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A Global Perspective/Health Inequity in Heart Failure, An Issue of Heart Failure Clinics, E-Book

A Global Perspective/Health Inequity in Heart Failure, An Issue of Heart Failure Clinics, E-Book

Pablo Castro

(2016)

Additional Information

Book Details

Abstract

This special issue of Heart Failure Clinics examines heart failure with a truly global perspective, exposing health inequities in the treatment of heart failure.

Table of Contents

Section Title Page Action Price
Front Cover Cover
A Global Perspective/HealthInequity in Heart Failure \r i
Copyright\r i
Contributors iii
CONSULTING EDITORS iii
EDITORS iii
AUTHORS iii
Contents vii
Foreword: Heart Failure: A Global Pandemic and Not Just a Disease of the West\r vii
Socioeconomic Inequalities in Heart Failure\r vii
Heart Failure in Rural Communities\r vii
Inequalities in the Access to Advanced Therapy in Heart Failure\r vii
Gaps and Resemblances in Current Heart Failure Guidelines: A Clinical Perspective\r vii
Prognostic Factors in Hospitalization for Heart Failure in Asia\r viii
Biomarkers for Heart Failure in Asia\r viii
Heart Transplant in Asia\r viii
Epidemiology of Heart Failure in Asia\r viii
Identifying Barriers and Practical Solutions to Conducting Site-Based Research in North America: Exploring Acute Heart Fail .\r ix
Hospitalized Heart Failure in the United States: Lessons Learned from Clinical Trial Populations\r ix
The Impact of Worsening Heart Failure in the United States\r ix
End-of-life Heart Failure Care in the United States\r ix
Epidemiology of Heart Failure in Europe\r x
Acute Heart Failure Syndromes in the Elderly: The European Perspective\r x
Characteristics of Intensive Care in Patients Hospitalized for Heart Failure in Europe\r x
HEART FAILURE CLINICS\r xi
FORTHCOMING ISSUES xi
January 2016 xi
April 2016 xi
RECENT ISSUES xi
July 2015 xi
April 2015 xi
Preface: Heart Failure: A Global Pandemic and Not Just a Disease of the West\r xiii
Socioeconomic Inequalities in Heart Failure 507
Key points 507
BACKGROUND 507
SOCIOECONOMIC STATUS AND HEART FAILURE 508
EDUCATIONAL LEVEL AND OCCUPATION 508
HEALTH LITERACY AND HEART FAILURE 509
BRIDGING THE GAPS IN SOCIOECONOMIC INEQUALITY 510
FUTURE DIRECTIONS 511
SUMMARY 511
REFERENCES 511
Heart Failure in Rural Communities 515
Key points 515
BACKGROUND 515
EPIDEMIOLOGY 516
ORGANIZATIONAL FACTORS IN RURAL HEALTH SYSTEMS 517
Health System Policies 517
Health Care Providers’ Adherence to Guidelines in the Rural Setting 517
PATIENT-RELATED FACTORS IN RURAL COMMUNITIES 518
ROLE OF INTERVENTIONS TO IMPROVE CHRONIC HEART FAILURE OUTCOMES IN RURAL COMMUNITIES 518
Simplified Diagnostic Approach 518
Telemedicine Support 518
Patient Education 519
Primary Health Care Provider Education and Training 519
SUMMARY 519
REFERENCES 520
Inequalities in the Access to Advanced Therapy in Heart Failure 523
Key points 523
INTRODUCTION 523
SOME DEFINITIONS 523
Developing Countries 523
The Chilean Health Care Model, as a Model of a Developing Country 524
Defining Advanced Heart Failure 524
GENERAL APPROACH TO ADVANCED THERAPIES AND INTRODUCTION TO THE PROBLEM OF INEQUALITIES 524
Cardiac Resynchronization Therapy and Implantable Cardioverter-Defibrillators 524
Mechanical Cardiac Support 525
Heart Transplant 526
OTHER FACTORS THAT MAKE DIFFICULT THE ACCESS TO ADVANCED THERAPIES 526
Economic Issues 526
Access to Health Care 526
Low Number of Heart Failure Specialists 527
SUMMARY 527
REFERENCES 527
Gaps and Resemblances in Current Heart Failure Guidelines 529
Key points 529
INTRODUCTION 529
GRADING THE EVIDENCE AND CLASSIFYING THE RECOMMENDATIONS 529
DEFINITIONS AND TYPES OF HEART FAILURE 531
PHARMACOLOGIC TREATMENT IN HEART FAILURE 532
Angiotensin I–Converting Enzyme Inhibitors 532
Angiotensin Receptor Blockers 532
Mineralocorticoid Receptor Antagonists 533
β-Blockers 534
Digoxin 535
Hydralazine and Isosorbide 535
Oral Anticoagulants 536
NOVEL TREATMENTS 536
Ivabradine 536
Angiotensin Receptor–Neprilysin Inhibitors 536
DEVICE RECOMMENDATIONS IN HEART FAILURE 536
Cardiac Resynchronization Therapy 536
Implantable Cardioverter-Defibrillators for Primary Prevention 538
SUMMARY 538
REFERENCES 538
Prognostic Factors in Hospitalization for Heart Failure in Asia 543
Key points 543
INTRODUCTION 543
PROGNOSTIC FACTORS OF MORTALITY AND MORBIDITY 544
Age 544
Hyponatremia 545
Systolic Blood Pressure 545
Renal Dysfunction 546
Left Ventricular Function 546
Ventricular Conduction Disturbance 546
Anemia 546
Evidence-based Medication Adherence 547
Hospitalization 547
EMERGING PROGNOSTIC FACTORS 547
Hemoconcentration 547
OTHER PROGNOSTIC FACTORS 547
SUMMARY 548
REFERENCES 548
Biomarkers for Heart Failure in Asia 551
Key points 551
INTRODUCTION 551
KEY PLAYERS 551
JAPAN AND THE NATRIURETIC PEPTIDE STORY 552
THE HONG KONG HERITAGE IN BIOMARKERS FOR HEART FAILURE 553
NEW DEVELOPMENTS FROM ASIA IN BIOMARKERS FOR HEART FAILURE 553
Peptide Biomarkers for Heart Failure in Asia 553
News on Nonpeptide Markers from Asia 555
Nucleic Acids as Biomarkers in Heart Failure 555
Genotyping for Heart Failure in Asia 556
Asia Is Organizing 557
Markers When East Meets West 557
REFERENCES 558
Heart Transplant in Asia 563
Key points 563
INTRODUCTION 563
HEART FAILURE IN ASIA 563
Prevalence of Heart Failure 563
Patients’ Characteristics of Heart Failure in Asia 564
Advanced Heart Failure in Asia 564
Heart Failure Management in Asia 564
Heart Failure Outcome in Asia 564
HEART TRANSPLANT IN ASIA 564
History 564
Incidence and Prevalence 565
Recipient and Cause of End-Stage Heart Disease 565
Screening for Donors 565
Survival 567
HEART TRANSPLANT IN SPECIAL SITUATIONS 568
Rheumatic Heart Disease 568
Elderly 568
Hepatitis B Virus Infection 568
POST–HEART TRANSPLANT CARE 568
Immunosuppression and Rejection 568
Endomyocardial Biopsy 568
HEART TRANSPLANT COMPLICATION 568
Primary Graft Failure 568
Cardiac Allograft Vasculopathy 568
Cardiac Arrhythmia 568
Malignancy 569
Infection 569
Mechanical Circulatory Support Devices in Asia 569
Barriers and Key to Success in Heart Transplant Program in Asia 569
Law 569
Ethical Issue 569
Infrastructure 569
Donor Shortage 569
Limitation of Data 570
Future 570
SUMMARY 570
REFERENCES 570
Epidemiology of Heart Failure in Asia 573
Key points 573
INTRODUCTION 573
IMPORTANT ISSUES FOR EPIDEMIOLOGIC COMPARISON 573
Definitions of Heart Failure in Registries of Patients Hospitalized for Heart Failure 573
Site Selection 574
The Time Frame 574
Ethnic Differences 575
EPIDEMIOLOGIC COMPARISON OF PATIENTS HOSPITALIZED FOR HEART FAILURE IN ASIA 575
Patient Characteristics 575
Management 575
Outcome 577
SUMMARY 578
REFERENCES 578
Identifying Barriers and Practical Solutions to Conducting Site-Based Research in North America 581
Key points 581
INTRODUCTION 582
BARRIER: POOR VISIBILITY OF CARDIOVASCULAR DISEASE AND CLINICAL TRIALS WITHIN THE INSTITUTION AND THE BROADER COMMUNITY 582
BARRIER: INABILITY OF STUDY SPONSORS TO IDENTIFY SITES CAPABLE OF ENROLLING HIGH VOLUME AND QUALITY PATIENTS 583
BARRIER: TIME-CONSUMING STUDY PROTOCOLS THAT DO NOT REFLECT THE DAY-TO-DAY REALITIES OF PATIENT CARE 584
BARRIER: INADEQUATE INFRASTRUCTURE FOR RECRUITMENT OF PARTICIPANTS AND STUDY CONDUCT 586
BARRIER: UNDERDEVELOPED RELATIONSHIPS BETWEEN CARDIOLOGISTS AND OTHER PHYSICIANS CARING FOR THE CARDIAC PATIENT 587
BARRIER: MISALIGNMENT OF INCENTIVES BETWEEN PRINCIPLE INVESTIGATORS AND PARENT CLINICAL FACILITY 587
BARRIER: LIMITED UPFRONT TRAINING AND ONGOING SUPPORT FOR STUDY COORDINATORS AND OTHER STAFF 588
SUMMARY 588
REFERENCES 588
Hospitalized Heart Failure in the United States 591
Key points 591
UNITED STATES STUDY ENROLLMENT 592
PATIENT CHARACTERISTICS 593
LENGTH OF STAY AND READMISSION RISK 596
THERAPY UTILIZATION 596
CLINICAL OUTCOMES 597
POTENTIAL FUTURE DIRECTIONS FOR UNITED STATES TRIALS 598
SUMMARY 599
REFERENCES 600
The Impact of Worsening Heart Failure in the United States 603
Key points 603
INTRODUCTION AND DEFINITIONS 603
ESTABLISHING A DEFINITION FOR WORSENING HEART FAILURE AS A CLINICAL TRIAL ENDPOINT 604
INITIAL DESCRIPTIONS OF THE INCIDENCE OF WORSENING HEART FAILURE AND ASSOCIATED OUTCOMES 605
WORSENING HEART FAILURE AS A TRIAL ENDPOINT 605
ASSOCIATION OF WORSENING HEART FAILURE WITH CLINICAL OUTCOMES 605
TREATMENT OF WORSENING HEART FAILURE 611
PREDICTION OF WORSENING HEART FAILURE 611
DEVELOPING THERAPEUTICS AND TREATMENT STRATEGIES THAT DECREASE WORSENING HEART FAILURE 612
SUMMARY 613
REFERENCES 613
End-of-life Heart Failure Care in the United States 615
Key points 615
INTRODUCTION 615
RESOURCE USE 616
PREDICTING DEATH 616
Hospitalized Setting 616
Ambulatory Setting 616
MANAGEMENT OPTIONS 617
Prolonging Life 617
Symptom Management 618
PALLIATIVE CARE AND HOSPICE 619
CHALLENGES AND SOLUTIONS 619
SUMMARY 620
REFERENCES 620
Epidemiology of Heart Failure in Europe 625
Key points 625
INTRODUCTION 625
PATIENTS HOSPITALIZED FOR ACUTE HEART FAILURE 626
Italian Network on Heart Failure Outcome Registry Findings 626
European Society of Cardiology Heart Failure Pilot Survey 627
European Society of Cardiology Heart Failure Long-Term Registry 629
AMBULATORY PATIENTS WITH CHRONIC HEART FAILURE 632
Italian Network on Heart Failure Outcome Registry Findings 632
European Society of Cardiology Heart Failure Pilot and Long-Term registries 633
SUMMARY 634
REFERENCES 634
Acute Heart Failure Syndromes in the Elderly 637
Key points 637
INTRODUCTION 637
CLINICAL PRESENTATION OF ELDERLY PATIENTS WITH ACUTE HEART FAILURE 639
COMORBIDITIES 640
MANAGEMENT OF ELDERLY PATIENTS WITH ACUTE HEART FAILURE 640
OUTCOMES OF ELDERLY PATIENTS WITH ACUTE HEART FAILURE 641
PREDICTORS OF CLINICAL OUTCOMES OF ELDERLY PATIENTS WITH ACUTE HEART FAILURE 641
COMPARISON OF THE EUROPEAN AND NORTH AMERICAN EXPERIENCE IN ELDERLY WITH ACUTE HEART FAILURE 643
SUMMARY AND FUTURE DIRECTIONS 643
REFERENCES 644
Characteristics of Intensive Care in Patients Hospitalized for Heart Failure in Europe 647
Key points 647
INTRODUCTION 647
DATA SOURCE INFORMATION 648
INTENSIVE CARE UNIT ADMISSION RATES 648
BASELINE CHARACTERISTICS OF PATIENTS ADMITTED TO INTENSIVE CARE UNITS 649
IN-HOSPITAL THERAPIES AND INVASIVE PROCEDURES 650
INTENSIVE CARE UNIT OUTCOMES 652
INTENSIVE CARE UNIT TRIAGE 653
CLINICAL RESEARCH IN THE INTENSIVE CARE UNIT SETTING 654
EUROPEAN PERSPECTIVES ON TRAINING AND EDUCATION IN CRITICAL CARE 654
SUMMARY 655
REFERENCES 655