With Gregorio Tersalvi, Mayo Clinic, Rochester, Minnesota - USA, Lars Kober and Jawad Haider Butt, Rigshospitalet - Copenhagen University Hospital, Copenhagen - Denmark, Jolie Bruno, Inselspital, Bern University Hospital, University of Bern, Bern - Switzerland, Jorg Hausleiter, LMU University Hospital, LMU Munich, Munich - Germany, Benedikt Norbert Beer, University Medical Center Hamburg-Eppendorf, Hamburg - Germany, Marianna Adamo, University and Civil Hospital of Brescia, Brescia - Italy and Novi Yanti Sari, Siloam Hospitals Group, Jakarta - Indonesia.

In this episode, we discuss the late-breaking clinical science presented at ESC Congress 2026 in Munich, Germany.

First, Jolie Bruno interviews Lars Kober and Jawad Haider Butt on hydralazine plus isosorbide dinitrate in HFrEF, covering the results of the H-HeFT trial and of the accompanying H-ISDN meta-analysis. H-HeFT compared H-ISDN with placebo in patients with symptomatic heart failure and an ejection fraction of 40% or less, while the meta-analysis pooled three placebo-controlled trials to assess the effect of H-ISDN on mortality and heart failure events.

Next, Benedikt N. Beer interviews Jorg Hausleiter, who highlights the key findings of TRIC-I-HF, a randomised, open-label trial of transcatheter tricuspid valve repair on top of medical therapy versus medical therapy alone in patients with severe tricuspid regurgitation and heart failure.

Finally, Novi Yanti Sari interviews Marianna Adamo, who co-chaired the 2026 ESC Guidelines for the management of heart failure and outlines the main novelties of the document.

This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

Presenter: Gregorio Tersalvi, Mayo Clinic, Rochester, Minnesota - USA

Segment 1:

• Title: H-HeFT: Hydralazine-Isosorbide Dinitrate in HFrEF + H-ISDN Meta-Analysis
• Results paper: not yet published
• Design paper: Wiggers H, Køber L, Gislason G, et al. The DANish randomized, double-blind, placebo controlled trial in patients with chronic HEART failure (DANHEART): A 2 × 2 factorial trial of hydralazine-isosorbide dinitrate in patients with chronic heart failure (H-HeFT) and metformin in patients with chronic heart failure and diabetes or prediabetes (Met-HeFT). Am Heart J. 2021;231:137-146. doi:10.1016/j.ahj.2020.09.020

Segment 2:

• Title: TRIC-I-HF (TRICuspid Intervention in Heart Failure)
• Results paper: Hausleiter J, Stocker TJ, Geisler T, et al. Tricuspid-Valve Intervention in Heart Failure. N Engl J Med. Published online August 30, 2026. doi:10.1056/NEJMoa2606934
• Design paper: Stocker TJ, Geisler T, Rottbauer W, et al. Rationale and design of the TRIC-I-HF-DZHK24 (TRICuspid Intervention in Heart Failure) trial. Eur J Heart Fail. 2025;27(10):1895-1904. doi:10.1002/ejhf.3795

Segment 3:

• Title: Highlights from the 2026 ESC Guidelines for the management of heart failure
• Guideline paper: Køber L, Adamo M, Ruwald AC, et al. 2026 ESC Guidelines for the management of heart failure. Eur Heart J. Published online August 28, 2026. doi:10.1093/eurheartj/ehag100