The in- and out-of-hospital management of HF patients: results from a nationwide Belgian survey.
(2021) Acta Cardiologica : an international journal of cardiology — Vol. 76, n° 6, p. 632-641 (2021)
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Martens, Pieter 
- Abstract
- (en) BACKGROUND: We conducted a nationwide survey to describe the in-and out-of-hospital flow (diagnosis, treatment and follow-up) of patients with heart failure with reduced ejection fraction (HFrEF). METHOD: A survey was developed with five dedicated HF cardiologists. The data are all self-reported by cardiologists. RESULTS: The response rate was 84%. Presence of a dedicated HF cardiologist or HF nurse was indicated by 49% and 46% of the hospitals respectively. Devices (p < .05), angiotensin receptor neprilysin inhibitors, and rehabilitation are considered more standard of care therapy by dedicated compared to non-dedicated HF cardiologists. Most cardiologists indicated that target dosages of HF drugs can be reached in 25‒75% of patients. Achieving >75% of the target dose seems easier for angiotensin converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB) (22%) and mineralocorticoid receptor antagonists (25%), compared to β-blockers (10%) and angiotensin receptor neprilysin inhibitors (7%). 62%, 49% and 4% of the cardiologists indicated to use subtypes of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and β-blockers respectively not validated in the HF population. In the acute setting, dedicated HF cardiologists (23%) are less influenced by blood parameters for decongestion compared to non-dedicated HF cardiologists (39%). They tend to change patients more to guideline-recommended drugs (60% vs 47%). Six minutes walk test and ergospirometry are significantly more used by dedicated compared to non-dedicated HF cardiologists for HF drug change (17% and 29% vs 2% and 4%). CONCLUSION: This survey showed that a minority of hospitals have HF care. Those that do, report a higher implementation of guideline-recommended diagnosis, treatment and follow-up of HF patients. Competent authorities could use this survey as a tool to improve HF care.
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Ghys, L. F., Martens, P., Heggermont, W. A., Gabriel, L., Heyse, A., Troisfontaines, P., & Maris, M. (2021). The in- and out-of-hospital management of HF patients: results from a nationwide Belgian survey. Acta Cardiologica : an international journal of cardiology, 76(6), 632-641. https://doi.org/10.1080/00015385.2020.1765105 (Original work published 2021)