Dr Rudolf de Boer Previews Exciting ESC Congress 2021 Highlights

Two highlights at this year’s ESC Congress 2021 will be new ESC heart failure guidelines and presentation of the EMPEROR-Preserved and EMPEROR-Pooled trial data, noted Rudolf de Boer, MD, PhD, clinical cardiologist and professor of translational cardiology, University Medical Center Groningen, the Netherlands.

De Boer will be presenting “HFpEF Management: State of the Art SGLT2 Inhibitors,” on day 2 of ESC Congress 2021, this year’s virtual annual meeting of the European Society of Cardiology.

Transcript

What will be some of the biggest news to come out of ESC Congress 2021?

So, clearly, a few of the highlights of this meeting—much to my liking, I must say—have to do with heart failure. We will have the new ESC heart failure guidelines being presented. This, of course, is the absolute highlight of the meeting. It's very important; it's been 5 years. Two months ago or so we already saw a preview on what the pharmacological treatment algorithm looks like for heart failure with reduced ejection fraction, but now we will see that the whole guideline being presented is very important. I assume there will be interesting changes in device therapy, some diagnostics, clearly the use of SGLT2 [sodium-glucose cotransporter 2] inhibitors will be highlighted, and likely the use of sacubitril/valsartan will be prioritized. So I think there will be a number of important perspectives there.

A second highlight, in my humble opinion, is the presentation of the EMPEROR-Preserved and the EMPEROR-Pooled [trial results], because for the first time, we have a drug now that has shown efficacy over the full spectrum of left ventricular ejection fraction [LVEF]. So I'll be very interested to see if there is any interaction with LVEF or not. I hope for the latter because that means, as physicians, our lives are going to be substantially easier and we can just employ drugs without always thinking of EF.

With regards to COVID-19, I'm not entirely sure if there's a lot of news in this ESC meeting. We, of course, in the beginning of the pandemic, had seen quite disturbing data on how the heart was involved in COVID-19 infections, with very high rates of myocarditis and perimyocarditis. Later publications actually have negated these initial findings, and as it stands now, it seems that myocarditis is relatively rare. This, of course, is an important topic also because the use of COVID-19 vaccinations has also been associated, especially in young males, with the onset of myocarditis.

I guess the main issue with regards to COVID-19 care, for cardiology care, is that COVID-19 kind of pushes away all other important cares—albeit cardiovascular care, renal care, cancer care—because patients are hospitalized for such a long period. So this is more of an organizational issue that plays in in several countries in the Western world, including in the Netherlands; I believe also in the USA. Although in some countries to a lesser extent, for example, in Germany, it plays less in because there are many more ICU beds than in other countries. But that's an organizational issue.

It's a pity that, again, ESC is on the virtual scale and not live. That has to do with COVID-19, and I sincerely hope that next year it will be live again.