Johns Hopkins Brings Specialized Heart Failure Care to the Greater Washington Area

Johns Hopkins Medicine has established a dedicated heart failure hub in the Greater Washington area, providing patients with expert diagnostics and care close to home. Johns Hopkins cardiologists Steven Hsu and Ilton Cubero Salazar, both practicing in the Greater Washington area, completed fellowships at the Johns Hopkins University School of Medicine in advanced heart failure and transplant cardiology — an increasingly in-demand cardiology subspecialty.

“Our understanding of heart failure, and cardiomyopathies in general, has grown tremendously,” says Hsu, a faculty member of the Johns Hopkins Medicine Division of Cardiology since 2017, and medical director of mechanical circulatory support at Johns Hopkins. “There are now many known causes, new diagnoses to consider and better treatment options.” Hsu splits his time between the Johns Hopkins Cardiology office in Bethesda and The Johns Hopkins Hospital in Baltimore.

Heart failure can stem from various causes, be chronic or acute, and affect different parts of the heart.

“When my colleagues who are general cardiologists have questions about how to evaluate for conditions like amyloidosis, sarcoidosis or genetic cardiomyopathies, they often send those patients to me,” says Cubero Salazar, who joined Johns Hopkins cardiology as a heart failure specialist in 2024. He treats patients at Sibley Memorial Hospital and Suburban Hospital, and provides outpatient care at the Johns Hopkins cardiology clinics in Bethesda and Rockville.

Heart failure specialists recommend that primary care doctors and general cardiologists refer patients to them who have worsening symptoms of heart failure, including fatigue, shortness of breath and swelling. Other signs of worsening heart failure include recent heart failure hospitalizations, lower blood pressure or escalating diuretic requirements.

Patients with evidence of emerging kidney and lung abnormalities, including pulmonary hypertension, also warrant referral. “Worsening renal function, or an elevation in pulmonary pressures on an echocardiogram, also known as pulmonary hypertension, are early signs that blood flow is too slow, resulting in a traffic jam of sorts in both the heart and kidneys,” Hsu notes.

Hsu and Cubero Salazar begin care by talking with patients about their symptoms and previous tests and treatments to determine if specialized diagnostics are needed, such as MRIs, PET scans, genetic tests or heart biopsies.

Based on the test results, treatments often include beta blockers, angiotensin receptor-neprilysin inhibitors, aldosterone antagonists and diuretics. These improve symptoms and can work in combination to strengthen the heart. More specialized treatments may be necessary depending on the cause of the cardiomyopathy.

For patients who are seriously ill and in need of longer lasting solutions, Hsu and Cubero Salazar work with a team of Johns Hopkins surgeons to offer more advanced options. Surgical therapies such as heart transplantation or left ventricular assist devices can be lifesaving options for patients with advanced heart failure. These surgeries are performed at The Johns Hopkins Hospital, which is one of the leading heart transplant centers on the East Coast and the top center in the mid-Atlantic, with 65 heart transplants completed in 2024.

“Advanced heart failure carries a poor prognosis of only one to two remaining years. On the other hand, a heart transplant on average offers 12 to 15 more years and a heart pump on average seven to 10 more years,” Hsu notes.

“We care deeply about the patients we meet,” says Hsu. “We can now deliver the very best Hopkins has to offer, right here in the Greater Washington area.”