Diagnostic and therapeutic practice for Heart Failure with preserved ejection fraction around the world: An international survey

IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Current Problems in Cardiology Pub Date : 2024-08-29 DOI:10.1016/j.cpcardiol.2024.102799
Clara Saldarriaga MD , Sydney Stephanie Goldfeder de Gracia MD , Maria Isabel Palacio Mejia MD , Anastasia Shchendrygina MD PHD , Keisuke Kida MD PHD , Charles Fauvel MD PHD , Marta Zaleska-Kociecka MD PHD , Massimo Mapelli MD PHD , Hafsteinn Einarsson PHD , Federica Guidetti MD PHD , Gina Gonzalez Robledo MD , Ivan Milinkovic MD PHD , Guillermina Esperon MD , Alberto Tejero MD , Anja Zupan Meznar MD PHD , Yasmin Rustamova MD PHD , Julie Vishram-Nielsen MD PHD , Dania Mohty MD , Shelley Zieroth MD , Anders Barasa MD PHD , Nathan Mewton MD PHD
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Abstract

Background and aims

There is a gap in knowledge about implementing diagnostic tools and therapy for heart failure with preserved ejection fraction (HFpEF) in clinical practice. This survey aimed to assess real-world practice in HFpEF diagnosis and treatment in the international medical community.

Methods

An independent academic web-based 29-question survey was designed by a group of heart failure specialists and posted by email and through scientific societies and social networks to a broad community of physicians worldwide.

Results

1.460 physicians from 95 countries answered the survey, with a mean age of 42.2±10.4 years, 39.4 % females, and 85.1 % were cardiologists. The left ventricular ejection fraction cut-off value selected for HFpEF diagnosis was 50 % for 89 % of participants. The scores for the probability of diagnosis of HFpEF were used only by 47.2 %, and H2FPEF was the most used score (31 %). Natriuretic peptides were used by 87.4 % of participants for the diagnostic workup, while the diastolic stress test was only used by 26.2 %. 54.4 % of participants chose SGLT2 inhibitors as their first drug treatment, followed by diuretics (18.6 %) and ACE inhibitors (8.4 %).

Conclusions

In an international academic survey on HFpEF management, the criteria for screening and diagnosis of HFpEF patients remain aligned with classic international guidelines with a low use of diagnostic scores. SGLT2i is the leading therapeutic drug class used for this heterogeneous patient population. These results raise the need to improve education and awareness on diagnosing and managing HFpEF patients.

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全球射血分数保留型心力衰竭的诊断和治疗实践:一项国际调查。
背景和目的:在临床实践中,有关射血分数保留型心力衰竭(HFpEF)诊断工具和治疗方法的实施知识尚存在空白。这项调查旨在评估国际医学界在 HFpEF 诊断和治疗方面的实际做法:方法:由一组心衰专家设计了一项独立的学术性网络调查,包含 29 个问题,并通过电子邮件、科学协会和社交网络向全球广大医师群体发布:来自 95 个国家的 1460 名医生回答了调查,平均年龄为(42.2±10.4)岁,女性占 39.4%,85.1% 为心脏病专家。89%的参与者在诊断高频心衰时选择的左心室射血分数临界值为50%。只有 47.2% 的人使用了 HFpEF 诊断概率评分,H2FPEF 是使用最多的评分(31%)。87.4%的参与者在诊断过程中使用了利钠肽,而只有 26.2% 的参与者使用了舒张压试验。54.4%的参与者选择SGLT2抑制剂作为首选药物治疗,其次是利尿剂(18.6%)和ACE抑制剂(8.4%):结论:在一项关于高频血栓栓塞治疗的国际学术调查中,高频血栓栓塞患者的筛查和诊断标准与经典国际指南保持一致,诊断评分的使用率较低。SGLT2i 是用于这类异质性患者的主要治疗药物。这些结果表明,有必要加强有关诊断和管理 HFpEF 患者的教育和宣传。
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来源期刊
Current Problems in Cardiology
Current Problems in Cardiology 医学-心血管系统
CiteScore
4.80
自引率
2.40%
发文量
392
审稿时长
6 days
期刊介绍: Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.
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