Point-of-care heart failure platform: where are we now and where are we going to?

ABSTRACT

Introduction

Heart failure (HF) remains a leading cause of cardiovascular (CV) mortality in patients with CV disease. The point-of-care (POC) HF platform seems to be an ideal noninvasive workflow-adapted system for personally adjusted management of patients with HF.

Areas covered

In the present manuscript, we reviewed the literature covering some relevant studies regarding the role of point-of care heart failure platform in the risk stratification, earlier diagnosis and prognostically beneficial treatment of patients with different phenotypes of HF.

Expert opinion

POC HF platform including personal consultation, optimization of the comorbidity treatment, step-by-step HF diagnostic algorithm, single biomarker measurements, has also partially been provided in the current guidelines. Although there are several obstacles to implement POC in routine practice, such as education level, aging, affordability of health care, even partial implementation of POC can also improve clinical outcomes. POC seems to be an evolving model, more research studies are required to clearly see whether it helps to make better decisions with diagnosis and care of HF, as well helps to achieve better clinical outcomes.

In summary, the POC HF platform is considered to be a more effective tool than conventional algorithm of HF management.

KEYWORDS:

• Heart failure
• point-of-care therapy
• biomarker-guided therapy
• translational therapy
• guideline-directed medical therapy

Abbreviations

ACC	=	American College of Cardiology
AHA	=	American Heart Association
CV	=	cardiovascular
ESC	=	European Society of Cardiology
ELISA	=	Enzyme-Linked Immunosorbent Assay
GDMT	=	guideline-directed medical therapy
HBTR	=	home-based tele-rehabilitation
HF	=	heart failure
HFpEF	=	heart failure with preserved ejection fraction
HFrEF	=	heart failure with reduced ejection fraction
LVEF	=	left ventricular ejection fraction
MRA	=	mineralocorticoid receptor antagonist
NICE	=	the UK National Institute for Health and Care Excellence
POC	=	point-of care
6MWD	=	6-minute walking distance

Article highlights

• Guideline-directed medical therapy of HF seems to show poor adherence of the patients in routine clinical practice.

• The point-of-care HF platform is a potentially effective personal strategy for improved management of patients with HF.

• The point-of-care HF platform configures economically reasonable approaches for screening, diagnosis and therapy.

• Biomarker-guided HF management is a powerful part of the point-of-care platform toward improved prognosis.

Declaration of interest

The authors have no other financial interest or financial conflict with the subject matter or materials that are discussed in the paper.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.