Advanced Heart Failure Epidemiology and Outcomes

Dunlay, Shannon M.; Roger, Véronique L.; Killian, Jill M.; Weston, Susan A.; Schulte, Philip; Subramaniam, Anna V.; Blecker, Saul; Redfield, Margaret M.

doi:10.1016/j.jchf.2021.05.009

Cited by 79 publications

(66 citation statements)

References 32 publications

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“…The gold standard ESC definition that we applied required manual review of electronic health record data by a clinician to identify patients with advanced HF. 7 , 8 Although we recently described advanced HF in a population-based community cohort, it is imperative to gain a more comprehensive understanding of patients with advanced HF and their outcomes across broader populations. Development of electronic algorithms can help facilitate that goal.…”

Section: Discussionmentioning

confidence: 99%

“…In this cohort of patients with a diagnostic code for HF, the patients with advanced HF were known, as they had been previously identified by our group using a rigorous process that included manual review of electronic health record data. The process used to identify patients with advanced HF has been previously described 8 ; in brief, we applied the ESC’s advanced HF case definition. 7 The ESC case definition requires all of the following within a 12-month period: (1) hospitalizations or ED visits for HF/VA; (2) 1 or more echocardiographic signs of severe HF, including severely reduced EF, significantly reduced right ventricular function, severe inoperable valvular heart disease or congenital heart disease, or significant diastolic dysfunction; (3) severe exercise limitations; and (4) persistent New York Heart Association class III (advanced) or IV symptoms despite attempts to optimize medical, surgical, and device-based therapy.…”

Section: Methodsmentioning

confidence: 99%

“… 7 This resulted in a comprehensive, population-based cohort of individuals with advanced HF, and we have described their characteristics and outcomes in detail. 8 However, this process was not facile or easily reproducible. Our next step was to develop algorithms that could be more easily applied but still accurately identify patients with advanced HF so that we could begin to better understand and treat this population.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Identifying Patients With Advanced Heart Failure Using Administrative Data

Dunlay¹,

Blecker²,

Schulte³

et al. 2022

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Identifying Patients With Advanced Heart Failure Using Administrative Data

Dunlay¹,

Blecker²,

Schulte³

et al. 2022

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…This alarming epidemic is anticipated to worsen as the global population continuously grows older, contributing to a sustained healthspan–lifespan gap, further compounded by a younger, increasingly more morbid population at risk of developing heart failure [ 4 , 5 , 6 ]. Chronic heart failure syndrome is malignant in its progressive non-reversible nature, and notoriously refractory to treatment options resulting in recurrent hospitalizations and poor survival causing death in two-thirds of patients within five years of diagnosis [ 7 ]. Pump failure is a common manifestation of florid disease shared across heart failure etiologies, provoked by complex underlying cardiomyopathic substrates [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Mass Customized Outlook for Regenerative Heart Failure Care

Yamada

Bartúnek

Behfar

et al. 2021

IJMS

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Heart failure pathobiology is permissive to reparative intent. Regenerative therapies exemplify an emerging disruptive innovation aimed at achieving structural and functional organ restitution. However, mixed outcomes, complexity in use, and unsustainable cost have curtailed broader adoption, mandating the development of novel cardio-regenerative approaches. Lineage guidance offers a standardized path to customize stem cell fitness for therapy. A case in point is the molecular induction of the cardiopoiesis program in adult stem cells to yield cardiopoietic cell derivatives designed for heart failure treatment. Tested in early and advanced clinical trials in patients with ischemic heart failure, clinical grade cardiopoietic cells were safe and revealed therapeutic improvement within a window of treatment intensity and pre-treatment disease severity. With the prospect of mass customization, cardiopoietic guidance has been streamlined from the demanding, recombinant protein cocktail-based to a protein-free, messenger RNA-based single gene protocol to engineer affordable cardiac repair competent cells. Clinical trial biobanked stem cells enabled a systems biology deconvolution of the cardiopoietic cell secretome linked to therapeutic benefit, exposing a paracrine mode of action. Collectively, this new knowledge informs next generation regenerative therapeutics manufactured as engineered cellular or secretome mimicking cell-free platforms. Launching biotherapeutics tailored for optimal outcome and offered at mass production cost would contribute to advancing equitable regenerative care that addresses population health needs.

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“…However, compounds such as spironolactone, sacubitril/valsartan, and sodium–glucose cotransporter 2 inhibitors (SGLT-2i) have proved to be effective over a wide range of LVEF [ 13 ]. Moreover, recent evidence suggests that acute HF and advanced HF may occur at any level of LVEF, and prognosis is unrelated to LVEF [ 14 ].…”

mentioning

confidence: 99%