With the modern medicine, timely access to specialized care often makes the difference between life and death. For patients with heart failure, this reality has never been more true but a troubling new study indicates that roughly 40% of individuals with heart failure do not see a cardiologist even once per year despite strong evidence that even one yearly visit would greatly enhance survival.Published in the European Heart Journal and delivered at the Heart Failure Congress 2025, the research led by Dr. Guillaume Baudry and Professor Nicolas Girerd from the Clinical Investigation Centre at Nancy University Hospital in France indicates that annual cardiology follow-ups are linked to a 24% lower risk of mortality. The results give rise to immediate questions regarding discrepancies in access to specialist care and how health systems everywhere can improve support for heart failure patients.Heart failure ensues when the heart becomes incapable of circulating blood, usually a result of ailments like coronary artery disease, hypertension, or past heart attacks. Although irreversible in a majority of instances, heart failure can be treated for many decades with the proper medications, lifestyle modifications, and follow-up visits. Cardiologists have the key role in providing this expert care.While the previous research took its data from a handful of middle-class medical centers, the new study, based on medical records of 655,919 heart failure patients in France, discovered that almost two in five patients saw no cardiologist whatsoever within a 12-month window. And such minimal contact has dire consequences. In accordance with the scientists, for every 11–16 patients who did visit a cardiologist on at least an annual basis, one life could be saved."Ever since we understood the importance of specialist care for cancer, we've also known that heart failure needs specialist attention," said Dr. Baudry. "Our study offers proof that even clinically stable patients can gain benefit from regular care by a cardiologist."How Often Should You Visit a Cardiologist?To maximize care delivery, the research stratified patients according to two straightforward but strongly predictive factors: recent hospitalization for heart failure and diuretic use (a common set of medications used to counteract fluid accumulation). These factors were used to determine which patients required more frequent follow-ups with specialists.Patients with no recent hospitalization and no diuretic use were improved by at least one visit a year, cutting their risk of death from 13% to 6.7%.Those who had not been recently hospitalized but were on diuretics required two to three visits yearly, reducing their risk from 21.3% to 11.9%.Those hospitalized in the past five years (but not the recent year) also needed two to three visits to reduce risk from 24.8% to 12.9%.The most at-risk group—those hospitalized in the previous year—benefited most from quarterly visits, lowering death rates from 34.3% to 18.2%.Importantly, these recommendations are based on existing resource constraints within national healthcare systems, making them practical and scalable globally.The study also identified significant differences in access to seeing a cardiologist. Women, older patients, and patients with other chronic conditions like diabetes or pulmonary disease were less likely to be referred for cardiology treatment. Indeed, 33.8% of women did not visit a cardiologist in a year, versus 27.9% of men. Women were also less likely to take drugs like RAS inhibitors, which are routine in heart failure treatment.In spite of these differences, women actually fared better overall in mortality and hospitalization rates—an intriguing and not yet fully explained result that merits further study.Professor Nicolas Girerd stressed the necessity of systematic reform: "Referral to a cardiologist should be as routine in heart failure as it is in cancer care. Our study demonstrates that two simple markers recent hospitalization and treatment with diuretics—can inform these decisions without the need for expensive diagnostic machinery."This big, population-based French study is a wake-up call, not only for European healthcare, but for health systems in general. In most nations, primary care doctors are overworked, and patients with complicated diseases such as heart failure might not get the specialist care they require.In a supporting editorial, Professor Lars Lund of Karolinska Institutet in Stockholm cautioned, "What good is 50 years of discovery and innovation in heart failure treatment if patients aren't accessing that care?" He further said that systemic initiatives are urgently required to include cardiology follow-up in the standard care pathways.Although this was an observational study and cannot establish direct causality, the scale and robustness of the findings are a powerful argument for change. The researchers plan now to conduct an interventional clinical trial to examine the effect of organized cardiologist follow-up on patient outcomes. They also want to investigate the problem in countries with varying models of healthcare in order to determine world applicability.Hidden Cost of Skipping Cardiology VisitsHeart failure doesn’t always arrive with drama — no sudden collapse, no flashing lights. Instead, it often unfolds quietly, with fatigue, shortness of breath, or swelling easily dismissed as aging or stress. But beneath that silence lies a ticking time bomb. The latest study from France highlights a shocking truth: failing to see a cardiologist even once a year could be a matter of life and death. This isn't about access to the latest technology or expensive tests, it's about presence. The absence of a specialist in a patient’s journey with heart failure can mean the absence of life-saving medication adjustments, early warning signs going unnoticed, and critical therapy not being initiated. The data is sobering — skipping that one visit could mean doubling the risk of death.Signs That Could Save LivesOne of the most powerful insights from the study is its identification of two simple, scalable criteria—recent hospitalization and diuretic use that can predict which heart failure patients are at highest risk. This is revolutionary in its simplicity. It doesn’t require advanced imaging, genomic testing, or expensive algorithms.