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Knowledge and application of ESC/HFA guidelines in the management of advanced heart failure

Guillaume Baudry1,2,3, Nicolas Girerd1,3, Maja Cikes4

  • 1Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et des Vaisseaux, Nancy, France.

European Journal of Heart Failure
|November 20, 2024
PubMed

Insights

Cardiologists show varied awareness of advanced heart failure guidelines, with specialists demonstrating higher knowledge. Improving referral pathways to tertiary centers is crucial for better patient outcomes.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Clinical Guidelines

Background:

  • Advanced heart failure (HF) management is complex, with referral delays hindering optimal care.
  • The 2021 European Society of Cardiology/Heart Failure Association (ESC/HFA) guidelines aim to standardize advanced HF care.
  • Understanding current guideline awareness and implementation among cardiologists is essential.

Purpose of the Study:

  • To assess cardiologists' awareness and application of the 2021 ESC/HFA advanced HF guidelines.
  • To identify barriers contributing to delayed referrals for advanced HF patients.
  • To evaluate perceptions of mechanical circulatory support (MCS) outcomes.

Main Methods:

  • An online survey was distributed to European cardiologists via the ESC mailing list from June to October 2023.
  • Respondents were categorized as heart failure cardiologists (HFCs), general cardiologists (GCs), or other participants (OPs).
  • The survey covered guideline knowledge, network organization, clinical case management, and MCS perceptions.

Main Results:

  • Heart failure cardiologists (84%) reported higher guideline knowledge compared to general cardiologists (57%) and others (62%).
  • HFCs more frequently used ESC/HFA criteria (76%) for advanced HF identification than GCs (44%) or OPs (48%).
  • Referring severe HF patients to tertiary centers was perceived as difficult by 8.4% of HFCs versus 19.6% of GCs and 18.2% of OPs.

Conclusions:

  • Significant knowledge and application gaps exist regarding advanced HF guidelines among cardiologists.
  • Targeted educational initiatives are needed to improve guideline adherence.
  • The referral process for advanced HF patients requires optimization to ensure timely access to specialized care.
Abstract

Keywords:
Advanced heart failureCardiologist educationESC/HFA guidelinesHealthcare networksMechanical circulatory supportTransplantation

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