This issue delves into the evolving role of hemodynamic assessment in heart failure management.

WASHINGTON, DC (NOVEMBER 11, 2025) – The Journal of Cardiac Failure (JCF) has released a special Focus Issue on Hemodynamics, highlighting the renewed importance of cardiovascular physiology as a foundation for modern heart failure care. Guest edited by Drs. Susanna Mak (University of Toronto), Daniel Burkhoff (Cardiovascular Research Foundation), and Mark Belkin (University of Chicago), the issue explores how hemodynamic insights are driving clinical and research innovation across the spectrum of heart failure syndromes.  

A central theme of the issue is the effort to reinvigorate physiology education in medical training and reintroduce hemodynamics as an essential tool for clinicians, researchers, and trainees. Controversial topics are also addressed, including ECMO loading and unloading, exercise testing methods, and the evolving role of invasive measurement in diagnosis and trial design. 

“As we explore the resurgence of invasive hemodynamics and its growing role in precision heart failure care, we’re especially grateful for the exceptional work of our guest editors whose expertise and vision shaped this comprehensive issue,” co-editor-in-chief Anuradha Lala, MD continued. “We encourage readers to engage with the full set of articles, which provide diverse and thought-provoking perspectives on this rapidly advancing field.”

Featured Articles Explore Elevated Cardiac Index (CI) and Assisted Aortic Pulsatility Index (API)

Featured in the issue are two new studies looking at elevated cardiac index (CI) and assisted aortic pulsatility index (API). These studies have indicated that elevated CI is the most significant hemodynamic predictor of all-cause mortality in high-output heart failure (HOHF) and API is a sensitive and specific predictor of survival to native recovery in patients with cardiogenic shock supported by an Intra-aortic balloon pump (IABP). 

“These studies exemplify how detailed hemodynamic assessment continues to refine our understanding of heart failure physiology and patient management,” said JCF co-editor-in-chief Robert J. Mentz, MD.

Upcoming Heart Failure Beat Podcast Episode to Feature Interview with Guest Editors

The three guest editors were interviewed for an upcoming episode of the Heart Failure Society of America’s Heart Failure Beat podcast, on which Dr. Belkin shared that, “Hemodynamics helps us uncover the secrets of cardiac physiology—one measurement at a time.” The episode is forthcoming and can be found online or on popular podcast platforms when it is published.

The full line-up for the JCF November issue is as follows:  

Original Research Papers  

• Aortic Pulsatility Index as a Marker of Weaning to Native Recovery in Patients Supported With an Impella CP for Cardiogenic Shock
  • Editorial: Aortic Pulsatility Index, Ventriculoarterial Coupling, and Cardiac Efficiency as Markers of Myocardial Recovery: Ushering in the Era of Applied Energetics
• Hemodynamic Profiles During Pulmonary Artery Pressure Sensor Implantation: Risk Stratification in Chronic Heart Failure With Reduced Ejection Fraction
  • Editorial: The Role of Hemodynamic Staging in Ambulatory Advanced Heart Failure 
• Association of Hemodynamic Variables with the Risk of Heart transplant Waitlist Death and Deterioration 
  • Editorial: Can Complicated Be Made Simple? A Continuous Distribution Dilemma 
• Invasive Hemodynamic Predictors of Mortality in High-Output Heart Failure
  • Editorial: Reframing Risk in High-Output Heart Failure: More Flow, More Problems
• Diagnosing HFpEF in Patients with Unexplained Dyspnea using Invasive Left Ventricular Pressure-Volume Loops 
  • Editorial: Right (or Wrong) Heart Catheterization: The Limitations of Conventional Diagnostics for Heart Failure With Preserved Ejection Fraction
• Diagnostic Performance of Passive Leg-Raise and Low-Workload Exercise to Diagnose Heart Failure With Preserved Ejection Fraction
• Cardiac Dysfunction, Exercise Reserve, and Outcomes in Patients with HFpEF with an Implanted Pacemaker 
  • Editorial: The Dog Wagging the Tail Wagging the Dog: Pacemakers as a Surrogate (and Treatment?) for More Extensive Negative Cardiac Remodeling in HFpEF 
• Association of Moderate-Severe Tricuspid Regurgitation with Exercise Hemodynamics and Outcomes in Patients with Heart Failure with Preserved Ejection Fraction: Multicenter Study 
• Prognostic Value and Reproducibility of Simplified Non-Invasive Pulmonary Artery Pressure-Flow Relationships in Exercise Echocardiography 
  • Editorial: From Slope to Spot: Advancing Noninvasive Hemodynamic Assessment in Unexplained Exertional Dyspnea

State-of-the-Art-Review

• Impella SmartAssist Technology: Practical Foundations and Clinical Management 
• Current and Future Landscape of Remote Hemodynamic Monitoring 

Perspectives

• Supine Is Divine: Hemodynamic Exercise Testing Assessments Should Be in the Supine Position 
• Fight for Upright: Hemodynamic Exercise Testing Assessments Should Be Made in the Upright Position 
• Hemodynamic Inclusion Criteria for Trials of Heart Failure With Preserved Ejection Fraction, Cardiogenic Shock, and Pulmonary Arterial Hypertension

Brief Reports 

• Immediate Effects of Transcatheter Aortic Valve Replacement on Left Ventricular Cardiac Mechanics in Moderate Aortic Stenosis: A Case Series With In Vivo Pressure-Volume Reconstructions
• Agreement Among Cardiac Output Measurement Techniques in High Cardiac Output States 
• First In Human study of a Novel Left Atrial Pressure Sensor - the Microtech LVAD study
• Sex-based Differences in Hemodynamic Data Obtained by Echocardiography in Patients with Cardiogenic Shock

Research Letter

• Effects of Cardiac Contractility Modulation Therapy on Cardiac Hemodynamics: Focus on Myocardial Work

JCF Ignite!

• Point: Breaking the Circuit: Evaluating Afterload Assumptions in Extracorporeal Membrane Oxygenation 
• Counterpoint: Breaking through the confusion: Extracorporeal Membrane Oxygenation Does Not Always Unload the Heart

ECT Spotlight

• The Hemodynamic Tipping Point: A Personal Journey Through the Rise of Hemodynamics, Innovation, and Intervention 
• Seeking Truth, Connecting with Patients, and Inspiring Innovation: The Power of Invasive Hemodynamics 
• From Brazil to Boston: Pursuing Precision Medicine Through Immersion in Hemodynamics

Patient Perspective

• The Pulmonary Hypertension Association of Canada: Patient Voices from Bench to Bedside and Beyond        

The full issue will be available online on November 11. If you would like copies of the manuscripts above, or to connect with an author for an interview, 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