Fauvel, Charles, Bonnet, Guillaume, Mullens, Wilfried, Giraldo, Clara Ines Saldarriaga, Meznar, Anja Zupan, Barasa, Anders, Tokmakova, Mariya ORCID: 0000-0002-8144-6965, Shchendrygina, Anastasia, Costa, Francisco Moscoso, Mapelli, Massimo ORCID: 0000-0001-9985-7407, Zemrak, Filip, Tops, Laurens F., Jakus, Nina, Sultan, Arian, Bahouth, Fadel ORCID: 0000-0003-4353-9703, Hadjseyd, Chahr-Eddine, Salvat, Muriel, Anselmino, Matteo, Messroghli, Daniel, Weberndorfer, Vanessa, Giverts, Ilya, Bochaton, Thomas, Berthelot, Emmanuelle, Legallois, Damien, Beauvais, Florence, Bauer, Fabrice, Lamblin, Nicolas, Damy, Thibaud, Girerd, Nicolas, Sebbag, Laurent, Pezel, Theo, Cohen-Solal, Alain, Rosano, Giuseppe, Roubille, Francois and Mewton, Nathan (2023). Sequencing and titrating approach of therapy in heart failure with reduced ejection fraction following the 2021 European Society of Cardiology guidelines: an international cardiology survey. Eur. J. Heart Fail., 25 (2). S. 213 - 223. HOBOKEN: WILEY. ISSN 1879-0844

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Abstract

Aims In symptomatic patients with heart failure and reduced ejection fraction (HFrEF), recent international guidelines recommend initiating four major therapeutic classes rather than sequential initiation. It remains unclear how this change in guidelines is perceived by practicing cardiologists versus heart failure (HF) specialists. Methods and results An independent academic web-based survey was designed by a group of HF specialists and posted by email and through various social networks to a broad community of cardiologists worldwide 1 year after the publication of the latest European HF guidelines. Overall, 615 cardiologists (38 [32-47] years old, 63% male) completed the survey, of which 58% were working in a university hospital and 26% were HF specialists. The threshold to define HFrEF was <= 40% for 61% of the physicians. Preferred drug prescription for the sequential approach was angiotensin-converting enzyme inhibitors or angiotensin receptor-neprilysin inhibitors first (74%), beta-blockers second (55%), mineralocorticoid receptor antagonists third (52%), and sodium-glucose cotransporter 2 inhibitors (53%) fourth. Eighty-four percent of participants felt that starting all four classes was feasible within the initial hospitalization, and 58% felt that titration is less important than introducing a new class. Age, status in training, and specialization in HF field were the principal characteristics that significantly impacted the answers. Conclusion In a broad international cardiology community, the 'historical approach' to HFrEF therapies remains the preferred sequencing approach. However, accelerated introduction and uptitration are also major treatment goals. Strategy trials in treatment guidance are needed to further change practices. [GRAPHICS] .

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Fauvel, CharlesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonnet, GuillaumeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mullens, WilfriedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giraldo, Clara Ines SaldarriagaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meznar, Anja ZupanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barasa, AndersUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tokmakova, MariyaUNSPECIFIEDorcid.org/0000-0002-8144-6965UNSPECIFIED
Shchendrygina, AnastasiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Costa, Francisco MoscosoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mapelli, MassimoUNSPECIFIEDorcid.org/0000-0001-9985-7407UNSPECIFIED
Zemrak, FilipUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tops, Laurens F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jakus, NinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sultan, ArianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bahouth, FadelUNSPECIFIEDorcid.org/0000-0003-4353-9703UNSPECIFIED
Hadjseyd, Chahr-EddineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Salvat, MurielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anselmino, MatteoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Messroghli, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weberndorfer, VanessaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giverts, IlyaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bochaton, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berthelot, EmmanuelleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Legallois, DamienUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Beauvais, FlorenceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bauer, FabriceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lamblin, NicolasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Damy, ThibaudUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Girerd, NicolasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sebbag, LaurentUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pezel, TheoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cohen-Solal, AlainUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosano, GiuseppeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roubille, FrancoisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mewton, NathanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-698945
DOI: 10.1002/ejhf.2743
Journal or Publication Title: Eur. J. Heart Fail.
Volume: 25
Number: 2
Page Range: S. 213 - 223
Date: 2023
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1879-0844
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69894

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