Management of patients with heart failure treated in cardiology consultations: IC-BERG Study
Por:
Barrios, V, Escobar, C, Cortes, C, Sales, J, Figal, D and Marimon, X
Publicada:
1 ago 2020
Categoría:
Medicine (miscellaneous)
Resumen:
Objective: To determine the perception and management of heart failure with reduced ejection fraction (HFrEF) by clinical cardiologists and to establish a consensus with recommendations.
Methods: We employed the modified Delphi method among a panel of 150 experts who answered a questionnaire that included 3 blocks: definition and perception of patients with "stable" HFrEF (15 statements), management of patients with "stable" HFrEF (51 statements) and recommendations for optimising the management and follow-up (9 statements). The level of agreement was assessed with a Likert 9-point scale.
Results: A consensus of agreement was reached on 49 statements, a consensus of disagreement was reached on 16, and 10 statements remained undetermined. There was consensus regarding the definition of "stable" HF (82%), that HFrEF had a silent nature that could increase the mortality risk for mildly symptomatic patients (96%) and that the drug treatment should be optimised, regardless of whether a patient with HFrEF remains stable in the same functional class (98.7%). In contrast, there was a consensus of disagreement regarding the notion that treatment with an angiotensin receptor-neprilysin inhibitor is justified only when the functional class worsens (90.7%).
Conclusions: Our current understanding of "stable" HF is insufficient, and the treatment needs to be optimised, even for apparently stable patients, to decrease the risk of disease progression. (C) 2020 The Authors. Published by Elsevier Espana, S.L.U.
Filiaciones:
Barrios, V:
Univ Alcald, Hosp Univ Ramon & Cajal, Serv Cardiol, Madrid, Spain
Escobar, C:
Hosp Univ La Paz, Serv Cardiol, Madrid, Spain
Cortes, C:
Hosp San Pedro Alcantara, Serv Cardiol, Caceres, Spain
:
Hosp Arnau Vilanova, Serv Cardiol, Valencia, Spain
Figal, D:
Hosp Univ Virgen Arrixaca, Serv Cardiol, Murcia, Spain
Marimon, X:
Hosp Santa Creu & Sant Pau, Serv Cardiol, Barcelona, Spain
hybrid
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