, Michalski P, et al. Impact of readiness for discharge from the hospital on the implementation of the therapeutic plan. Medical Research Journal. 2020; 5(4): 256264, doi: 10.5603/mrj.a2020.0047.
  18. Kubica A, Gruchała M, Jaguszewski M, et al. Adherence to treatment a pivotal issue in long-term treatment of patients with cardiovascular diseases. An expert standpoint. Medical Research Journal. 2018; 2(4): 123127, doi: 10.5603/mrj.2017.0016.
  19. Kubica A. Self-reported questionnaires for a comprehensive assessment of patients after acute coronary syndrome. Medical Research Journal. 2019; 4(2): 106109, doi: 10.5603/mrj.a2019.0021.
  20. Kubica A, Kosobucka A, Michalski P, et al. Self-reported questionnaires for assessment adherence to treatment in patients with cardiovascular diseases. Medical Research Journal. 2018; 2(4): 115122, doi: 10.5603/mrj.2017.0015.
  21. Buszko K, Pietrzykowski Ł, Michalski P, et al. Validation of the Functioning in Chronic Illness Scale (FCIS). Medical Research Journal. 2018; 3(2): 6369, doi: 10.5603/mrj.2018.0011.
  22. Buszko K, Kosobucka A, Michalski P, et al. The readiness for hospital discharge of patients after acute myocardial infarction: a new self--reported questionnaire. Medical Research Journal. 2017; 2(1): 2028, doi: 10.5603/mrj.2017.0004.