Prof Isabella Kardys (Erasmus MC University Medical Center, Rotterdam, NL) joins us to discuss how proteomic phenotyping, serial biomarkers and digital monitoring could enable more personalised, proactive heart failure care.

Prof Kardys outlines work applying large-scale proteomics to HFpEF, where serial profiling of around 5,000 proteins in over 400 patients has revealed distinct subphenotypes that differ in prognosis, biology and possible treatment response. She describes joint modelling of individual NT-proBNP trajectories to predict prognosis and time repeat testing, reflects on two decades of telemonitoring evidence, and closes with practical guidance for clinicians seeking more precise follow-up.

Interview Questions:

1. In HFrEF and HFpEF, how could proteomics-based phenotyping change patient management, rather than just adding a label?
2. How could serial biomarker measurements be used in practice — how could repeat natriuretic peptides truly alter treatment plans, instead of simply confirming impressions?
3. For remote monitoring, apps and wearables, is there currently enough evidence to adjust therapy or follow up heart failure patients on the basis of such measurements?
4. Which combinations of phenotype, imaging and biomarkers (with or without digital tools) do you already consider robust enough for routine risk stratification, and which do you still view as research-stage?
5. For colleagues aiming for more precise and proactive follow-up, what steps could they take now?

Recorded on-site at HFA 26, Barcelona.
Editors: Jordan Rance
Videographer: David Ben-Harosh, Tom Green
Support: This is an independent interview produced by Radcliffe Cardiology.