Position Statements for Heart Failure with Preserved Ejection Fraction

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Journal name: The Malaysian Journal of Medical Sciences
Original article title: From Primary to Tertiary Care: Expert Position Statements to Guide Heart Failure with Preserved Ejection Fraction Diagnosis
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Wan Azman Wan Ahmad, Azmee Mohd Ghazi, Abdul Kahar Abdul Ghapar, Tamil Selvan Muthusamy, Houng Bang Liew, Imran Zainal Abidin, Mei Lin Ong, Noel Thomas Ross, Yee Ling Cham, Wing Sze Ho, Mayuresh Fegade, David Soon Ping Chew


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: From Primary to Tertiary Care: Expert Position Statements to Guide Heart Failure with Preserved Ejection Fraction Diagnosis

Year: 2023 | Doi: 10.21315/mjms2023.30.1.5

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized as the predominant form of heart failure in aging populations globally, particularly in low-to-middle income Asian countries. However, significant challenges persist in diagnosing this condition effectively, leading to delays in treatment and management. To address this issue, the Malaysian HFpEF Working Group (MY-HPWG) convened to evaluate the current diagnostic modalities for HFpEF and propose accessible, practical tools suitable for various healthcare settings. Their goal was to enhance early diagnosis in primary and secondary care environments and streamline referrals to specialized care facilities.

The Role of Natriuretic Peptides in Diagnosis

One of the central recommendations from the MY-HPWG focuses on the use of natriuretic peptide (NP) biomarkers, which have proven essential in diagnosing HFpEF. These biomarkers, particularly brain natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP), provide crucial information regarding heart function and aid in distinguishing heart failure from other conditions presenting with similar symptoms. The working group advises that the measurement of NP levels should be a standard part of the diagnostic process for patients suspected of having HF. In situations where echocardiography may not be readily available, NP assays offer a valuable, non-invasive alternative to facilitate timely diagnosis. However, clinicians should be aware of factors like age, obesity, and renal function that can impact NP levels, necessitating cautious interpretation of results.

Conclusion

The MY-HPWG emphasizes that timely and accurate diagnosis of HFpEF is critical, given the complexity and heterogeneous nature of the condition. Utilizing readily accessible and non-invasive tools such as NP biomarkers and basic echocardiography can substantially improve diagnosis rates in primary and secondary healthcare settings. Additionally, patients with unclear diagnoses should be promptly referred to tertiary care for comprehensive assessments. By implementing these recommendations, the working group aims to enhance patient management, reduce healthcare disparities, and ultimately improve outcomes for individuals suffering from HFpEF.

FAQ section (important questions/answers):

What is heart failure with preserved ejection fraction (HFpEF)?

HFpEF is a common form of heart failure primarily affecting older populations. It is characterized by normal ejection fraction but impaired heart function leading to symptoms like breathlessness and fatigue.

What are the challenges in diagnosing HFpEF in Asia?

In many low-to-middle income Asian countries, including Malaysia, there are significant challenges in diagnosing HFpEF. These include limited access to diagnostic tools, underrecognition of symptoms, and reliance on guidelines that may not fit local healthcare contexts.

What diagnostic tools does the MY-HPWG recommend for HFpEF?

The MY-HPWG recommends using accessible and non-invasive tools such as natriuretic peptide biomarkers and basic echocardiograms to facilitate timely diagnosis and effective management of patients suspected of having HFpEF.

Why is early intervention critical for patients with HFpEF?

Early intervention is essential as it can significantly improve patient outcomes. Efficient diagnosis and treatment of HFpEF may help reduce hospitalizations, manage comorbidities, and ultimately lower mortality rates associated with heart failure.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Position Statements for Heart Failure with Preserved Ejection Fraction”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
Table refers to a structured format used to present data systematically, usually in rows and columns. In the context of research and medical articles, tables effectively summarize key information such as study findings, patient demographics, test results, or clinical characteristics, allowing easier comparison and understanding of results for readers.

2) Study (Studying):
A study is a systematic investigation aimed at establishing facts, principles, or generalizations about a specific phenomenon. In medical contexts, studies often evaluate the effects of treatments, identify disease characteristics, or assess the efficacy of diagnostic tools. Results from studies inform clinical practices and guidelines, shaping patient care approaches.

3) Disease:
Disease refers to a pathological condition characterized by identifiable signs and symptoms, which can disrupt normal bodily functions. Understanding diseases, such as heart failure with preserved ejection fraction, is crucial for diagnosing conditions, developing effective treatments, and implementing healthcare strategies to improve patient outcomes and enhance overall public health.

4) Filling (Filled):
Filling, in a cardiovascular context, often refers to the dynamics of blood entering the heart chambers. Proper filling is essential for maintaining adequate circulation and ensuring that the heart can pump blood efficiently. Dysfunction during filling phases can lead to heart failure symptoms, necessitating accurate diagnosis and management strategies.

5) Sign:
A sign is an objective indication of a medical condition that can be observed, measured, or detected during a clinical examination. Signs of heart failure may include jugular venous distension or abnormal heart sounds. Identifying signs is crucial for healthcare providers to establish diagnoses and guide treatments in patient care.

6) Performance:
Performance relates to the effectiveness and efficiency with which a medical procedure or diagnostic test operates. In evaluating tests for heart failure, performance metrics such as sensitivity and specificity determine how accurately they identify patients. High-performance tests enhance diagnosis and treatment strategies, ultimately improving patient outcomes in clinical practice.

7) Measurement:
Measurement refers to the process of quantitatively assessing a specific variable or parameter. In medicine, accurate measurement of biomarkers, blood pressure, or echocardiographic findings is vital for diagnosing conditions like heart failure. Reliable measurements guide clinical decisions, treatment plans, and monitoring of disease progression in patients.

8) Death:
Death signifies the cessation of all biological functions that sustain life. In medical research, understanding mortality rates associated with diseases, like heart failure, is crucial for developing preventative strategies. Epidemiological studies help identify risk factors, contributing to effective interventions aimed at reducing patient mortality and improving overall public health.

9) Epidemic:
An epidemic is a widespread occurrence of an infectious disease or a health-related issue within a community or region over a specific period. Regarding heart failure, increasing prevalence, particularly in aging populations, requires focused healthcare strategies to address rising healthcare burdens, resource allocation, and public health responses to manage the condition.

10) Wall:
Wall refers to the structural elements within the body, such as the heart wall or blood vessel wall. Changes in the heart wall, such as hypertrophy, can indicate underlying conditions like heart failure. Understanding these structural variations is critical for diagnosing diseases and tailoring appropriate treatment plans for patients.

11) Rules:
Rules are established guidelines or principles that govern conduct or standard procedures in specific contexts, including medical practice. Clinical practice guidelines often provide rules for diagnosing and managing diseases like heart failure with preserved ejection fraction. Adherence to these rules promotes consistent, evidence-based care among healthcare providers.

12) Relative:
Relative generally describes a comparison between two or more entities. In medical contexts, it can refer to relative risk, which compares the probability of an event (like disease development) occurring in different populations. By assessing relative differences, researchers can identify risk factors and guide treatment decisions effectively.

13) Writing:
Writing is the act of composing text, particularly in academic or clinical contexts. In medical publications, clear writing is crucial to convey research findings, clinical guidelines, or treatment recommendations effectively. Well-structured writing enhances understanding, facilitates knowledge transfer among healthcare professionals, and improves patient education regarding medical conditions.

14) Meeting:
Meeting refers to a gathering of individuals for discussion, decision-making, or knowledge sharing. In the medical field, expert meetings often discuss clinical guidelines and recommendations based on recent findings. Such collaborative discussions improve diagnostic and treatment strategies, benefiting overall patient care and promoting effective healthcare practices.

15) Medicine:
Medicine is the science and practice of diagnosing, treating, and preventing diseases. It encompasses various disciplines, including pharmacology, surgery, and primary care. Advances in medicine, guided by research and clinical evidence, contribute significantly to improving patient outcomes by developing new therapies, diagnostic tools, and management strategies for health conditions.

16) Quality:
Quality in healthcare refers to the standard of care provided, encompassing aspects such as efficacy, safety, and patient-centeredness. High-quality care ensures that patients receive appropriate diagnoses, treatments, and follow-up, leading to improved health outcomes. Continuous quality improvement initiatives aim to enhance healthcare systems and deliver better services to patients.

17) Surrounding:
Surrounding refers to the environment or context within which health issues occur. Factors surrounding a patient's health, including socio-economic conditions, access to healthcare, and community resources, significantly influence health outcomes. Understanding these contextual factors is essential for creating effective interventions and targeted healthcare strategies for diverse populations.

18) Knowledge:
Knowledge encompasses the information, understanding, and skills acquired through experience or education. In healthcare, developing knowledge is vital for healthcare professionals to provide accurate diagnoses, offer effective treatments, and educate patients. Continuing education and research contribute to expanding medical knowledge, enhancing clinical practice, and improving patient care.

19) Goldsmith:
Goldsmith can refer to individuals who might have contributed to research or concepts discussed in clinical settings. In medical literature, authors' names such as 'Goldsmith' are often cited in studies related to specific diseases, treatments, or medical theories, indicating their influence and contributions to the field of medicine.

20) Bunting:
Bunting may refer to contributors to specific research or discussions in clinical contexts, pertaining to their expertise in heart failure management or related health issues. Authors like Bunting provide valuable insights into disease characteristics, treatment modalities, and clinical outcomes, thus shaping the understanding of heart failure in current literature.

21) Peacock:
Peacock typically refers to a contributor to medical or research literature. Their work may involve studies on diseases such as heart failure while providing significant insights into diagnosis, treatment, or management strategies. Recognizing authors in clinical research reinforces collaborative efforts geared towards advancing patient care and understanding medical conditions.

22) Vaidya:
Vaidya denotes a contributor to clinical literature, often reflecting their expertise and research in the field. Authors contributing work related to heart failure may provide critical analysis and findings that influence treatment approaches, clinical guidelines, and patient management, thereby enhancing healthcare delivery and patient outcomes.

23) Bhalla:
Bhalla may refer to a researcher or clinician who influences heart failure studies or healthcare practices. Recognizing such contributors emphasizes the collaborative nature of medical research. Their findings and perspectives can enrich understanding of disease mechanisms, clinical presentations, and interventions, ultimately aiding in achieving better patient care.

24) Edema (Oedema):
Oedema refers to excess fluid accumulation in tissues, often a symptom associated with heart failure. In heart failure with preserved ejection fraction (HFpEF), patients commonly experience peripheral oedema and pulmonary congestion, leading to impaired quality of life. Understanding oedema's role helps healthcare providers manage symptoms and tailor treatment effectively.

25) Gupta:
Gupta typically refers to an author or contributor in the context of healthcare literature. In studies addressing health issues, such as heart failure, Gupta may provide insights or findings that enhance clinical practices, suggesting evidence-based recommendations for diagnosis, management, or understanding pathophysiology, ultimately serving patient care needs.

26) Nanda (Namda):
Nanda is a name commonly found among contributors to healthcare research or literature. The works of authors named Nanda may focus on critical health issues, providing insights into effective practices, diagnostic methodologies, or treatment approaches, thereby enriching the understanding of diseases faced by patients and enhancing overall care delivery.

27) Khera:
Khera likely refers to an individual who has contributed to medical research or literature. Their studies may focus on key health issues, including heart failure. Acknowledging Khera's work emphasizes the collaborative nature of research, contributing to advancements in medical knowledge and promoting better healthcare practices for affected populations.

28) Blood:
Blood is a vital fluid that circulates in the body, transporting oxygen, nutrients, and waste products. In the context of heart failure, various blood tests can assess biomarkers like natriuretic peptides, which help diagnose and manage heart conditions. Understanding blood dynamics is critical for optimal patient care and treatment strategies.

29) Cenni:
Senni is generally a name associated with someone who contributes to medical research or literature. Researcher contributions, like those of Senni, can provide invaluable insights into diseases such as heart failure, helping to advance knowledge related to treatment, patient outcomes, and the efficacy of various medical interventions.

30) Raja:
Raja signifies an author or contributor in medical literature. Contributions may involve studying diseases, such as heart failure, to understand epidemiology, treatment strategies, and patient management techniques. Recognizing authors' works, like that of Raja, is important for acknowledging their role in advancing medical research and improving community health.

31) Shala (Sala):
Sala typically refers to a contributor in the medical field, particularly concerning research addressing heart failure and its management. Their work often adds to the broader understanding of disease mechanisms, treatments, and patient care strategies, ultimately benefiting clinical guidelines and enhancing patient outcomes in healthcare settings.

32) Beta:
Beta often refers to beta-blockers, a class of medications widely used in managing heart failure. Understanding the pharmacological effects of beta-blockers, their mechanisms, and clinical applications is crucial for healthcare providers to determine appropriate treatments—especially as they improve cardiac function and reduce mortality in heart failure patients.

33) Sah:
Shah indicates an individual contributing to medical literature, particularly related to heart failure. Their findings can help elucidate conditions like heart failure with preserved ejection fraction, enhancing diagnostic accuracy and informing treatment strategies. Recognizing such contributors underscores the collaborative effort necessary to advance medical knowledge and improve healthcare outcomes.

34) Mota:
Mota might refer to an author or researcher influential in the field of cardiac health or heart failure. Research contributions from individuals like Mota can focus on advancing the understanding of heart failure mechanisms, diagnostic methods, and effective interventions, supporting clinical practices that promote better patient care.

35) Ayasa (Ayasha):
Ayas generally points to a contributor to medical literature. Such authors may engage in research on heart conditions, elucidating clinical aspects that significantly impact diagnosis and treatment approaches. Their role is essential for the health community, linking research findings to practical applications that enhance patient care and management.

36) Bell:
Bell refers to an individual typically engaged in publishing medical research or literature. Contributions may cover critical areas in heart failure management, shedding light on clinical care strategies and promoting evidence-based practices. Recognizing authors like Bell enhances collaboration in healthcare, focusing on tailored interventions for improved patient outcomes.

37) Calculation:
Calculation is the process of quantifying or determining numerical values. In medical contexts, calculations are often used to evaluate test results, medication dosages, or risk scores in patient assessments. Accurate calculations are crucial for effective treatment planning and monitoring of conditions like heart failure, significantly impacting management strategies.

38) Observation:
Observation refers to the systematic act of monitoring patients to assess signs, symptoms, and responses to treatments. Observational studies contribute to understanding disease management, helping to identify patterns, uncover associations, and guide clinical decision-making. Effective observation is foundational for quality patient assessment in healthcare settings.

39) Attending:
Attending refers to the act of being present, particularly in a medical context as it pertains to healthcare professionals stepping into clinical roles to oversee patient care. Attending physicians are critical in providing direct patient management, supervising residents, and ensuring that treatment adheres to current guidelines for optimal outcomes.

40) Swelling:
Swelling refers to the abnormal enlargement of body tissues due to fluid accumulation. In heart failure patients, swelling often indicates fluid retention and is a key symptom to monitor. Recognizing the severity and pattern of swelling can guide treatment, ensuring timely interventions to alleviate symptoms and enhance quality of life.

41) Learning:
Learning involves acquiring knowledge, skills, and understanding through experience or education. In healthcare, continuous learning is vital for professionals to keep up with advancements in medical science, diagnostic techniques, and treatment modalities. Promoting a culture of learning ensures that patient care remains effective, evidence-based, and responsive to new findings.

42) Raising:
Raising typically refers to the act of promoting awareness, knowledge, or funding towards a specific issue or cause. In healthcare, raising awareness about diseases, treatment options, and public health initiatives is crucial for advocating holistic approaches to patient care and improving health outcomes within communities.

43) Surface:
Surface relates to the outermost layer of structures, which can encompass various physiological aspects. In cardiovascular medicine, the concept of surface may refer to the cardiac and vascular surfaces that interact with blood flow. Understanding these surface interactions is crucial for diagnostics, treatments, and interventions in managing heart conditions.

44) Reason:
Reason signifies the underlying justification or basis for a particular decision or action. In medical contexts, clinicians must provide rational explanations for diagnostic choices, treatment plans, and healthcare strategies. Adequately articulating reasons fosters patient understanding, compliance, and trust in healthcare interactions, ultimately enhancing patient care and outcomes.

45) Hand:
Hand alludes to the disciplined techniques and practices utilized by healthcare professionals to provide care. In a medical setting, hands-on examinations and interventions are critical for diagnosis and treatment. The dexterous use of hands reflects the blend of technical skill and compassionate care central to effective healthcare delivery.

46) Gold (Golden):
Gold often symbolizes high standards or quality, particularly in medical accreditation and performance benchmarking. In healthcare settings, identifying best practices and striving for 'gold standard' treatment protocols is essential for ensuring optimal patient outcomes. Promoting excellence in healthcare practices aligns with continuous improvement and patient-centered care philosophies.

47) Burning (Burn, Burned, Burnt):
Burn refers to damage caused by heat or chemicals to the skin or tissues. In medical contexts, managing burn injuries involves assessing severity and coordinating treatments to promote healing. Understanding the implications of burn injuries is crucial for developing effective interventions and providing comprehensive care to affected patients.

48) Post:
Post can refer to various meanings, including a 'post' appointment in healthcare contexts, where professionals review cases and treatment plans after initial consultations. Posting updates or findings enhances ongoing communication within healthcare teams, facilitating improved patient management and ensuring that care decisions evolve based on fresh insights and data.

49) Life:
Life refers to the condition of living organisms, characterized by biological processes and experiences. In healthcare, the focus on enhancing quality of life drives many treatment strategies and interventions aimed at improving the well-being of patients suffering from chronic diseases like heart failure. Effective care ensures that patients lead fulfilling lives despite their conditions.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Position Statements for Heart Failure with Preserved Ejection Fraction’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

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