European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: unknown
Published: Sept. 9, 2024
Language: Английский
Circulation Journal, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 13, 2025
Background: Evaluating the applicability of quality indicators (QIs) for heart failure (HF) care is crucial to addressing practice variability and improving outcomes by promptly translating guideline recommendations into QIs.
Language: Английский
Citations
1
European Journal of Heart Failure, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 13, 2025
The European Society of Cardiology (ESC) develops clinical practice guidelines for a number cardiovascular diseases including heart failure (HF) to provide evidence-based, up-to-date recommendations designed be applicable in daily practice.1, 2 These serve as vital tool healthcare professionals, offering guidance on patient management based clinically reviewed contemporary evidence. However, observational studies highlight gap and geographic variations the implementation guideline recommendations,3, 4 resulting missed opportunities reduce morbidity, mortality, utilization associated with HF.5 is complex challenging process influenced by multiple factors. Numerous barriers enablers have been identified.6 First, related themselves include their complexity, limited accessibility, poor applicability real-world practice. Second, providers lack knowledge skills, well language multi-ethnic countries. Additionally, patient-related factors, such awareness, adherence, financial constraints, play significant role. Finally, institutional resource-related challenges, time suboptimal networks, inadequate interprofessional communication pathways, insufficient incentives or reimbursement, further complicate effective implementation. In many low- middle-income countries (LMICs), which account approximately 50% global mortality,7 magnitude 'evidence–practice' HF care less appreciated likely more substantial compared developed (Figure 1). Many developing structured approach care, delayed follow-up access specialists advanced therapies.8, 9 Understanding systems challenges these regions therefore critical. Unfortunately, research from LMICs remains sparse. For example, between 2008 2017, 80% publications originated high-income countries, while only 0.2% came LMICs. Syria, instance, contributed 5% all LMICs, equates just 10 disease over decade.7, Syrian crisis had profound impact system, undertreatment conditions, HF.8, 11 During war years, Syria's infrastructure suffered extensive damage, leading severe shortages medical equipment, pharmacotherapies, skilled professionals who are capable performing procedures.8, 12 According Archive, than 445 attacks hospitals regime were documented, economic cost exceeding 1 trillion euros. 2022, survey was conducted Syria assess recommended processes patients.8 findings revealed that ongoing has placed an enormous strain system patients alike, 70% unable necessary treatments due barriers, local availability, expertise. showed do not receive optimal guideline-directed therapy (GDMT), 90% device-based prohibitive costs. Furthermore, absence expertise cardiac resynchronization (CRT) procedures adds another challenge providing comprehensive main official companies devices last fewer five CRT implanted entire country both 2023 2024. This means 1% eligible received it. Preventive measures also lacking optimization long-term illnesses, diabetes, hypertension, chronic kidney disease. Surprisingly, this day, major facilities primary percutaneous coronary intervention (PCI), acute myocardial infarction fibrinolysis instead. Primary PCI available private settings. one most factors contributing development HF. individual approaches undertaken address gaps.11, share raise awareness across numerous educational meetings organized different cities. efforts led physicians living abroad collaboration physicians. social media utilized platform disseminate initiatives effectively. Tailored explored adapt circumstances. left bundle branch pacing (LBBP), utilizes traditional two-chamber but ventricular electrode branch, introduced viable affordable alternative treatment biventricular indication CRT. As part initiative, LBBP cases performed Damascus through collaborative effort operators Germany results highly encouraging, demonstrating comparable outcomes cost-effective solution afford CRT.12 Whilst equipoise still awaiting strong body evidence, introducing extremely important initiative given accessibility affordability Now, renewed sense motivation following country's progress toward stability freedom, we committed continuing work look forward expand authorities decision-makers build previous experiences transform level. Our focus initiate programme defining gaps current solutions feasible sustainable, systematic collection data using harmonized definitions, participation international registries. Such accomplishments can made possible dedicated support professional bodies ESC World Health Organization. Strategies would defined spread among at levels, students cardiology consultants. achieved conducting workshops Europe around world. obtain grants bodies. Secondly, aim essential materials improve outcomes, GDMT. plan establish programmes 'Cardiac Devices Syria' pacemakers, implantable-cardioverter defibrillators, devices, technologies currently widely Syria. implement called 'PCI hospital—an step preventing goals Western health organizations. We grateful Armin Schweitzer his technical graphical help. written under supervision Cardiovascular Association National Heart Failure Working Group. Open Access funding enabled Projekt DEAL. Conflict interest: A.A. reports speaker honoraria Boston Scientific Bayer. All other authors nothing disclose.
Language: Английский
Citations
0
European Journal of Internal Medicine, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 1, 2025
Language: Английский
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Zeitschrift für Herz- Thorax- und Gefäßchirurgie, Journal Year: 2025, Volume and Issue: unknown
Published: March 5, 2025
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Herz, Journal Year: 2025, Volume and Issue: unknown
Published: March 13, 2025
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European Heart Journal, Journal Year: 2025, Volume and Issue: unknown
Published: April 24, 2025
Language: Английский
Citations
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European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(10), P. 2258 - 2260
Published: Aug. 18, 2024
Language: Английский
Citations
1
ESC Heart Failure, Journal Year: 2024, Volume and Issue: unknown
Published: Oct. 20, 2024
Abstract Aims We aimed to create a predictive model utilizing machine learning (ML) identify new cases of congestive heart failure (CHF) in individuals with diabetes primary health care (PHC) through the analysis diagnostic data. Methods used sex‐ and age‐matched case–control design. Cases CHF were identified across all outpatient settings 2015–2022 ( n = 9098). included 30 years above, by sex age groups 30–65 >65 years. The controls (five per case) sampled from without at any time between 2010 2022, total 45 490. From stochastic gradient boosting (SGB) technique model, we obtained rank 10 most important factors related newly diagnosed diabetes, normalized relative influence (NRI) score corresponding odds ratio marginal effects (OR ME ). Area under curve (AUC) was calculated. Results For women years, 488 3240 CHF, respectively, men 1196 4174 cases. Among four (divided lower higher age) for found number visits 12 months before diagnosis (NRI 44.3%–55.9%), coronary artery disease 2.9%–7.8%), atrial fibrillation flutter 6.6%–12.2%) ‘abnormalities breathing’ (ICD‐10 code R06) 2.6%–4.4%) groups. younger women, COPD 2.7%) contributed effect, while older oedema 3.1%) 3.5%) effect. both groups, chronic renal had effect 3.9%–5.1%) prediction among patients high, AUC around 0.85 sensitivity over 0.783 specificity 0.708 Conclusions An SGB using routinely collected data about diagnoses care, can accurately predict risk diabetes. Age difference warrant further examination.
Language: Английский
Citations
1
European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: unknown
Published: Sept. 9, 2024
Language: Английский
Citations
0