New studies reveal high mortality in valvular-related shock, reduced dementia risk with SGLT2 inhibitors, and new insight into biomarker-guided treatment response
WASHINGTON, DC (April 14, 2026) – The April issue of the Journal of Cardiac Failure (JCF) brings new clarity to several high-risk and understudied areas in heart failure (HF) care, including cardiogenic shock related to valvular heart disease – an entity associated with a 40% in-hospital mortality rate – and the potential for Sodium-glucose Cotransporter-2 Inhibitor (SGLT2) inhibitors to reduce dementia risk in patients with heart failure and diabetes.
Articles highlighted in the April issue of JCF include:
New data from the Critical Care Cardiology Trials Network provide a closer look at the role of valvular heart disease in cardiogenic shock, drawing on more than 5,000 cardiac ICU admissions. While valvular disease accounts for a minority of cases, it is associated with markedly high in-hospital mortality, approaching 40%, and a distinct clinical profile, including a greater likelihood of preserved ejection fraction and the need for valve-directed intervention.
In a separate population-based cohort study, investigators examined cognitive outcomes among older adults with both heart failure and diabetes initiating glucose-lowering therapies. Compared to DPP-4 inhibitors, initiation of SGLT2 inhibitors was associated with a significantly lower risk of incident dementia, with findings suggesting a potential role for these agents in modifying cognitive risk in a population already vulnerable to decline.
Complementing these findings, Finally, new analyses from the DAPA-HF trial further explore the role of biomarkers in risk stratification, focusing on growth differentiation factor-15 (GDF-15), a marker of systemic stress. Higher baseline levels of GDF-15 were strongly associated with increased risk of worsening heart failure or cardiovascular death. While dapagliflozin did not meaningfully alter GDF-15 levels, patients with higher baseline concentrations experienced greater absolute benefit from therapy, reinforcing the biomarker’s value in identifying higher-risk populations.
“These studies highlight how heart failure care is increasingly shaped by factors beyond traditional cardiac endpoints, from structural contributors like valvular disease to systemic risks such as cognitive decline,” said JCF co-editors-in-chief, Anu Lala, MD and Robert J. Mentz, MD. “What’s particularly compelling is how these insights begin to refine not just risk, but how we think about targeting therapy.”
These findings are part of a broader collection of studies in this issue examining mechanisms of disease, treatment response, and risk stratification across the heart failure spectrum.
View the full issue online. For interviews with authors, please contact Laura Poko at lpoko@hfsa.org.
About the Journal of Cardiac Failure
The Journal of Cardiac Failure (JCF) publishes the highest quality science in the field of heart failure with a focus on diversity, equity, and inclusion, mentorship, multidisciplinary partnerships, and patient-centeredness. Published papers span original investigator-initiated work to state-of-the-art reviews, guidelines and scientific statements, expert perspectives, early career and trainee spotlight pieces, patient and patient-partner narratives. JCF also emphasizes the power of language and prioritizes innovative approaches to dissemination of published work to reach and impact the broader heart failure community.
About the Heart Failure Society of America
The Heart Failure Society of America, Inc. (HFSA) represents the first organized effort by heart failure experts from the Americas to provide a forum for all those interested in heart function, heart failure, and congestive heart failure (CHF) research and patient care. The mission of HFSA is to provide a platform to improve and expand heart failure care through collaboration, education, innovation, research, and advocacy. HFSA members include physicians, scientists, nurses, nurse practitioners, pharmacists, trainees, other healthcare workers and patients. For more information, visit hfsa.org.
Media Contact: Laura Poko, 301-798-4493, ext. 226, lpoko@hfsa.org