Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 3 complete abstracts (567 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (ventricular dysfunction), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as myocardial infarction.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Cardiac Failure; Heart Decompensation; Decompensation, Heart; Congestive Heart Failure; Heart Failure, Congestive; Heart Failure, Right-Sided; Heart Failure, Right Sided; Right-Sided Heart Failure.
Where it fits in the MeSH classification
- Broader topics
- Heart Diseases
- Narrower topics
- Cardio-Renal Syndrome; Dyspnea, Paroxysmal; Edema, Cardiac; Heart Failure, Diastolic; Heart Failure, Systolic
Related concepts
- Ventricular Dysfunction
- Myocardial Infarction
Research landscape
PubMed indexes 168,462 records tagged with the MeSH heading “Heart Failure” (counts retrieved 2026-10-29). 46,607 of them (27.7%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 54,008 records.
Reviews account for 32,354 records (19.2%) and meta-analyses for 3,017. Randomized controlled trials number 8,579 (5.1%) as a share of all records on the topic.
Show the data
| Period | Records |
|---|---|
| through 1999 | 36,994 |
| 2000-2009 | 30,853 |
| 2010-2019 | 54,008 |
| 2020 onward | 46,607 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 32,354 | 19.2% |
| Meta-analyses | 3,017 | 1.8% |
| Randomized controlled trials | 8,579 | 5.1% |
Method: PubMed query "Heart Failure"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in cardiovascular medicine
Cardiovascular medicine has an unusually large body of randomized trials, so the type of outcome matters: hard clinical events such as death, heart attack and stroke carry more weight than changes in blood pressure, cholesterol or imaging markers that only predict risk. Observational studies can show associations but are confounded by age, lifestyle and other illness. Check whether a result is about prevention or treatment, the baseline risk of participants, and the absolute rather than only the relative size of any benefit.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Conduction system vs. biventricular pacing in heart failure with reduced ejection fraction: a meta-analysis of randomized controlled trials | 2026 | Meta-analysis Design not recorded in structured metadata | 2 | cc by PMID 42586561 · DOI · PMC13466950 |
| Gut microbiome shifts in chronic systolic heart failure are associated with disease severity and clinical improvement | 2026 | Research article Design not recorded in structured metadata | 1 | cc by PMID 42786289 · DOI · PMC13658019 |
| Targeting PKGIα Cys42 attenuates cardiac dysfunction in heart failure with preserved ejection fraction | 2026 | Research article Design not recorded in structured metadata | 1 | cc by PMID 42616901 · DOI · PMC13488924 |
Conduction system vs. biventricular pacing in heart failure with reduced ejection fraction: a meta-analysis of randomized controlled trials [1]
Abstract reading summary — source excerpts
- Opening excerpt
- AimsConduction system pacing (CSP) has emerged as a physiologic alternative to cardiac resynchronization therapy (CRT) with biventricular pacing (BiVP) in heart failure with reduced ejection fraction (HFrEF), yet its comparative effects remain uncertain.
- Closing excerpt
- Conduction system pacing is also associated with improved functional capacity, without significant differences in safety or procedural outcomes.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (265 words)
AimsConduction system pacing (CSP) has emerged as a physiologic alternative to cardiac resynchronization therapy (CRT) with biventricular pacing (BiVP) in heart failure with reduced ejection fraction (HFrEF), yet its comparative effects remain uncertain. This meta-analysis sought to compare outcomes of CSP vs. BiVP in patients with HFrEF undergoing CRT.Methods and resultsMEDLINE, Embase, Scopus, and the Cochrane Database were searched through 4 May 2026. Randomized controlled trials (RCTs) were synthesized using random-effects meta-analysis. Thirteen RCTs including 1320 participants were analysed (657 CSP, 663 BiVP). Conduction system pacing was associated with a lower risk of the composite of hospitalization for heart failure (HHF) or all-cause mortality compared with BiVP (46 vs. 83 events; odds ratio [OR] 0.51, 95% confidence interval [CI] 0.28-0.93). No significant differences were observed for HHF alone (OR 0.68, 95% CI 0.36-1.27) or all-cause mortality (OR 0.75, 95% CI 0.36-1.58). Conduction system pacing was associated with greater improvement in the 6-min walk distance (mean difference [MD] 21.53 m, 95% CI 4.33-38.73) and New York Heart Association functional class (standardized mean difference [SMD] -0.27, 95% CI -0.47 to -0.07), but not quality of life. Conduction system pacing also reduced QRS duration compared with BiVP (MD -10.94 ms, 95% CI -17.55 to -4.34), with no significant differences in left ventricular ejection fraction, left ventricular end-systolic volume, overall pacing threshold, total procedure time, fluoroscopy time, any complication, or reintervention.ConclusionIn patients with HFrEF undergoing CRT, CSP is associated with lower composite risk of HHF or all-cause mortality compared with BiVP. Conduction system pacing is also associated with improved functional capacity, without significant differences in safety or procedural outcomes.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42586561 · DOI · PMC13466950
Gut microbiome shifts in chronic systolic heart failure are associated with disease severity and clinical improvement [2]
Abstract reading summary — source excerpts
- Opening excerpt
- The contribution of the gut microbiome to chronic heart failure (HF) remains poorly defined.
- Closing excerpt
- Together, these findings define gut microbiome alterations in chronic systolic HF, identify candidate microbiome biomarkers of disease severity and trajectory, and suggest microbiome-derived metabolites as potential therapeutic targets.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (148 words)
The contribution of the gut microbiome to chronic heart failure (HF) remains poorly defined. We performed integrated microbiome and host multi-omic profiling of adults with chronic systolic HF due to nonischemic cardiomyopathy (n = 59) and healthy participants (n = 50), including longitudinal sampling in some cases. Here we show that patients with HF have depletion of anti-inflammatory Bifidobacterium and reduced short-chain fatty acid biosynthetic potential, alongside altered microbiome-immune system interactions. Longitudinal analysis revealed that higher Bifidobacterium abundance was associated with clinical improvement. Multi-omic integration prioritized indole-3-propionic acid (IPA), a gut metabolite with cardioprotective properties, as a candidate mechanistic link. We confirmed that Bifidobacterium species can produce IPA in vitro and circulating IPA levels were associated with milder HF severity. Together, these findings define gut microbiome alterations in chronic systolic HF, identify candidate microbiome biomarkers of disease severity and trajectory, and suggest microbiome-derived metabolites as potential therapeutic targets.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42786289 · DOI · PMC13658019
Targeting PKGIα Cys42 attenuates cardiac dysfunction in heart failure with preserved ejection fraction [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent condition associated with substantial morbidity and mortality, yet effective therapeutic options remain limited.
- Closing excerpt
- These findings collectively highlight Cys42 in PKGIα as a promising therapeutic target for HFpEF and identify urolithin A as a previously unidentified activator of this protective mechanism.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (154 words)
Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent condition associated with substantial morbidity and mortality, yet effective therapeutic options remain limited. As oxidation of Cys42 in cyclic guanosine monophosphate (cGMP)-dependent protein kinase Iα (PKGIα) can enhance vessel and diastolic relaxation, processes impaired in HFpEF, we sought to target this mechanism using natural compounds with predicted thiol reactivity. Among these, urolithin A emerged as a compound with a previously unidentified and counterintuitive mode of action, directly modifying Cys42 in PKGIα. In a multihit HFpEF model that closely mimics the human condition, urolithin A improved diastolic function and attenuated cardiac remodeling through cysteine 42-dependent activation of PKGIα. These findings were further validated in human engineered heart tissue, where urolithin A enhanced both relaxation and contraction kinetics. These findings collectively highlight Cys42 in PKGIα as a promising therapeutic target for HFpEF and identify urolithin A as a previously unidentified activator of this protective mechanism.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42616901 · DOI · PMC13488924
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Mineralocorticoid receptor antagonists in heart failure: an individual patient level meta-analysis [4]
- Research article Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis [5]
- Research article Atrial Fibrillation Ablation in Heart Failure With Reduced vs Preserved Ejection Fraction: A Systematic Review and Meta-Analysis [6]
- Research article SGLT2 Inhibitors, Functional Capacity, and Quality of Life in Patients With Heart Failure: A Systematic Review and Meta-Analysis [7]
- Research article Genome-wide association study meta-analysis provides insights into the etiology of heart failure and its subtypes [8]
- Research article Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction [9]
References
- Karakasis P, Vlachos K, Siontis KC, Cano Ó, Tzeis S, Strik M, et al.. Conduction system vs. biventricular pacing in heart failure with reduced ejection fraction: a meta-analysis of randomized controlled trials. . 2026. PMID 42586561 · DOI · PMC13466950
- Mamic P, Shi H, Zhou W, Bararpour N, Contrepois K, Park H, et al.. Gut microbiome shifts in chronic systolic heart failure are associated with disease severity and clinical improvement. . 2026. PMID 42786289 · DOI · PMC13658019
- Su J, Zhao Y, Coleman P, Yang X, Holt M, Raabe J, et al.. Targeting PKGIα Cys42 attenuates cardiac dysfunction in heart failure with preserved ejection fraction. . 2026. PMID 42616901 · DOI · PMC13488924
- Jhund PS, Talebi A, Henderson AD, Claggett BL, Vaduganathan M, Desai AS, et al.. Mineralocorticoid receptor antagonists in heart failure: an individual patient level meta-analysis. Lancet. 2024. PMID 39232490 · DOI
- Usman MS, Bhatt DL, Hameed I, Anker SD, Cheng AYY, Hernandez AF, et al.. Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2024. PMID 38768620 · DOI
- Oraii A, McIntyre WF, Parkash R, Kowalik K, Razeghi G, Benz AP, et al.. Atrial Fibrillation Ablation in Heart Failure With Reduced vs Preserved Ejection Fraction: A Systematic Review and Meta-Analysis. JAMA Cardiol. 2024. PMID 38656292 · DOI · PMC11044015
- Gao M, Bhatia K, Kapoor A, Badimon J, Pinney SP, Mancini DM, et al.. SGLT2 Inhibitors, Functional Capacity, and Quality of Life in Patients With Heart Failure: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024. PMID 38573633 · DOI · PMC11192183
- Henry A, Mo X, Finan C, Chaffin MD, Speed D, Issa H, et al.. Genome-wide association study meta-analysis provides insights into the etiology of heart failure and its subtypes. Nat Genet. 2025. PMID 40038546 · DOI · PMC11985341
- Kristensen AMD, Rossello X, Atar D, Yndigegn T, Kimura T, Latini R, et al.. Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction. N Engl J Med. 2026. PMID 41211954 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
See how EvidenceLib is built. Spotted an error? Email support@evidencehelix.com.
Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.