Acute heart failure syndromes: the ‘Cinderella’ of heart failure research

Acute heart failure syndromes (AHFS) comprises a heterogeneous set of conditions, which has received relatively little clinical attention, despite being one of the most commonly encountered syndromes in emergency medicine. The condition is one of the most common reasons for hospitalization in the developed world and is associated with substantial costs, in terms of morbidity, mortality, days spent in hospital, and financial expenditure. When compared with acute myocardial infarction, which accounts for a similar number of hospitalizations each year, the low number and small scale of clinical studies of AHFS is striking. This has resulted in a relative lack of progress in developing new therapies and in establishing optimal treatment strategies. New studies are exigently needed to address these needs. In the setting of this requirement for a greater understanding of AHFS, several population-based studies are in progress, with the aim of collecting epidemiological data on the condition. One such study is the EFICA observational cohort study of patients hospitalized with AHFS in France. This will provide information on the clinical and aetiological features, management, and outcomes of AHFS, which should steer the design of treatment strategies and clinical trials that are essential to improve management of this condition.