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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

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Critical appraisal of costly therapy modalities for heart failure in a developing country

Diego Chemello1, Livia Goldraich, Juglans Alvarez

  • 1Hospital de Clinicas de Porto Alegre, Division of Cardiology, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil, 90035-903.

Current Heart Failure Reports
|September 28, 2013
PubMed

Insights

Advanced heart failure management in Brazil faces resource limitations for devices like CRT, ICDs, and VADs. Heart transplantation offers favorable outcomes and resource allocation for eligible patients, especially those with Chagas

Area of Science:

  • Cardiology
  • Health Economics
  • Public Health

Background:

  • Heart failure management faces challenges in resource allocation for advanced therapies, including cardiac devices and transplantation.
  • Middle-income countries like Brazil experience specific constraints due to limited financial resources and specialized centers.
  • Chagas' disease presents unique considerations for heart failure treatment in Brazil.

Purpose of the Study:

  • To evaluate strategies for resource allocation in advanced heart failure management in Brazil.
  • To assess the suitability of cardiac devices (CRT, ICD, VAD) versus heart transplantation in the Brazilian context.
  • To consider the impact of Chagas' disease on treatment outcomes and resource utilization.

Main Methods:

  • Review of current guidelines for cardiac device implantation (CRT, ICD) and ventricular assist devices (VADs).
  • Analysis of health economic factors influencing the adoption of advanced therapies in Brazil.
  • Consideration of outcomes data for heart transplantation in patients with and without Chagas' disease.

Main Results:

  • Cardiac device use requires strict guideline adherence, adapted to public financial constraints.
  • Ventricular assist device programs are nascent in Brazil, demanding cautious resource allocation.
  • Heart transplantation shows favorable outcomes for advanced heart failure patients, including those with Chagas' disease, and offers better resource allocation.

Conclusions:

  • Heart transplantation is a viable and attractive option for advanced heart failure in Brazil, balancing outcomes and resource management.
  • Careful consideration and adaptation of cardiac device strategies are necessary within Brazil's economic and healthcare landscape.
  • Further research is needed on the outcomes of electric devices in patients with Chagas' disease.

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