Chronic Heart Failure: Treatment Challenges and Latest Innovations in Therapy

Abstract

Chronic heart failure (CHF) is a major global health problem that contributes to increased morbidity, mortality, and economic burden on healthcare systems. Its rising prevalence, driven by population aging and high rates of cardiovascular comorbidities, highlights the need for effective and sustainable treatment strategies. This study aimed to review current challenges and recent innovations in CHF management through a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 23 articles published between 2020 and 2025 were selected and analyzed using the Population, Intervention, Comparison, and Outcome (PICO) framework. The review evaluated developments in pharmacological and non-pharmacological therapies for CHF. The findings indicate a shift in treatment approaches from symptom-based management to therapies targeting molecular and pathophysiological mechanisms. Pharmacological innovations, including sodium–glucose cotransporter-2 inhibitors, angiotensin receptor–neprilysin inhibitors, ivabradine, and intravenous iron supplementation, have shown benefits in reducing hospitalization and improving quality of life. Non-pharmacological interventions such as cardiac resynchronization therapy, gene therapy, and telemedicine have also demonstrated positive effects on clinical outcomes and healthcare efficiency. Despite these advances, challenges such as delayed diagnosis, limited access to advanced therapies, and poor patient adherence remain significant barriers. Therefore, future CHF management should emphasize personalized medicine, digital health integration, and strengthened healthcare systems to improve treatment effectiveness and sustainability.