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On Saturday, the latest evidence in heart failure (HF) management will be discussed at a joint symposium with the Heart Failure Association (HFA).
Professor Anna Strömberg (Linköping University, Linköping, Sweden) provided some background on what attendees can expect from the session: “Current ESC guidelines on HF were published in 20161 and an update is scheduled to be published in 2021, but in-between the guideline updates, new information is emerging from new studies that may alter how we view and interpret current guideline recommendations. On one hand, we want to follow and implement the current guidelines but on the other, when there are new interesting data appearing that may improve patient management, we also want to take these into account. However, individual studies can sometimes be hard to interpret without guidance, while published recommendations have been developed and extensively reviewed by a very prominent group of HF experts. During my presentation, I will provide an update on information about new HF medications that we may need to take into account in this ‘mid-era’ phase between the guidelines.”
Prof. Strömberg will also be talking about implementation of the 2016 guidelines, including recommendations on novel approaches that have not been previously included and practical ways for implementation going forward. “For instance, treatment with sacubitril/valsartan is recommended for certain patients with HF with reduced ejection fraction and its use in clinical practice needs to be considered, such as whether it is prescribed in the HF clinic or in primary care. There are also some practical and logistical questions surrounding iron supplementation in iron-deficient patients with HF; for example, how and where should intravenous iron be given, how should patients be screened and how should the organization of care be adapted? Recommendations on sacubitril/valsartan and on iron supplementation provide some examples of new 2016 guidance that has not been fully incorporated into standard HF management as yet.”
Following Prof. Strömberg’s presentation, Professor Tiny Jaarsma (Linköping University, Linköping, Sweden) will discuss recent evidence on non-invasive monitoring and whether this may have a guidelinerecommended place in HF management. The 2016 HF guidelines state that the clinical benefits of telemedicine suggested by several meta-analyses have not been confirmed by numerous prospectively initiated trials.1 Indeed, the role of remote monitoring strategies in HF was listed as a gap in the evidence. However, there have been some exciting new findings on non-invasive telemonitoring in HF recently and data from some of these studies may be mentioned in updated 2021 guidelines. As one example, Prof. Jaarsma described recent findings from the Telemedical Interventional Management in Heart Failure II (TIM-HF2) trial that investigated the efficacy of remote patient management vs usual care on mortality and morbidity in 1,571 German patients with HF.2 Patients randomised to remote patient management received devices providing daily measures of body weight, blood pressure, ECG and self-reported health status. The authors found that this structured remote patient management intervention reduced the time spent in hospital for unplanned cardiovascular reasons more than usual care and there was also a reduction in all-cause mortality.
Prof. Jaarsma said, “New data from studies such as TIM-HF2 are important, although I believe we still have unanswered questions on telemonitoring interventions before they are fully ready for the prime time. As nurses and allied professionals, we are interested in reducing hospitalisations, but we are also looking at how we can help our patients to feel better and more in control—as such, rehospitalisation isn’t always our primary endpoint. With further refinements, the role of technology will expand, as will the involvement of nurses and allied professionals with technology. Importantly, we will see an increasing role of nurses and allied professionals overall in the management of HF as part of a greater focus on a multidisciplinary approach. We look forward to seeing how the new ESC HF guidelines evolve and taking an active role in their development.”
Professor Izabella Uchmanowicz, Congress Coordinator, explained, “Development of guidelines is only the first step on their route to applicability. Successful introduction also involves dissemination, implementation and evaluation. Two of the most effective forms of guideline dissemination are active learning from experts as opinion leaders and continuing education. EuroHeartCare Congress provides an excellent forum for dissemination by creating sessions that explain the guidelines and emphasise their importance in everyday practice.”
Joint session with HFA
Saturday: 11:45 – 12:45; Orange
Our mission: To reduce the burden of cardiovascular disease
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