Research areas: metabolic cardiology

Prof. von Haehling is DZHK Professor of Metabolic Cardiology. He is spokesperson for the Heart Failure Working Group of the German Society of Cardiology and deputy editor of the journal ESC Heart Failure.

Prof. von Haehling and his team are researching clinically relevant aspects of heart failure and cardio-oncology. The focus of their work is on comorbidities of heart failure and on maintaining physical fitness in everyday life. To this end, various aspects of cardiovascular metabolism and possible therapeutic interventions are investigated. This includes in particular the loss of functional tissue such as the breakdown of skeletal muscle seen in sarcopenia, as this has a direct influence on physical resilience. Prof. von Haehling and his team were able to show that sarcopenia is a common concomitant disease in heart failure (more than 20% of patients are affected), which occurs earlier than the average age of patients would suggest. In addition, Prof. von Haehling's team was able to show that heart failure patients with sarcopenia have impaired function of the inner layer of peripheral vessels and that sarcopenia contributes to increased mortality in affected patients. Prof. von Haehling's work led to the inclusion of sarcopenia in the list of comorbidities of heart failure in the guidelines of the European Society of Cardiology. Bone metabolism is also affected, and Prof. von Haehling and his team were able to prove that heart failure patients are severely affected by the loss of bone architecture and bone density. Certain blood biomarkers such as osteoprotegerin, osteocalcin, C-terminal agrin fragment and also kynurenine appear to be able to predict the course of the changes in body composition.

Another focus of the work of Prof. von Haehling's team is cardio-oncology. This is based on the assumption that malignant tumor diseases contribute to changes in the cardiovascular system that have a strong impact on physical resilience and quality of life. International and European networking - as well as direct study results from the working group itself - has an influence on the development of guidelines in this area. For example, Prof. von Haehling's working group was able to show that hand strength, haemoglobin and resting pulse directly predict the quality of life of affected patients and that the pathophysiological changes in malignant tumor diseases contribute to a heart failure-like picture. Studies on blood biomarkers also play a role in this context, as they can detect or predict relevant changes at an early stage.

Kerwagen F, Riemer U, Wachter R, von Haehling S, Abdin A, Böhm M, Schulz M, Störk S. Impact of the COVID-19 pandemic on implementation of novel guideline-directed medical therapies for heart failure in Germany: a nationwide retrospective analysis. Lancet Reg Health Eur. 2023 Nov 7;35:100778. doi: 10.1016/j.lanepe.2023.100778. PMID: 38023333.

Anker MS, Potthoff SK, Lena A, Porthun J, Hadzibegovic S, Evertz R, Denecke C, Fröhlich AK, Sonntag F, Regitz-Zagrosek V, Rosen SD, Lyon AR, Lüscher TF, Spertus JA, Anker SD, Karakas M, Bullinger L, Keller U, Landmesser U, Butler J, von Haehling S. Cardiovascular health-related quality of life in cancer: a prospective study comparing the ESC HeartQoL and EORTC QLQ-C30 questionnaire. Eur J Heart Fail. 2023 Sep;25(9):1635-1647. doi: 10.1002/ejhf.2951. Epub 2023 Aug 22. PMID: 37369985.

Loncar G, Garfias-Veitl T, Valentova M, Vatic M, Lainscak M, Obradović D, Dschietzig TB, Doehner W, Jankowska EA, Anker SD, von Haehling S. Bone status in men with heart failure: results from the Studies Investigating Co-morbidities Aggravating Heart Failure. Eur J Heart Fail. 2023 May;25(5):714-723. doi: 10.1002/ejhf.2794. Epub 2023 Mar 7. PMID: 36781201.

von Haehling S, Müller-Hennessen M, Garfias-Veitl T, Goßling A, Neumann JT, Sörensen NA, Haller PM, Hartikainen T, Vollert JO, Möckel M, Blankenberg S, Westermann D, Giannitsis E. Role of Copeptin and hs-cTnT to Discriminate AHF from Uncomplicated NSTE-ACS with Baseline Elevated hs-cTnT-A Derivation and External Validation Study. Cells. 2023 Mar 31;12(7):1062. doi: 10.3390/cells12071062. PMID: 37048135.

von Haehling S, Birner C, Dworatzek E, Frantz S, Hellenkamp K, Israel CW, Kempf T, Klein HH, Knosalla C, Laufs U, Raake P, Wachter R, Hasenfuss G. Travelling with heart failure: risk assessment and practical recommendations. Nat Rev Cardiol. 2022 May;19(5):302-313. doi: 10.1038/s41569-021-00643-z. Epub 2022 Jan 6. PMID: 34992256.

von Haehling S, Arzt M, Doehner W, Edelmann F, Evertz R, Ebner N, Herrmann-Lingen C, Garfias Macedo T, Koziolek M, Noutsias M, Schulze PC, Wachter R, Hasenfuß G, Laufs U. Improving exercise capacity and quality of life using non-invasive heart failure treatments: evidence from clinical trials. Eur J Heart Fail. 2021 Jan;23(1):92-113. doi: 10.1002/ejhf.1838. Epub 2020 May 11. PMID: 32392403.

von Haehling S, Garfias Macedo T, Valentova M, Anker MS, Ebner N, Bekfani T, Haarmann H, Schefold JC, Lainscak M, Cleland JGF, Doehner W, Hasenfuss G, Anker SD. Muscle wasting as an independent predictor of survival in patients with chronic heart failure. J Cachexia Sarcopenia Muscle. 2020 Oct;11(5):1242-1249. doi: 10.1002/jcsm.12603. Epub 2020 Aug 6. PMID: 32767518.

Fülster S, Tacke M, Sandek A, Ebner N, Tschöpe C, Doehner W, Anker SD, von Haehling S. Muscle wasting in patients with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure (SICA-HF). Eur Heart J. 2013 Feb;34(7):512-9. doi: 10.1093/eurheartj/ehs381. Epub 2012 Nov 23. PMID: 23178647.