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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Influence of predictive modeling in implementing optimal heart failure therapy
Hari Prasad1, Jaspinder Sra, Wayne C Levy
1Department of Internal Medicine, Guthrie Clinic, Ltd, Sayre, Pennsylvania 18840, USA.
The American Journal of the Medical Sciences
|January 15, 2011
Summary
The Seattle Heart Failure Model (SHFM) improved heart failure (HF) treatment by graphically showing survival benefits, leading to more pharmacologic and device therapy. This approach significantly boosted patient care in an ambulatory setting.
Area of Science:
- Cardiology
- Clinical Medicine
- Health Informatics
Background:
- A significant gap exists between evidence-based heart failure (HF) guidelines and current treatment practices.
- The Seattle Heart Failure Model (SHFM) is a validated tool for predicting HF patient outcomes.
- Physician adoption of guideline-recommended therapies may be enhanced by visualizing treatment benefits.
Purpose of the Study:
- To evaluate if graphical representation of survival improvements using the SHFM can modify physician behavior regarding HF treatment.
- To assess the impact of the SHFM on the intensification of pharmacologic and device therapy in ambulatory HF patients.
Main Methods:
- Fifty HF patients with left ventricular ejection fraction <40% were selected from 10 primary care physicians.
- The SHFM was used to estimate survival before and after implementing guideline-recommended pharmacologic (ACE/ARB, statin, beta-blocker, aldosterone blocker) and device therapies (ICD, biventricular pacing).
- Therapeutic changes and their impact on survival estimates were discussed in focused sessions with physicians.
Main Results:
- In 82% of patients, medical or device therapy was altered, with 50% receiving advanced medical therapy and 10% considered for device referral.
- Combined medical and device therapy adjustments occurred in 22% of patients.
- These interventions increased estimated mean life expectancy from 8.8 to 10.9 years (P < 0.001).
Conclusions:
- The SHFM effectively prompted intensification of HF therapy in an ambulatory care setting.
- Visualizing survival benefits using the SHFM can be a powerful tool to bridge the gap between guidelines and clinical practice.
- This approach holds promise for improving the management of heart failure patients in primary care.
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