Heart failure is not one single disease pattern. Two people may have the same diagnosis but different causes, symptoms, heart structure, kidney function, rhythm problems, blood pressure, diabetes status or treatment tolerance. Personalized medicine in heart failure aims to combine this information so that diagnosis, monitoring and treatment decisions are better matched to each patient. This blog explains what personalized medicine means in heart failure, how doctors use phenotypes, echocardiography, biomarkers, guideline-directed therapy, comorbidity management and emerging tools such as artificial intelligence. It also outlines practical steps patients can take, when to seek medical help, and why treatment should always be individualized by a qualified healthcare professional.

Suggested Doctors from Doctors365
Dr Petar Pekic — Cardiology/Internal Medicine. Dr Pekic is an internal medicine specialist and cardiology subspecialist whose Doctors365 profile states professional interests in cardiac arrhythmias and cardiac device implantation and follow-up, making him relevant for patients with heart failure, rhythm problems or device-related questions.

Dr Andreas Müssigbrodt — Cardiology, Internal Medicine and Family Medicine. His Doctors365 profile describes board certification in internal medicine and cardiology, with expertise in cardiac resynchronization therapy and complex arrhythmias, both of which may be important in selected heart failure patients.

Personalized medicine in heart failure means adapting care to the individual patient’s heart function, symptoms, test results, other medical conditions, treatment tolerance and personal health goals. Heart failure is a complex syndrome in which the heart cannot pump or fill well enough to meet the body’s needs, and it can occur with reduced, mildly reduced or preserved ejection fraction [1]. Modern guidelines already support patient-centred care, because treatment choices depend on the type of heart failure, blood pressure, kidney function, potassium levels, rhythm disorders, diabetes, frailty and other factors [1]. Newer research is also exploring how biomarkers, imaging, genetics, multi-omics and artificial intelligence may help doctors understand why one patient responds differently from another [2,3]. This does not replace clinical judgement, but it may make heart failure care more precise and safer.

Why Heart Failure Needs a Personalized Approach

Heart failure is not the same in every patient. One person may develop heart failure after a heart attack, another because of long-standing high blood pressure, valve disease, arrhythmia, inherited cardiomyopathy, diabetes, kidney disease or other causes. Personalized care begins with identifying the likely cause and the heart failure phenotype, which includes ejection fraction, symptoms, congestion, rhythm, blood pressure and comorbidities [1].

In heart failure with reduced ejection fraction, guideline-directed medical therapy often includes several medication classes, such as renin-angiotensin system inhibition or angiotensin receptor-neprilysin inhibition, beta-blockers, mineralocorticoid receptor antagonists and SGLT2 inhibitors when appropriate [1]. However, the dose and sequence may need adjustment according to kidney function, potassium levels, blood pressure, heart rate, side effects and patient preference [1]. This is where “personalized” does not mean experimental; it often means applying evidence-based therapy carefully to the real person in front of the doctor.

Phenotypes, Imaging and Biomarkers

A key part of personalized medicine in heart failure is phenotyping. This means grouping patients by meaningful clinical patterns rather than treating everyone as identical. For example, heart failure with preserved ejection fraction is especially heterogeneous and may be linked to obesity, atrial fibrillation, high blood pressure, diabetes, kidney disease, pulmonary hypertension or other conditions [4]. Reviews of HFpEF highlight that diagnostic algorithms, echocardiography, natriuretic peptides and careful assessment of alternative diagnoses can help identify the most likely clinical pattern [4].

Imaging is also central. Echocardiography can assess ejection fraction, valve disease, chamber size, wall thickness, pulmonary pressures and diastolic function. In selected patients, cardiac magnetic resonance imaging, CT coronary imaging or nuclear imaging may help evaluate cardiomyopathy, scar, inflammation, amyloidosis or coronary disease. Precision cardiology research suggests that advanced imaging, biomarkers and electrophysiology may deepen personalization beyond standard clinical assessment [3].

Biomarkers such as BNP or NT-proBNP can support diagnosis and monitoring, but they must be interpreted in context. Levels may be affected by age, kidney disease, obesity, atrial fibrillation and acute illness. A result should not be used alone to decide treatment; it should be combined with symptoms, examination, imaging and medical history.

Treatment Matching and Comorbidities

Personalized heart failure treatment is also about matching therapy to the patient’s wider health profile. A person with diabetes and heart failure may benefit from treatments that address both conditions when clinically appropriate. A patient with atrial fibrillation may need rhythm or rate assessment, anticoagulation consideration and evaluation of whether rhythm problems worsen symptoms. A person with chronic kidney disease may need closer monitoring of kidney function and potassium when medications are adjusted.

For heart failure with mildly reduced or preserved ejection fraction, research increasingly focuses on phenotype-targeted therapy rather than a single blanket approach. Reviews describe the need to identify patterns such as obesity-related HFpEF, atrial fibrillation-associated HFpEF or kidney disease-associated HFpEF so that treatment trials and clinical care can better match the underlying biology [5]. This is promising, but it must be interpreted carefully: many approaches remain under study, and patients should not start or stop medication without medical advice.

Genetics, Multi-Omics and Digital Tools

Some forms of heart failure are related to inherited cardiomyopathies. In these situations, genetic testing may be considered by specialists, particularly when there is unexplained cardiomyopathy, a strong family history, sudden cardiac death in relatives, or features suggesting a specific inherited condition. However, genetic testing is not needed for every person with heart failure and should usually be paired with expert counselling.

Multi-omics research, including genomics, transcriptomics, proteomics and metabolomics, aims to understand heart failure beyond traditional labels [6]. These tools may eventually help identify disease mechanisms, predict risk or guide therapy more precisely. At present, most are still mainly research tools rather than routine tests for all patients [3,6].

Artificial intelligence may also support personalized medicine in heart failure by analysing large amounts of data from electronic health records, ECGs, imaging, wearable devices and remote monitoring [7]. AI may help with risk prediction, earlier detection, phenotype classification and treatment support, but studies also warn that models require strong validation, fairness, transparency and clinical utility before routine use [7]. Technology should support clinicians and patients, not replace careful medical evaluation.

Why This Matters in Real Life

Personalized medicine in heart failure matters because small differences can change care. A medication that is helpful for one patient may need a lower dose, slower introduction or closer monitoring in another. Symptoms such as breathlessness may come from heart failure, lung disease, anaemia, obesity, deconditioning or anxiety, so diagnosis must be careful. A patient with dizziness and low blood pressure may need a different treatment plan from a patient with fluid overload and high blood pressure.

This approach can also improve communication. Patients often understand their condition better when doctors explain why a treatment was chosen, what benefit is expected, what side effects to watch for and when follow-up blood tests are needed. Personalized care should include shared decision-making, realistic goals and attention to quality of life.

Practical Advice for Patients

Patients with heart failure should keep an updated medication list and bring it to appointments. It is helpful to track symptoms such as breathlessness, swelling, fatigue, reduced exercise tolerance, dizziness, palpitations and sudden weight changes. Daily weight monitoring may be recommended for some patients, especially those prone to fluid retention, but targets should be agreed with a healthcare professional.

Do not stop heart failure medication suddenly unless a doctor advises it, because symptoms may worsen. Ask your doctor what each medication is for, what monitoring is needed, and which side effects require contact. Lifestyle advice should also be individualized, including physical activity, salt intake, fluid advice, vaccination, smoking cessation, alcohol guidance and management of blood pressure, diabetes, cholesterol and kidney disease.

When to Seek Medical Help

Seek urgent medical care if breathlessness is sudden, severe or worsening, if there is chest pain, fainting, blue lips, severe weakness, confusion, coughing pink frothy sputum or rapidly increasing swelling. Patients should also contact a doctor promptly if they gain weight quickly, develop new palpitations, have worsening ankle or abdominal swelling, feel dizzy after medication changes, or notice reduced urination. Heart failure can change over time, so new or worsening symptoms should not be ignored.

Conclusion

Personalized medicine in heart failure is about combining evidence-based care with the patient’s individual clinical picture. It uses heart failure type, cause, symptoms, imaging, biomarkers, rhythm, kidney function, comorbidities, treatment tolerance and patient priorities to guide safer decisions. Emerging tools such as genetics, multi-omics, remote monitoring and artificial intelligence may make care more precise in the future, but they must be used responsibly and validated carefully. The most important message is that heart failure care should be individualized, reviewed regularly and guided by qualified healthcare professionals.

Book a consultation with a Doctors365 cardiology specialist to discuss symptoms, test results, treatment options and follow-up needs. Personalized advice should always be based on your medical history, examination and appropriate investigations.

References

1. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure. J Am Coll Cardiol. 2022;79(17):e263-e421. doi:10.1016/j.jacc.2021.12.012. PubMed: https://pubmed.ncbi.nlm.nih.gov/35379503/
2. Palaparthi EC, Reddy PA, Padala T, Karthika KSV, Paka R, Reddy VA, et al. The rise of personalized medicine in heart failure management: a narrative review. Cureus. 2025;17(5):e83731. doi:10.7759/cureus.83731. PubMed: https://pubmed.ncbi.nlm.nih.gov/40486428/
3. Hasenfuß G, Schuster A, Bergau L, Toischer K. Präzisionsmedizin vertieft die personalisierte Medizin in der Kardiologie [Precision medicine enhances personalized medicine in cardiology]. Inn Med (Heidelb). 2024;65(3):239-247. doi:10.1007/s00108-024-01663-w. PubMed: https://pubmed.ncbi.nlm.nih.gov/38294501/
4. Rasalam R, Sindone A, Deed G, Audehm RG, Atherton JJ. State of precision medicine for heart failure with preserved ejection fraction in a new therapeutic age. ESC Heart Fail. 2025;12(3):1544-1557. doi:10.1002/ehf2.15205. PubMed: https://pubmed.ncbi.nlm.nih.gov/39844745/
5. Rosano GMC, Vitale C, Spoletini I. Precision cardiology: phenotype-targeted therapies for HFmrEF and HFpEF. Int J Heart Fail. 2024;6(2):47-55. doi:10.36628/ijhf.2023.0058. PubMed: https://pubmed.ncbi.nlm.nih.gov/38694928/
6. Esquivel Gaytan A, Bomer N, Grote Beverborg N, van der Meer P. 404-error “Disease not found”: unleashing the translational potential of -omics approaches beyond traditional disease classification in heart failure research. Eur J Heart Fail. 2024. doi:10.1002/ejhf.3268. PubMed: https://pubmed.ncbi.nlm.nih.gov/38741225/
7. Yoon M, Lee CJ, Park JJ. Application and potential of artificial intelligence in heart failure: past, present, and future. Int J Heart Fail. 2023;6(1):11-19. doi:10.36628/ijhf.2023.0050. PubMed: https://pubmed.ncbi.nlm.nih.gov/38303917/

Written by
Dr. Diellza Rabushaj, MD