Tag Archives: British Society for Heart Failure

Prevalence Among patients with a diagnosis of heart failure (HF), it is reported that up to 40-50% may have HFpEF.1 HFpEF also accounts for an increasing proportion of HF-related hospitalisations.2 There is a strong association between HFpEF, older age, and cardiovascular and non-cardiovascular comorbidities. As life expectancy and comorbidity rates rise, the proportion of HF patients with HFpEF and resulting impact of HFpEF on healthcare services is projected to increase. Clinical presentation Patients with HFpEF experience similar symptoms and signs to patients with HF with reduced ejection fraction (HFrEF), including breathlessness, fatig

Heart failure as a neurohormonal disorder Professor Milton Packer (Baylor University Medical Center, Dallas, Texas, USA) highlighted in the Philip Poole Wilson Memorial lecture the journey through heart failure (HF) research and how common, important and serious it is with more deaths from HF than all cancers combined. The foundation of HF research is based on the view that it is a haemodynamic disease and, until 1970, diuretics were the prime focus of drug development. In the 1970s, vasodilator and inotropic drugs were developed to keep haemodynamic variables in the normal range and to stimulate cardiac contractility, which markedly improve

Drug therapy From treating dropsy… Treating congestion is an essential role of the heart failure specialist with diuretic therapy being the cornerstone of treatment. There is an evidence vacuum, however, in how best to relieve congestion. For example, which agents to use, at what doses and with what escalation strategy? Dr Peter Cowburn (Southampton General Hospital) delivered an exemplary lecture highlighting the importance of relieving congestion, the current evidence base and practical advice from his personal experience on how best to achieve the goal of euvolaemia. Relieving congestion matters and, when achieved, is associated with lo

Cardio-oncology and obstetrics Many cancer therapies are cardiotoxic, and as cancer survival has improved over recent decades so the number of patients living to develop cardiovascular complications of these therapies has risen. A recent position statement by the European Society of Cardiology stresses that “the cured cancer patient of today…[is at risk of becoming]…the heart failure patient of tomorrow”1 and management of these patients increasingly involves a cardiologist. In a highly educational presentation, Dr Zaheer Yousef (University Hospital of Wales, Cardiff) addressed the management of left ventricular systolic dysfunction (

CPET: an overview of “the cardiac cycle” The breathless patient with heart failure and comorbidity can pose a diagnostic conundrum: is the dyspnoea cardiac or respiratory (or something else entirely)? Dr Christopher Boos (Poole Hospital NHS Foundation Trust) outlined the role of cardiopulmonary exercise testing (CPET) in such situations. CPET integrates a broad range of variables related to cardiorespiratory function, including oxygen uptake and expiratory ventilation, along with blood pressure and electrocardiogram (ECG) tracing. It provides objective information on physiological performance under stress: key output data include peak VO2

Bridging the gap: from trials to inner cities Within the field of heart failure, there is a breadth of prognostic therapies derived from large, randomised controlled trials. Professor Iain Squire (Glenfield Hospital, Leicester) described how new treatments require approval in the European Union before they can be implemented into clinical practice within the member states. The European Medicines Agency (EMA) ensures the best use of scientific resources across Europe. While certain classes of technologies must undergo licencing via a centralised procedure, most therapies will be eligible for licensing by one member state on behalf of other na

BSH Parliament day Professor Andrew Clark (President of the British Society for Heart Failure) is pictured here (centre) carrying out an echocardiogram in the House of Commons. He was at a BSH event to help raise awareness that a person diagnosed with heart failure is likely to have a worse prognosis than if they were diagnosed with most cancers. This is despite the availability of specialist heart failure services that can have a remarkable impact on a patient’s chance of survival, but for which there is inconsistent access over the UK leading to wide variations in care and outcomes. Over 60 MPs, Peers, and professional and patient groups

Counting the cost of acute heart failure In the first keynote lecture, Professor John McMurray (BHF Cardiovascular Research Centre, Glasgow) began by addressing the definition of acute heart failure (HF). He felt the term ‘acute’ was unhelpful, as it can be applied to a broad spectrum of clinical presentation, from the rapid onset of acute pulmonary oedema, to the subacute deterioration in chronic HF symptoms (predominantly peripheral oedema) that culminates in hospitalisation. Accordingly, the new 2013 American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) HF guidelines refer to ‘the hospitalised patient’,

A new treatment for acute heart failure? The recently published RELAX-AHF (Efficacy and Safety of Relaxin for the Treatment of Acute Heart Failure) study was a prospective, randomised, double-blind, placebo-controlled trial carried out in a targeted population of patients with acute HF.1 Relaxin is a physiological hormone that regulates maternal adaptations to pregnancy, increasing cardiac output, renal blood flow, and arterial compliance, alongside decreased peripheral vascular resistance.2,3 Serelaxin is a recombinant human relaxin-2 shown to have beneficial effects on symptoms and outcomes in early studies.4 The primary end points in thi

There is incontrovertible, large-scale, randomised-controlled evidence for morbidity and mortality benefit of beta-blockers in heart failure (trials include MERIT-HF, COPERNICUS, CIBIS II),1-3 she said, but the evidence for adverse effects in lung disease is based on animal studies, case reports and small scale human studies.4 Beta blockade in COPD, however, is fully endorsed by The European Society of Cardiology (ESC), National Institute for Clinical Excellence (NICE) and Cochrane reviews.5-7 Dr Hardman’s presentation highlighted for trainees an important area where significant improvements can be achieved. Cardiac and respiratory func