Heart Failure Care in Greece: A Call for Action

Heart failure (HF) remains a major public health challenge in Greece, affecting an estimated 300,000 individuals and imposing a substantial burden through high mortality, recurrent hospitalizations, impaired quality of life, and escalating healthcare costs. Although significant advances in pharmacological therapies, device-based interventions, and multidisciplinary care have improved outcomes in recent years, important gaps persist in the implementation of evidence-based HF care across the country. This viewpoint from the Heart Failure Working Group of the Hellenic Society of Cardiology (HCS) highlights five strategic priorities for the development of a comprehensive national HF strategy. First, improving the recognition and diagnosis of heart failure with preserved ejection fraction (HFpEF), an increasingly prevalent and frequently underdiagnosed condition, through greater awareness, structured diagnostic pathways, and the adoption of emerging technologies, including artificial intelligence. Second, strengthening the national advanced HF network by establishing coordinated referral pathways and equitable access to advanced therapies such as heart transplantation and durable left ventricular assist devices. Third, integrating palliative care into routine HF management to address symptom burden, psychosocial needs, and advance care planning throughout the disease trajectory. Fourth, expanding access to cardiac rehabilitation through hospital-based, community-based, and home-based programs capable of overcoming geographical disparities and improving functional outcomes. Fifth, developing a specialized HF nursing workforce through structured education and certification programs aligned with European standards. Collectively, these interconnected priorities provide a framework for advancing and modernizing HF care in Greece. A national HF registry is proposed as the foundational infrastructure supporting all five priorities.