Tag Archives: BSH

25in25 The meeting began with an update on the 25in25 initiative from BSH Chair-Elect Dr Lisa Anderson (St George’s University Hospital, London). This national quality improvement initiative, led by the BSH in collaboration with over 54 national and international healthcare organisations, has the goal of reducing heart failure deaths by 25% over the next 25 years. With already over one million people in the UK living with heart failure, a number which is expected to double by 2040, the ambitious initiative is eagerly awaited. In the UK alone this could translate to over 10,000 lives saved per year. A population health approach underpins th

Preparing for the next 25 years Opening the meeting, BSH Chair Professor Roy Gardner (University of Glasgow) spoke about the BSH‘s aim to reduce HF mortality by 25% in 25 years, which would need the bringing together of all stakeholders to improve: Prevention strategies Identifying those at risk Early accurate diagnosis Appropriate treatment In his speech, he encouraged us to be more ambitious for further progress, to raise awareness of HF, and to educate more widely to achieve further progress and benefit more patients. 25 Fellows for 25 years Table 1. The new British Society for Heart Failure Fellows John Baxter, Sunderland Lynd

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

The campaign wants healthcare professionals to help increase public awareness of the most common heart failure symptoms – failure to breathe, fatigue, fluid build up – so medical advice is sought early to improve outcomes from the disease. A recent NICE Impact report1 showed 80% of heart failure is diagnosed in hospital but 40% of people had symptoms that should have triggered an earlier assessment in primary care. This suggests that many people who are living with undiagnosed heart failure are only seeking medical help as an emergency admission into hospital. Materials to educate the public about self-recognition of symptoms and

The partnership acknowledges the challenge posed by heart failure as the end point for most cardiovascular disease and reflects the increasing burden it places directly and indirectly on our health systems and community. There are currently nearly one million people living with heart failure in the UK. Many more may be undiagnosed. Together the BJC and BSH will raise further awareness and provide a platform for doctors, nurses and other healthcare professionals to engage with the public health challenges of diagnosing and treating those with heart failure optimally. BSH Chair, Dr Simon Williams, Consultant Cardiologist (Wythenshawe Hospital,

Advanced heart failure From a trainee’s perspective, recognising when a heart failure (HF) patient is entering into the advanced stages is critical and sets off “transplant alarm bells”. Dr Sai Bhagra (Royal Papworth Hospital, Cambridge) delivered a great talk on this spectrum of the disease, essentially defining this as a failure of optimal therapy, requiring escalating diuretics with the development of end-organ dysfunction. The 2018 European Society of Cardiology definition of advanced HF encompasses: severe symptom limitation severe cardiac impairment pulmonary/systemic congestion requiring intravenous diuretics or malignant arrhy

NICE heart failure guidelines The latest National Institute for Health and Care Excellence (NICE) guidelines for management of chronic heart failure (NG 106)1 were presented by Dr Abdallah Al-Mohammed (Sheffield Teaching Hospitals). It was fascinating to hear Dr Al-Mohammed describe his work on producing the guidelines with respect to what recommendations the authors are permitted to include and how recommendations may be presented. Key changes include the removal of a history of a previous myocardial infarction from the initial assessment of a patient with suspected chronic heart failure. Other changes include the guidelines now using the te

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