Clinical practices and attitudes regarding the diagnosis and management of heart failure: findings from the CORE Needs Assessment Survey

Howlett, Jonathan G.; Comín‐Colet, Josep; Dickstein, Kenneth; Fuat, Ahmet; Pölzl, Gerhard; Delaney, Sean W.

doi:10.1002/ehf2.12205

Cited by 17 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There were no differences in the global scores between specialists and fellows, although fellows performed better for questions on most recent updates, such as the indications for treatment with sacubitril/ valsartan, and specialists on less recent indications, such as loop diuretic indications. Previous surveys reported that the adherence of physicians and nurses to current guidelines on HF was suboptimal [11,12]. This was also true for Geriatrician, as reported by a European survey including nine countries, that showed that a poor knowledge of the relevant guidelines, rather than an objective difficulty in putting them in practice, was at the basis of poor adherence [13].…”

Section: Discussionmentioning

confidence: 87%

“…Most of the previously published surveys on the knowledge, clinical attitudes and management of patients affected by HF were mainly addressed to cardiologists and general practitioners or nurses [11][12][13], while geriatricians, who frequently manage patients with this disease, are rarely studied [13]. Furthermore, no survey had included fellows, that are often actively involved in the management of HF in acute care wards.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Management of heart failure: an Italian national survey on fellows/specialists in geriatrics

et al. 2020

View full text Add to dashboard Cite

Background Heart failure (HF) is often managed by geriatricians. Few data are available on their knowledge and attitudes about this condition. Aims To compare perceptions and knowledge on HF of specialists/fellows in geriatrics working in Italy. Methods This nationwide survey carried out by the Italian Society of Gerontology and Geriatrics in May-June 2019 enrolled 283 specialists/fellows in geriatrics in Italy. Results were stratified by qualification (specialist/fellow) and performance (lower/ higher quartile of correct answers). Results About half (55.5%) of the participants worked in acute care wards, 190 were residents, and 93 specialists. The overall proportion of correct answers was 70.8%, with no differences between specialists and fellows. There was a poor knowledge, with no differences between groups, about the target doses of ACE-inhibitors (36% of correct answers), the pharmacological treatment of HF with preserved ejection fraction (HFpEF) (37% of correct answers), and the inotropes indicated in acute HF (35% of correct answers). Compared to specialists, fellows performed better on indication (88% vs 76%, P = 0.019) and mechanism of action (93% vs 84%, P = 0.023) of sacubitril/valsartan, and on therapeutic indications of patients with atrial fibrillation (92% vs 75%, P < 0.001). Conclusions Globally, there was a good knowledge of the latest guidelines on the diagnosis and management of HF. However, for some important topics, such as HFpEF, that is the most common HF manifestation in older adults, the observed performance was relatively poor, indicating the need for focused educational campaigns.

show abstract

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Management of heart failure: an Italian national survey on fellows/specialists in geriatrics

et al. 2020

View full text Add to dashboard Cite

show abstract

“…SOBOTA‐HF study will, with comprehensive transthoracic echocardiography and external independent core echocardiography laboratory centre, be able to investigate the prevalence of three HF phenotypes per LVEF. For the purposes of the primary endpoint, we will apply the ESC guidelines criteria; nonetheless, we will also adopt other criteria for diagnosis of diastolic dysfunction, which will allow the comparison of different approaches, also in conjunction with different natriuretic peptide cut‐offs to suggest the optimal practice to be adopted in daily routine …”

Section: Discussionmentioning

confidence: 99%

Heart failure prevalence in the general population: SOBOTA‐HF study rationale and design

et al. 2019

View full text Add to dashboard Cite

Aims Epidemiological heart failure (HF) data in the era of natriuretic peptides and echocardiography are scarce. The primary aim of this study is to evaluate the HF prevalence in the general population. We will also investigate natriuretic peptide cut-off for diagnosis of HF. Finally, we will be able to identify left ventricular function phenotypes and study relations between cardiac function, clinical presentation, and health-related quality of life. Methods and resultsScreening Of adult urBan pOpulation To diAgnose Heart Failure (SOBOTA-HF) is a cross-sectional prevalence study in a representative sample of Murska Sobota residents aged 55 years or more. Individuals will be invited to attend screening visit with point-of-care N-terminal pro-b-type natriuretic peptide (NT-proBNP) testing. All subjects with NT-proBNP ≥ 125 pg/mL will be invited for a diagnostic visit that will include history and physical examination, electrocardiogram, echocardiography, blood and urine sampling, ankle brachial index, pulmonary function tests, body composition measurement, physical performance tests, and questionnaires. To validate the screening procedure, a control group (NT-proBNP < 125 pg/mL) will undergo the same diagnostic evaluation. An external centre will validate echocardiography results, and the HF diagnosis will be adjudicated within an international HF expert panel. Overall and age-specific HF prevalence will be calculated in individuals ≥ 55 years and extrapolated to the whole population. Conclusions The SOBOTA-HF study will test the latest HF guideline diagnostic criteria in the general population sample. Next to HF prevalence, it will provide insight into left ventricular function and general patient phenotype; we will also extend current understanding of natriuretic peptides for HF screening.

show abstract

“…40 Further, 34% of the patients who had a primary event experienced at least one other HF hospitalization and sacubitril/valsartan had a similar efficacy to reduce recurrent events ( Figure 1). 47,48 Further research is therefore focused on the optimization of medical treatment in HFrEF patients. 42,43 Based on these results, 40,44 sacubitril/valsartan is currently recommended as a replacement for ACEi/ARBs in ambulatory patients with HFrEF who remain symptomatic despite optimal medical treatment.…”

Section: Neurohormonal Antagonistsmentioning

confidence: 99%

Highlights in heart failure

et al. 2019

View full text Add to dashboard Cite

Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

show abstract

Clinical practices and attitudes regarding the diagnosis and management of heart failure: findings from the CORE Needs Assessment Survey

Cited by 17 publications

References 21 publications

Management of heart failure: an Italian national survey on fellows/specialists in geriatrics

Management of heart failure: an Italian national survey on fellows/specialists in geriatrics

Heart failure prevalence in the general population: SOBOTA‐HF study rationale and design

Highlights in heart failure

Contact Info

Product

Resources

About