The EuroHeart Failure Survey programme—a survey on the quality of care among patients with heart failure in Europe Part 2: treatment

Komajda, Michel; Folláth, Ferenc; Swedberg, Karl; Cleland, John G.F.; Aguilar, Juan Cosín; Cohen‐Solal, Alain; Dietz, Rainer; Gavazzi, Antonello; Gilst, Wiek H. van; Hobbs, FD Richard; Korewicki, J; Madeira, Hugo; Moiseyev, V.S.; Préda, István; Widimský, Jiří; Freemantle, Nick; Eastaugh, Joanne; Mason, James

doi:10.1016/s0195-668x(02)00700-5

Cited by 728 publications

(427 citation statements)

References 43 publications

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“…Current guidelines for the management of patients with ST‐elevation MI indicate β‐blockers, which are negative chronotropes and inotropes, for use immediately after MI and during early recovery. However, heart rate often remains elevated in patients treated with β‐blockers 50. While the therapeutic benefit of ivabradine in combination with conventional therapies in the post‐MI setting has yet to be determined, this study supports the need for more thorough investigation.…”

Section: Discussionsupporting

confidence: 56%

Heart Rate Reduction With Ivabradine Protects Against Left Ventricular Remodeling by Attenuating Infarct Expansion and Preserving Remote‐Zone Contractile Function and Synchrony in a Mouse Model of Reperfused Myocardial Infarction

O’Connor

Smith

Piras

et al. 2016

JAHA

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BackgroundIvabradine selectively inhibits the pacemaker current of the sinoatrial node, slowing heart rate. Few studies have examined the effects of ivabradine on the mechanical properties of the heart after reperfused myocardial infarction (MI). Advances in ultrasound speckle‐tracking allow strain analyses to be performed in small‐animal models, enabling the assessment of regional mechanical function.Methods and ResultsAfter 1 hour of coronary occlusion followed by reperfusion, mice received 10 mg/kg per day of ivabradine dissolved in drinking water (n=10), or were treated as infarcted controls (n=9). Three‐dimensional high‐frequency echocardiography was performed at baseline and at days 2, 7, 14, and 28 post‐MI. Speckle‐tracking software was used to calculate intramural longitudinal myocardial strain (Ell) and strain rate. Standard deviation time to peak radial strain (SD Tpeak Err) and temporal uniformity of strain were calculated from short‐axis cines acquired in the left ventricular remote zone. Ivabradine reduced heart rate by 8% to 16% over the course of 28 days compared to controls (P<0.001). On day 28 post–MI, the ivabradine group was found to have significantly smaller end‐systolic volumes, greater ejection fraction, reduced wall thinning, and greater peak Ell and Ell rate in the remote zone, as well as globally. Temporal uniformity of strain and SD Tpeak Err were significantly smaller in the ivabradine‐treated group by day 28 (P<0.05).ConclusionsHigh‐frequency ultrasound speckle‐tracking demonstrated decreased left ventricular remodeling and dyssynchrony, as well as improved mechanical performance in remote myocardium after heart rate reduction with ivabradine.

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Section: Discussionsupporting

confidence: 56%

Heart Rate Reduction With Ivabradine Protects Against Left Ventricular Remodeling by Attenuating Infarct Expansion and Preserving Remote‐Zone Contractile Function and Synchrony in a Mouse Model of Reperfused Myocardial Infarction

O’Connor

Smith

Piras

et al. 2016

JAHA

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“…In the Study on Heart failure Awareness and Perception Europe and EuroHeart Failure studies, effective first‐line medications were underutilized and/or prescribed at subtherapeutic doses in many patients with HF 5, 6. The CORE survey provides a current snapshot of prescribing practices on a global level and suggests that cardiologists and PCPs appeared to prescribe diuretics, MRAs, and other common HF medications at rates and/or doses that are inconsistent with guideline recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the effective diagnosis and treatment of patients with HF are essential 3, 4. However, many patients with HF are not receiving treatments and/or appropriate doses that demonstrate benefit in clinical trials and are not receiving care within a multidisciplinary framework that emphasizes effective long‐term management 5, 6, 7…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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AimsCORE is a continuing medical education initiative designed to support the evidence‐based management of heart failure (HF) in the primary and secondary care settings. The goal of the CORE Needs Assessment Survey is to describe current clinical practice patterns and attitudes among global stakeholders in HF care.Methods and resultsThe CORE Steering Committee guided the development of survey questions to assess clinical practice, confidence, and attitudes/perceptions among cardiologists, primary care physicians, and nurses involved in HF management. In total, 346 healthcare professionals from Australia (n = 59), Austria (n = 59), Canada (n = 60), Spain (n = 58), Sweden (n = 52), and the UK (n = 58) contributed survey data. Results revealed multiple gaps over the spectrum of HF care, including diagnosis (low recognition of the signs and symptoms of HF and limited use of diagnostic tests), treatment planning (underuse of recommended agents and subtherapeutic dosing), treatment monitoring and adjustment (lack of adherence to recommendations), and long‐term management (low confidence in providing patient education). Although primary care and specialist physicians and nurses shared common unmet needs, healthcare professional‐specific clinical gaps were also identified.ConclusionsThe CORE Needs Assessment Survey provides timely data describing current clinical practices and attitudes among physicians and nurses regarding key aspects of HF care. These findings will be useful for guiding the development of interventions tailored to the specific educational needs of different provider types and designed to support the evidence‐based care of patients with HF.

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“…There is evidence that neurohormonal antagonists are administered at lower rates and at lower doses in patients with more severe HF [43] and this may have a detrimental effect on prognosis [44]. It is therefore important to make every attempt to initiate and up-titrate all indicated medications to the doses shown to be effective.…”

Section: Medical Treatmentmentioning

confidence: 99%

Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

Metra

Ponikowski²,

Dickstein

et al. 2007

European J of Heart Fail

347

242

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Therapy has improved the survival of heart failure (HF) patients. However, many patients progress to advanced chronic HF (ACHF). We propose a practical clinical definition and describe the characteristics of this condition.Patients that are generally recognised as ACHF often exhibit the following characteristics: 1) severe symptoms (NYHA class III to IV); 2) episodes with clinical signs of fluid retention and/or peripheral hypoperfusion; 3) objective evidence of severe cardiac dysfunction, shown by at least one of the following: left ventricular ejection fraction b 30%, pseudonormal or restrictive mitral inflow pattern at Dopplerechocardiography; high left and/or right ventricular filling pressures; elevated B-type natriuretic peptides; 4) severe impairment of functional capacity demonstrated by either inability to exercise, a 6-minute walk test distance b 300 m or a peak oxygen uptake b 12-14 ml/kg/min; 5) history of N1 HF hospitalisation in the past 6 months; 6) presence of all the previous features despite optimal therapy. This definition identifies a group of patients with compromised quality of life, poor prognosis, and a high risk of clinical events. These patients deserve effective therapeutic options and should be potential targets for future clinical research initiatives.

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The EuroHeart Failure Survey programme—a survey on the quality of care among patients with heart failure in Europe Part 2: treatment

Cited by 728 publications

References 43 publications

Heart Rate Reduction With Ivabradine Protects Against Left Ventricular Remodeling by Attenuating Infarct Expansion and Preserving Remote‐Zone Contractile Function and Synchrony in a Mouse Model of Reperfused Myocardial Infarction

Heart Rate Reduction With Ivabradine Protects Against Left Ventricular Remodeling by Attenuating Infarct Expansion and Preserving Remote‐Zone Contractile Function and Synchrony in a Mouse Model of Reperfused Myocardial Infarction

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

Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

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