Bridging the gap in the symptomatic heart failure patient journey: insights from the Italian scenario

ABSTRACT

Background

The prognosis for heart failure (HF) patients remains poor, with a high mortality rate, and a marked reduction in quality of life (QOL) and functional status. This study aims to explore the ongoing needs of HF management and the epidemiology of patients followed by Italian HF clinics, with a specific focus on cardiac contractility modulation (CCM).

Research design and methods

Data from patients admitted to 14 HF outpatients clinics over 4 weeks were collected and compared to the results of a survey open to physicians involved in HF management operating in Italian centers.

Results

One hundred and five physicians took part in the survey. Despite 94% of patients receive a regular follow-up every 3–6 months, available therapies are considered insufficient in 30% of cases. Physicians reported a lack of treatment options for 23% of symptomatic patients with reduced ejection fraction (EF) and for 66% of those without reduced EF. Approximately 3% of HF population (two patients per month per HF clinic) meets the criteria for immediate CCM treatment, which is considered a useful option by 15% of survey respondents.

Conclusions

Despite this relatively small percentage, considering total HF population, CCM could potentially benefit numerous HF patients, particularly the elderly, by reducing hospitalizations, improving functional capacity and QOL.

KEYWORDS:

• Heart failure
• device therapy
• cardiac contractility modulation
• personalized medicine
• quality of life

Declaration of interests

M. Ziacchi received speaker’s fees from Abbott, Biotronik, Boston Scientific. R. Rordorf received modest speaking fees from Abbott and Boston Scientific. C. Tondo serves as a member of the Advisory Board of Medtronic, Boston Scientific. He receives lecture and proctor fees from Boston Scientific, Abbott, Medtronic, and Biosense&Webster. M. Biffi has undertaken educational activity and been on the Speaker’s Bureau for Biotronik, Boston Scientific, Medtronic, and Zoll. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

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

Author contributions

Conceptualization, M. Ziacchi, M. Biffi, and G. Sinagra; methodology, L. Potena, P. Marchese, F. Clemenza, and D. Masarone; software, M. Merlo, C. Ghiglieno, and A. Alonzo; validation, S. Ghio, M. Pellegrino, and C. Inserra; formal analysis, A. Spadotto, R. Rordorf, and M. Senni; investigation, D. Stolfo, G. Patti, A. D’Onofrio, G.B. Forleo, and G. Pacileo; resources, M.M. Caracciolo, D. Pini, F. Ammirati, F. Rametta, and G. Arcidiacono; data curation, F. Adamo, M. Mariani, M. Ruzzolini, M. Ciccarelli, and G.M. De Ferrari; writing – original draft preparation, A. Spadotto, N. Aspromonte, and M. Grimaldi; writing – review and editing, M. Ziacchi and M. Biffi; visualization, F. Colivicchi, G. Firetto, F. Giallauria, and S. Bianchi; supervision, G. Sinagra, M.G. Bongiorni, C. Tondo, and F. Oliva; project administration, M. Cipriani and M. Ziacchi. All authors have read and agreed to the published version of the manuscript.

Data availability statement

Digital database available from the corresponding author, M Ziacchi: [email protected].

Additional information

Funding

This paper was not funded.