100 results on '"Piepoli, Massimo F."'
Search Results
2. Comprehensive characterization of non-cardiac comorbidities in acute heart failure: an analysis of ESC-HFA EURObservational Research Programme Heart Failure Long-Term Registry.
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Chioncel O, Benson L, Crespo-Leiro MG, Anker SD, Coats AJS, Filippatos G, McDonagh T, Margineanu C, Mebazaa A, Metra M, Piepoli MF, Adamo M, Rosano GMC, Ruschitzka F, Savarese G, Seferovic P, Volterrani M, Ferrari R, Maggioni AP, and Lund LH
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- Humans, Stroke Volume, Aftercare, Prognosis, Patient Discharge, Registries, Heart Failure diagnosis, Heart Failure epidemiology, Heart Failure complications, Ischemic Attack, Transient, Parkinson Disease complications, Anemia diagnosis, Anemia epidemiology, Anemia complications, Cardiology, Arthritis, Rheumatoid complications, Sleep Apnea Syndromes complications, Stroke, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Disease, Chronic Obstructive complications
- Abstract
Aims: To evaluate the prevalence and associations of non-cardiac comorbidities (NCCs) with in-hospital and post-discharge outcomes in acute heart failure (AHF) across the ejection fraction (EF) spectrum., Methods and Results: The 9326 AHF patients from European Society of Cardiology (ESC)-Heart Failure Association (HFA)-EURObservational Research Programme Heart Failure Long-Term Registry had complete information for the following 12 NCCs: anaemia, chronic obstructive pulmonary disease (COPD), diabetes, depression, hepatic dysfunction, renal dysfunction, malignancy, Parkinson's disease, peripheral vascular disease (PVD), rheumatoid arthritis, sleep apnoea, and stroke/transient ischaemic attack (TIA). Patients were classified by number of NCCs (0, 1, 2, 3, and ≥4). Of the AHF patients, 20.5% had no NCC, 28.5% had 1 NCC, 23.1% had 2 NCC, 15.4% had 3 NCC, and 12.5% had ≥4 NCC. In-hospital and post-discharge mortality increased with number of NCCs from 3.0% and 18.5% for 1 NCC to 12.5% and 36% for ≥4 NCCs.Anaemia, COPD, PVD, sleep apnoea, rheumatoid arthritis, stroke/TIA, Parkinson, and depression were more prevalent in HF with preserved EF (HFpEF). The hazard ratio (95% confidence interval) for post-discharge death for each NCC was for anaemia 1.6 (1.4-1.8), diabetes 1.2 (1.1-1.4), kidney dysfunction 1.7 (1.5-1.9), COPD 1.4 (1.2-1.5), PVD 1.2 (1.1-1.4), stroke/TIA 1.3 (1.1-1.5), depression 1.2 (1.0-1.5), hepatic dysfunction 2.1 (1.8-2.5), malignancy 1.5 (1.2-1.8), sleep apnoea 1.2 (0.9-1.7), rheumatoid arthritis 1.5 (1.1-2.1), and Parkinson 1.4 (0.9-2.1). Anaemia, kidney dysfunction, COPD, and diabetes were associated with post-discharge mortality in all EF categories, PVD, stroke/TIA, and depression only in HF with reduced EF, and sleep apnoea and malignancy only in HFpEF., Conclusion: Multiple NCCs conferred poor in-hospital and post-discharge outcomes. Ejection fraction categories had different prevalence and risk profile associated with individual NCCs., Competing Interests: Conflict of interest: O. Chioncel declare no conflict of interest related to present work; ESC meeting support from Servier. L. Benson declare no conflict of interest. M. Crespo-Leiro reports unrelated to the present work: consultancy or speaker's honoraria from Novartis, AstraZeneca, Boehringer Ingelheim, Abbott, Medtronic, CareDx, Astellas and Vifor Pharma. S.D. Anker reports unrelated to the present work: Grants or contracts: Vifor Int, Abbott Vascular; Consulting fees: CVRx, Amgen, Respicardia, Novo Nordisk, Brahms, Novartis, Sanofi, Cordio; Leadership or fiduciary role in other board: Abbott Vascular, Astra Zeneca, Bayer AG, Bioventrix, Boehringer Ingelheim, Cardiac Dimension, Cardior, Impulse Dynamics, Janssen, Occlutech, Servier, Vifor Int, and V-Wave. A.J.S. Coats reports unrelated to the present work: speaker's honoraria from: Astra Zeneca, Bayer, Boehringer Ingelheim, Edwards, Menarini, Novartis, Servier, Vifor, Abbott, Actimed, Arena, Cardiac Dimensions, Corvia, CVRx, Enopace, ESN Cleer, Faraday, Impulse Dynamics, Respicardia, and Viatris. G. Filippatos reports lecture fees and/or committee membership in trials sponsored by Bayer, Vifor, Medtronic, Novartis, Servier, Boehringer Ingelheim, and research support from the European Union. T. McDonagh reports unrelated to the present work: speaker's honoraria from Abbot, Astra Zeneca, Boeringher Ingelheim and Edwards. C. Margineanu none related to the present work. A. Mebazaa reports unrelated to the present work: Grants or contracts from and consulting fees from Roche, 4TEEN4, Corteria; speaker's honoraria from MSD; Patents: S-Form Pharma. M. Metra reports personal fees from Amgen, AstraZeneca, Abbott Vascular, Bayer, Edwards Therapeutics, Livanova, Vifor Pharma, as member of Trials' Committees or advisory boards or for speeches at sponsored meetings in the last 3 years. M. Piepoli reports unrelated to the present work: consultancy, speaker's, institutional fees from Astra-Zeneca, Boehringer- Ingelheim, CHF solution, Menarini, Novartis, Servier M. Adammo reports speaker fees from Abbott Vascular and Medtronic. G.M.C. Rosano declare no conflict of interest. F. Ruschitzka has not received personal payments by pharmaceutical companies or device manufacturers in the last 3 years (remuneration for the time spent in activities, such as participation as steering committee member of clinical trials and member of the Pfizer Research Award selection committee in Switzerland, were made directly to the University of Zurich). The Department of Cardiology (University Hospital of Zurich/University of Zurich) reports research-, educational- and/or travel grants from Abbott, Amgen, Astra Zeneca, Bayer, Berlin Heart, B. Braun, Biosense Webster, Biosensors Europe AG, Biotronik, BMS, Boehringer Ingelheim, Boston Scientific, Bracco, Cardinal Health Switzerland, Corteria, Daiichi, Diatools AG, Edwards Lifesciences, Guidant Europe NV (BS), Hamilton Health Sciences, Kaneka Corporation, Kantar, Labormedizinisches Zentrum, Medtronic, MSD, Mundipharma Medical Company, Novartis, Novo Nordisk, Orion, Pfizer, Quintiles Switzerland Sarl, Roche Diagnostics, Sahajanand IN, Sanofi, Sarstedt AG, Servier, SIS Medical, SSS International Clinical Research, Terumo Deutschland, Trama Solutions, V- Wave, Vascular Medical, Vifor, Wissens Plus, ZOLL. The research and educational grants do not impact on Prof. Ruschitzka`s personal remuneration. G. Savarese reports unrelated to the present work: Grants or contracts: Vifor Pharma, Boehringer Ingelheim, Astra Zeneca, Merck, Cytokinetics; Consulting fees: Societa' Prodotti Antibiotici, Medical Education Global Solutions, Genesis, Agence Recherche (ANR); speaker's honoraria: Servier, Cytokinetics, Medtronic, Dynamicom Education, Vifor Pharma; Support for attending meetings: Boehringer Ingelheim; Data Safety Monitoring Bord or Advisory Board: Astra Zeneca, Uppsala Clinical Research Center, Servier. P. Seferovic reports unrelated to the present work: speaker's honoraria from Servier, Astra Zeneca, Menarini, Boehringer Ingelheim, Novartis and Roche diagnostic. M. Volterrani: none related to the present work. R. Ferrari reports unrelated to the present work: speaker's honoraria and support for attending meetings: Servier International, Merck Serono, Lupin, Sunpharma, Reddys Ltd; leadership or fiduciary role in other board: Scientific Director of Medical Trial Analysis. A. Maggioni: personal fees from AstraZeneca, Bayer, Fresenius, Novartis, outside the submitted work. L.H. Lund is supported by Supported by Karolinska Institutet, the Swedish Research Council [grant 523-2014-2336], the Swedish Heart Lung Foundation [grants 20150557, 20190310], and the Stockholm County Council [grants 20170112, 20190525] and reports unrelated to the present work: Grants: AstraZeneca, Vifor, Boston Scientific, Boehringer Ingelheim, Novartis, MSD; Consulting: Vifor, AstraZeneca, Bayer, Pharmacosmos, MSD, MedScape, Sanofi, Lexicon, Myokardia, Boehringer Ingelheim, Servier, Edwards Life Sciences, Alleviant; Speaker's honoraria: Abbott, OrionPharma, MedScape, Radcliffe, AstraZeneca, Novartis, Boehringer Ingelheim, Bayer; Patent: AnaCardio; Stock ownership: AnaCardio., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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3. A year in heart failure: updates of clinical and preclinical findings.
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Bäck M, von Haehling S, Papp Z, and Piepoli MF
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- Humans, Stroke Volume physiology, Risk Factors, COVID-19 epidemiology, Heart Failure epidemiology, Heart Failure therapy, Heart Failure diagnosis, Cardiology
- Abstract
We witnessed major advances in the management of heart failure (HF) in 2022. Results of recent clinical and preclinical investigations aid preventive strategies, diagnostic efforts, and therapeutic interventions, and collectively, they hold promises for a more effective HF care for the near future. Accordingly, currently available information extends the 2021 European Society of Cardiology guidelines and provides a solid background for the introduction of improved clinical approaches in the number of HF-related cases. Elaboration on the relationships between epidemiological data and risk factors lead to better understanding of the pathophysiology of HF with reduced ejection fraction and HF with preserved ejection fraction. The clinical consequences of valvular dysfunctions are increasingly interpreted not only in their haemodynamic consequences but also in association with their pathogenetic factors and modern corrective treatment possibilities. The influence of coronavirus disease 2019 pandemic on the clinical care of HF appeared to be less intense in 2022 than before; hence, this period allowed to refine coronavirus disease 2019 management options for HF patients. Moreover, cardio-oncology emerges as a new subdiscipline providing significant improvements in clinical outcomes for oncology patients. Furthermore, the introduction of state-of-the-art molecular biologic methods, multi-omic approaches forecast improved phenotyping and precision medicine for HF. All above aspects are addressed in this article that highlights a selection of papers published in ESC Heart Failure in 2022., (© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
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- 2023
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4. Editorial comment: Focus on clinical cardiology.
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Halasz G and Piepoli MF
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- Humans, Cardiovascular System, Cardiology
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- 2022
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5. Editorial comments: Focus on clinical cardiology and risk factors.
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Parati G, Halasz G, and Piepoli MF
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- Humans, Editorial Policies, Risk Factors, Cardiology, Cardiovascular System
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- 2022
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6. Congestion in heart failure: a circulating biomarker-based perspective. A review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology.
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Núñez J, de la Espriella R, Rossignol P, Voors AA, Mullens W, Metra M, Chioncel O, Januzzi JL, Mueller C, Richards AM, de Boer RA, Thum T, Arfsten H, González A, Abdelhamid M, Adamopoulos S, Anker SD, Gal TB, Biegus J, Cohen-Solal A, Böhm M, Emdin M, Jankowska EA, Gustafsson F, Hill L, Jaarsma T, Jhund PS, Lopatin Y, Lund LH, Milicic D, Moura B, Piepoli MF, Ponikowski P, Rakisheva A, Ristic A, Savarese G, Tocchetti CG, Van Linthout S, Volterrani M, Seferovic P, Rosano G, Coats AJS, and Bayes-Genis A
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- Humans, Adrenomedullin, Prognosis, Biomarkers, Heart Failure diagnosis, Cardiology
- Abstract
Congestion is a cardinal sign of heart failure (HF). In the past, it was seen as a homogeneous epiphenomenon that identified patients with advanced HF. However, current evidence shows that congestion in HF varies in quantity and distribution. This updated view advocates for a congestive-driven classification of HF according to onset (acute vs. chronic), regional distribution (systemic vs. pulmonary), compartment of distribution (intravascular vs. extravascular), and clinical vs. subclinical. Thus, this review will focus on the utility of circulating biomarkers for assessing and managing the different fluid overload phenotypes. This discussion focused on the clinical utility of the natriuretic peptides, carbohydrate antigen 125 (also called mucin 16), bio-adrenomedullin and mid-regional pro-adrenomedullin, ST2 (also known as interleukin-1 receptor-like 1), cluster of differentiation 146, troponin, C-terminal pro-endothelin-1, and parameters of haemoconcentration. The utility of circulation biomarkers on top of clinical evaluation, haemodynamics, and imaging needs to be better determined by dedicated studies. Some multiparametric frameworks in which these tools contribute to management are proposed., (© 2022 European Society of Cardiology.)
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- 2022
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7. Focus on sport cardiology and exercise.
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Halasz G and Piepoli MF
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- Exercise, Humans, Cardiology, Cardiovascular System, Sports
- Abstract
Competing Interests: Conflict of interest: None declared.
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- 2022
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8. Cardiac remodelling - Part 1: From cells and tissues to circulating biomarkers. A review from the Study Group on Biomarkers of the Heart Failure Association of the European Society of Cardiology.
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González A, Richards AM, de Boer RA, Thum T, Arfsten H, Hülsmann M, Falcao-Pires I, Díez J, Foo RSY, Chan MY, Aimo A, Anene-Nzelu CG, Abdelhamid M, Adamopoulos S, Anker SD, Belenkov Y, Ben Gal T, Cohen-Solal A, Böhm M, Chioncel O, Delgado V, Emdin M, Jankowska EA, Gustafsson F, Hill L, Jaarsma T, Januzzi JL, Jhund PS, Lopatin Y, Lund LH, Metra M, Milicic D, Moura B, Mueller C, Mullens W, Núñez J, Piepoli MF, Rakisheva A, Ristić AD, Rossignol P, Savarese G, Tocchetti CG, Van Linthout S, Volterrani M, Seferovic P, Rosano G, Coats AJS, and Bayés-Genís A
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- Biomarkers, Endothelial Cells pathology, Humans, Ventricular Remodeling physiology, Cardiology, Heart Failure
- Abstract
Cardiac remodelling refers to changes in left ventricular structure and function over time, with a progressive deterioration that may lead to heart failure (HF) development (adverse remodelling) or vice versa a recovery (reverse remodelling) in response to HF treatment. Adverse remodelling predicts a worse outcome, whilst reverse remodelling predicts a better prognosis. The geometry, systolic and diastolic function and electric activity of the left ventricle are affected, as well as the left atrium and on the long term even right heart chambers. At a cellular and molecular level, remodelling involves all components of cardiac tissue: cardiomyocytes, fibroblasts, endothelial cells and leucocytes. The molecular, cellular and histological signatures of remodelling may differ according to the cause and severity of cardiac damage, and clearly to the global trend toward worsening or recovery. These processes cannot be routinely evaluated through endomyocardial biopsies, but may be reflected by circulating levels of several biomarkers. Different classes of biomarkers (e.g. proteins, non-coding RNAs, metabolites and/or epigenetic modifications) and several biomarkers of each class might inform on some aspects on HF development, progression and long-term outcomes, but most have failed to enter clinical practice. This may be due to the biological complexity of remodelling, so that no single biomarker could provide great insight on remodelling when assessed alone. Another possible reason is a still incomplete understanding of the role of biomarkers in the pathophysiology of cardiac remodelling. Such role will be investigated in the first part of this review paper on biomarkers of cardiac remodelling., (© 2022 European Society of Cardiology.)
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- 2022
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9. Cardiac remodelling - Part 2: Clinical, imaging and laboratory findings. A review from the Study Group on Biomarkers of the Heart Failure Association of the European Society of Cardiology.
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Aimo A, Vergaro G, González A, Barison A, Lupón J, Delgado V, Richards AM, de Boer RA, Thum T, Arfsten H, Hülsmann M, Falcao-Pires I, Díez J, Foo RSY, Chan MYY, Anene-Nzelu CG, Abdelhamid M, Adamopoulos S, Anker SD, Belenkov Y, Ben Gal T, Cohen-Solal A, Böhm M, Chioncel O, Jankowska EA, Gustafsson F, Hill L, Jaarsma T, Januzzi JL, Jhund P, Lopatin Y, Lund LH, Metra M, Milicic D, Moura B, Mueller C, Mullens W, Núñez J, Piepoli MF, Rakisheva A, Ristić AD, Rossignol P, Savarese G, Tocchetti CG, van Linthout S, Volterrani M, Seferovic P, Rosano G, Coats AJS, Emdin M, and Bayes-Genis A
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- Biomarkers, Humans, Stroke Volume, Ventricular Function, Left, Ventricular Remodeling, Cardiology, Heart Failure
- Abstract
In patients with heart failure, the beneficial effects of drug and device therapies counteract to some extent ongoing cardiac damage. According to the net balance between these two factors, cardiac geometry and function may improve (reverse remodelling, RR) and even completely normalize (remission), or vice versa progressively deteriorate (adverse remodelling, AR). RR or remission predict a better prognosis, while AR has been associated with worsening clinical status and outcomes. The remodelling process ultimately involves all cardiac chambers, but has been traditionally evaluated in terms of left ventricular volumes and ejection fraction. This is the second part of a review paper by the Study Group on Biomarkers of the Heart Failure Association of the European Society of Cardiology dedicated to ventricular remodelling. This document examines the proposed criteria to diagnose RR and AR, their prevalence and prognostic value, and the variables predicting remodelling in patients managed according to current guidelines. Much attention will be devoted to RR in patients with heart failure with reduced ejection fraction because most studies on cardiac remodelling focused on this setting., (© 2022 European Society of Cardiology.)
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- 2022
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10. Editor comment: Focus on sport cardiology and exercise prescription.
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Halasz G and Piepoli MF
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- Exercise Therapy, Humans, Prescriptions, Cardiology, Sports
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- 2022
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11. Preventing heart failure: a position paper of the Heart Failure Association in collaboration with the European Association of Preventive Cardiology.
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Piepoli MF, Adamo M, Barison A, Bestetti RB, Biegus J, Böhm M, Butler J, Carapetis J, Ceconi C, Chioncel O, Coats A, Crespo-Leiro MG, de Simone G, Drexel H, Emdin M, Farmakis D, Halle M, Heymans S, Jaarsma T, Jankowska E, Lainscak M, Lam CSP, Løchen ML, Lopatin Y, Maggioni A, Matrone B, Metra M, Noonan K, Pina I, Prescott E, Rosano G, Seferovic PM, Sliwa K, Stewart S, Uijl A, Vaartjes I, Vermeulen R, Verschuren WM, Volterrani M, Von Haehling S, and Hoes A
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- Consensus, Humans, Patient Readmission, Risk Factors, Cardiology, Heart Failure diagnosis, Heart Failure epidemiology, Heart Failure prevention & control
- Abstract
The heart failure epidemic is growing and its prevention, in order to reduce associated hospital readmission rates and its clinical and economic burden, is a key issue in modern cardiovascular medicine. The present consensus document aims to provide practical evidence-based information to support the implementation of effective preventive measures. After reviewing the most common risk factors, an overview of the population attributable risks in different continents is presented, to identify potentially effective opportunities for prevention and to inform preventive strategies. Finally, potential interventions that have been proposed and have been shown to be effective in preventing HF are listed., (The article has been co-published with permission in the European Journal of Preventive Cardiology and European Journal of Heart Failure. All rights reserved. © The Author(s) 2022. The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article.)
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- 2022
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12. EAPC Core Curriculum for Preventive Cardiology.
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Wilhelm M, Abreu A, Adami PE, Ambrosetti M, Antonopoulou M, Biffi A, Cavarretta E, D'Ascenzi F, Gibson I, Grobbee DE, Iliou MC, Koskinas K, Marques-Vidal P, Nixdorff U, Papadakis M, Piepoli MF, Vassiliou V, Wood D, Dendale P, and Halle M
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- Certification, Curriculum, Exercise, Humans, Cardiology, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, Sports
- Abstract
Preventive cardiology encompasses the whole spectrum of cardiovascular disease (CVD) prevention, at individual and population level, through all stages of life. This includes promotion of cardiovascular (CV) health, management of individuals at risk of developing CVD, and management of patients with established CVD, through interdisciplinary care in different settings. Preventive cardiology addresses all aspects of CV health in the context of the social determinants of health, including physical activity, exercise, sports, nutrition, weight management, smoking cessation, psychosocial factors and behavioural change, environmental, genetic and biological risk factors, and CV protective medications. This is the first European Core Curriculum for Preventive Cardiology, which will help to standardize, structure, deliver, and evaluate training in preventive cardiology across Europe. It will be the basis for dedicated fellowship programmes and a European Society of Preventive Cardiology (EAPC) subspecialty certification for cardiologists, with the intention to improve quality and outcome in CVD prevention., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2022
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13. Education and certification on heart failure of the Heart Failure Association of the European Society of Cardiology.
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Mullens W, Coats A, Seferovic P, Metra M, Mebazaa A, Ruschitzka F, Filippatos G, Volterrani M, Ponikowski P, Jankowska EA, Chioncel O, McDonagh TA, Piepoli MF, Milicic D, Thum T, Hill L, Abdelhamid M, Adamopoulos S, Belenkov Y, Ben Gal T, Böhm M, Cohen-Solal A, Gustafsson F, Jaarsma T, Moura B, Rakisheva A, Ristic A, Bayes-Genis A, Van Linthout S, Anker SD, Tocchetti CG, Lopatin Y, Lund L, Savarese G, Čelutkienė J, Cowie M, Lambrinou E, Ray R, Lainscak M, Skouri H, Wallner M, and Rosano GMC
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- Certification, Europe epidemiology, Humans, Societies, Medical, Cardiology education, Heart Failure therapy
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- 2022
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14. Comprehensive multicomponent cardiac rehabilitation in cardiac implantable electronic devices recipients: a consensus document from the European Association of Preventive Cardiology (EAPC; Secondary prevention and rehabilitation section) and European Heart Rhythm Association (EHRA).
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Pedretti RFE, Iliou MC, Israel CW, Abreu A, Miljoen H, Corrà U, Stellbrink C, Gevaert AB, Theuns DA, Piepoli MF, Reibis R, Schmid JP, Wilhelm M, Heidbuchel H, Völler H, Ambrosetti M, Deneke T, Cornelissen V, R Heinzel F, Davos CH, Kudaiberdieva G, Frederix I, Svendsen JH, and Hansen D
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- Consensus, Electronics, Humans, Secondary Prevention, Cardiac Rehabilitation, Cardiology, Defibrillators, Implantable adverse effects
- Abstract
Cardiac rehabilitation (CR) is a multidisciplinary intervention including patient assessment and medical actions to promote stabilization, management of cardiovascular risk factors, vocational support, psychosocial management, physical activity counselling, and prescription of exercise training. Millions of people with cardiac implantable electronic devices live in Europe and their numbers are progressively increasing, therefore, large subsets of patients admitted in CR facilities have a cardiac implantable electronic device. Patients who are cardiac implantable electronic devices recipients are considered eligible for a CR programme. This is not only related to the underlying heart disease but also to specific issues, such as psychological adaptation to living with an implanted device and, in implantable cardioverter-defibrillator patients, the risk of arrhythmia, syncope, and sudden cardiac death. Therefore, these patients should receive special attention, as their needs may differ from other patients participating in CR. As evidence from studies of CR in patients with cardiac implantable electronic devices is sparse, detailed clinical practice guidelines are lacking. Here, we aim to provide practical recommendations for CR in cardiac implantable electronic devices recipients in order to increase CR implementation, efficacy, and safety in this subset of patients., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)
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- 2021
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15. COVID-19 vaccination in patients with heart failure: a position paper of the Heart Failure Association of the European Society of Cardiology.
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Rosano G, Jankowska EA, Ray R, Metra M, Abdelhamid M, Adamopoulos S, Anker SD, Bayes-Genis A, Belenkov Y, Gal TB, Böhm M, Chioncel O, Cohen-Solal A, Farmakis D, Filippatos G, González A, Gustafsson F, Hill L, Jaarsma T, Jouhra F, Lainscak M, Lambrinou E, Lopatin Y, Lund LH, Milicic D, Moura B, Mullens W, Piepoli MF, Ponikowski P, Rakisheva A, Ristic A, Savarese G, Seferovic P, Senni M, Thum T, Tocchetti CG, Van Linthout S, Volterrani M, and Coats AJS
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- Aged, COVID-19 Vaccines, Frail Elderly, Humans, SARS-CoV-2, Vaccination, COVID-19, Cardiology, Heart Failure, Iron Deficiencies
- Abstract
Patients with heart failure (HF) who contract SARS-CoV-2 infection are at a higher risk of cardiovascular and non-cardiovascular morbidity and mortality. Regardless of therapeutic attempts in COVID-19, vaccination remains the most promising global approach at present for controlling this disease. There are several concerns and misconceptions regarding the clinical indications, optimal mode of delivery, safety and efficacy of COVID-19 vaccines for patients with HF. This document provides guidance to all healthcare professionals regarding the implementation of a COVID-19 vaccination scheme in patients with HF. COVID-19 vaccination is indicated in all patients with HF, including those who are immunocompromised (e.g. after heart transplantation receiving immunosuppressive therapy) and with frailty syndrome. It is preferable to vaccinate against COVID-19 patients with HF in an optimal clinical state, which would include clinical stability, adequate hydration and nutrition, optimized treatment of HF and other comorbidities (including iron deficiency), but corrective measures should not be allowed to delay vaccination. Patients with HF who have been vaccinated against COVID-19 need to continue precautionary measures, including the use of facemasks, hand hygiene and social distancing. Knowledge on strategies preventing SARS-CoV-2 infection (including the COVID-19 vaccination) should be included in the comprehensive educational programmes delivered to patients with HF., (© 2021 European Society of Cardiology.)
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- 2021
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16. Editor comments: Focus on sport cardiology.
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Halasz G and Piepoli MF
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- Humans, Cardiology, Cardiovascular System, Sports
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- 2021
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17. Measuring physical activity with activity monitors in patients with heart failure: from literature to practice. A position paper from the Committee on Exercise Physiology and Training of the Heart Failure Association of the European Society of Cardiology.
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Klompstra L, Kyriakou M, Lambrinou E, Piepoli MF, Coats AJS, Cohen-Solal A, Cornelis J, Gellen B, Marques-Sule E, Niederseer D, Orso F, Piotrowicz E, Van Craenenbroeck EM, Simonenko M, Witte KK, Wozniak A, Volterrani M, and Jaarsma T
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- Exercise, Fitness Trackers, Humans, Monitoring, Physiologic, Cardiology, Heart Failure
- Abstract
The aims of this paper were to provide an overview of available activity monitors used in research in patients with heart failure and to identify the key criteria in the selection of the most appropriate activity monitor for collecting, reporting, and analysing physical activity in heart failure research. This study was conducted in three parts. First, the literature was systematically reviewed to identify physical activity concepts and activity monitors used in heart failure research. Second, an additional scoping literature search for validation of these activity monitors was conducted. Third, the most appropriate criteria in the selection of activity monitors were identified. Nine activity monitors were evaluated in terms of size, weight, placement, costs, data storage, water resistance, outcomes and validation, and cut-off points for physical activity intensity levels were discussed. The choice of a monitor should depend on the research aims, study population and design regarding physical activity. If the aim is to motivate patients to be active or set goals, a less rigorously tested tool can be considered. On the other hand, if the aim is to measure physical activity and its changes over time or following treatment adjustment, it is important to choose a valid activity monitor with a storage and battery longevity of at least one week. The device should provide raw data and valid cut-off points should be chosen for analysing physical activity intensity levels. Other considerations in choosing an activity monitor should include data storage location and ownership and the upfront costs of the device., (© 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
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- 2021
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18. Self-care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology.
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Jaarsma T, Hill L, Bayes-Genis A, La Rocca HB, Castiello T, Čelutkienė J, Marques-Sule E, Plymen CM, Piper SE, Riegel B, Rutten FH, Ben Gal T, Bauersachs J, Coats AJS, Chioncel O, Lopatin Y, Lund LH, Lainscak M, Moura B, Mullens W, Piepoli MF, Rosano G, Seferovic P, and Strömberg A
- Subjects
- Chronic Disease, Humans, Quality of Life, Self Care, Cardiology, Heart Failure
- Abstract
Self-care is essential in the long-term management of chronic heart failure. Heart failure guidelines stress the importance of patient education on treatment adherence, lifestyle changes, symptom monitoring and adequate response to possible deterioration. Self-care is related to medical and person-centred outcomes in patients with heart failure such as better quality of life as well as lower mortality and readmission rates. Although guidelines give general direction for self-care advice, health care professionals working with patients with heart failure need more specific recommendations. The aim of the management recommendations in this paper is to provide practical advice for health professionals delivering care to patients with heart failure. Recommendations for nutrition, physical activity, medication adherence, psychological status, sleep, leisure and travel, smoking, immunization and preventing infections, symptom monitoring, and symptom management are consistent with information from guidelines, expert consensus documents, recent evidence and expert opinion., (© 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
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- 2021
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19. Editor's presentation: Towards a personalised approach in exercise-based cardiovascular rehabilitation: An European Association of Preventive Cardiology (EAPC) call for action.
- Author
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Halasz G and Piepoli MF
- Subjects
- Europe, Exercise physiology, Humans, Cardiac Rehabilitation methods, Cardiology, Cardiovascular Diseases prevention & control, Exercise Therapy methods, Societies, Medical
- Published
- 2020
- Full Text
- View/download PDF
20. Focus on exercise and sport cardiology.
- Author
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Halasz G and Piepoli MF
- Subjects
- Cardiovascular Diseases physiopathology, Female, Humans, Male, Cardiology methods, Cardiovascular Diseases prevention & control, Exercise physiology, Sports physiology
- Published
- 2020
- Full Text
- View/download PDF
21. Risk prediction tools in cardiovascular disease prevention: A report from the ESC Prevention of CVD Programme led by the European Association of Preventive Cardiology (EAPC) in collaboration with the Acute Cardiovascular Care Association (ACCA) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP).
- Author
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Rossello X, Dorresteijn JA, Janssen A, Lambrinou E, Scherrenberg M, Bonnefoy-Cudraz E, Cobain M, Piepoli MF, Visseren FL, and Dendale P
- Subjects
- Europe, Humans, Risk Factors, Allied Health Personnel, Cardiology, Cardiovascular Diseases prevention & control, Critical Care standards, Primary Prevention standards, Risk Assessment methods, Societies, Medical
- Abstract
Risk assessment and risk prediction have become essential in the prevention of cardiovascular disease. Even though risk prediction tools are recommended in the European guidelines, they are not adequately implemented in clinical practice. Risk prediction tools are meant to estimate prognosis in an unbiased and reliable way and to provide objective information on outcome probabilities. They support informed treatment decisions about the initiation or adjustment of preventive medication. Risk prediction tools facilitate risk communication to the patient and their family, and this may increase commitment and motivation to improve their health. Over the years many risk algorithms have been developed to predict 10-year cardiovascular mortality or lifetime risk in different populations, such as in healthy individuals, patients with established cardiovascular disease and patients with diabetes mellitus. Each risk algorithm has its own limitations, so different algorithms should be used in different patient populations. Risk algorithms are made available for use in clinical practice by means of - usually interactive and online available - tools. To help the clinician to choose the right tool for the right patient, a summary of available tools is provided. When choosing a tool, physicians should consider medical history, geographical region, clinical guidelines and additional risk measures among other things. Currently, the U-prevent.com website is the only risk prediction tool providing prediction algorithms for all patient categories, and its implementation in clinical practice is suggested/advised by the European Association of Preventive Cardiology.
- Published
- 2020
- Full Text
- View/download PDF
22. Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high-risk combination. A statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology.
- Author
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Harjola VP, Parissis J, Bauersachs J, Brunner-La Rocca HP, Bueno H, Čelutkienė J, Chioncel O, Coats AJS, Collins SP, de Boer RA, Filippatos G, Gayat E, Hill L, Laine M, Lassus J, Lommi J, Masip J, Mebazaa A, Metra M, Miró Ò, Mortara A, Mueller C, Mullens W, Peacock WF, Pentikäinen M, Piepoli MF, Polyzogopoulou E, Rudiger A, Ruschitzka F, Seferovic P, Sionis A, Teerlink JR, Thum T, Varpula M, Weinstein JM, and Yilmaz MB
- Subjects
- Chest Pain, Electrocardiography, Humans, Acute Coronary Syndrome complications, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome epidemiology, Cardiology, Heart Failure complications, Heart Failure diagnosis, Heart Failure epidemiology
- Abstract
Acute coronary syndrome is a precipitant of acute heart failure in a substantial proportion of cases, and the presence of both conditions is associated with a higher risk of short-term mortality compared to acute coronary syndrome alone. The diagnosis of acute coronary syndrome in the setting of acute heart failure can be challenging. Patients may present with atypical or absent chest pain, electrocardiograms can be confounded by pre-existing abnormalities, and cardiac biomarkers are frequently elevated in patients with chronic or acute heart failure, independently of acute coronary syndrome. It is important to distinguish transient or limited myocardial injury from primary myocardial infarction due to vascular events in patients presenting with acute heart failure. This paper outlines various clinical scenarios to help differentiate between these conditions and aims to provide clinicians with tools to aid in the recognition of acute coronary syndrome as a cause of acute heart failure. Interpretation of electrocardiogram and biomarker findings, and imaging techniques that may be helpful in the diagnostic work-up are described. Guidelines recommend an immediate invasive strategy for patients with acute heart failure and acute coronary syndrome, regardless of electrocardiographic or biomarker findings. Pharmacological management of patients with acute coronary syndrome and acute heart failure should follow guidelines for each of these syndromes, with priority given to time-sensitive therapies for both. Studies conducted specifically in patients with the combination of acute coronary syndrome and acute heart failure are needed to better define the management of these patients., (© 2020 European Society of Cardiology.)
- Published
- 2020
- Full Text
- View/download PDF
23. Editor's presentation: Staying healthy and fighting cardiovascular disease at the time of COVID.
- Author
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Piepoli MF
- Subjects
- Cardiovascular Diseases diagnosis, Cardiovascular Diseases mortality, Cardiovascular Diseases physiopathology, Health Status, Humans, Prognosis, COVID-19, Cardiology, Cardiovascular Diseases therapy, Continuity of Patient Care, Delivery of Health Care, Integrated
- Published
- 2020
- Full Text
- View/download PDF
24. Heart Failure Association of the European Society of Cardiology Quality of Care Centres Programme: design and accreditation document.
- Author
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Seferović PM, Piepoli MF, Lopatin Y, Jankowska E, Polovina M, Anguita-Sanchez M, Störk S, Lainščak M, Miličić D, Milinković I, Filippatos G, and Coats AJS
- Subjects
- Accreditation, Europe, Humans, Quality of Health Care, Cardiology, Heart Failure therapy
- Abstract
Heart failure (HF) is the major contributor to cardiovascular morbidity and mortality. Given its rising prevalence, the costs of HF care can be expected to increase. Multidisciplinary management of HF can improve quality of care and survival. However, specialized HF programmes are not widely available in most European countries. These circumstances underlie the suggestion of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) for the development of quality of care centres (QCCs). These are defined as health care institutions that provide multidisciplinary HF management at all levels of care (primary, secondary and tertiary), are accredited by the HFA/ESC and are implemented into existing health care systems. Their major goals are to unify and improve the quality of HF care, and to promote collaboration in education and research activities. Three types of QCC are suggested: community QCCs (primary care facilities able to provide non-invasive assessment and optimal therapy); specialized QCCs (district hospitals with intensive care units, able to provide cardiac catheterization and device implantation services), and advanced QCCs (national reference centres able to deliver advanced and innovative HF care and research). QCC accreditation will require compliance with general and specific HFA/ESC accreditation standards. General requirements include confirmation of the centre's existence, commitment to QCC implementation, and collaboration with other QCCs. Specific requirements include validation of the centre's level of care, service portfolio, facilities and equipment, management, human resources, process measures, quality indicators and outcome measures. Audit and recertification at 4-6-year intervals are also required. The implementation of QCCs will evolve gradually, following a pilot phase in selected countries. The present document summarizes the definition, major goals, development, classification and crucial aspects of the accreditation process of the HFA/ESC QCC Programme., (© 2020 European Society of Cardiology.)
- Published
- 2020
- Full Text
- View/download PDF
25. A dialogue between the editor-in-chief and a deputy editor of a cardiology journal during the coronavirus outbreak: Take-home messages from the Italian experience.
- Author
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Piepoli MF and Emdin M
- Subjects
- COVID-19, Humans, Italy, SARS-CoV-2, Betacoronavirus, Cardiology, Communicable Disease Control organization & administration, Coronavirus Infections epidemiology, Coronavirus Infections prevention & control, Pandemics prevention & control, Physician's Role, Pneumonia, Viral epidemiology, Pneumonia, Viral prevention & control
- Published
- 2020
- Full Text
- View/download PDF
26. Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology.
- Author
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Piepoli MF, Abreu A, Albus C, Ambrosetti M, Brotons C, Catapano AL, Corra U, Cosyns B, Deaton C, Graham I, Hoes A, Lochen ML, Matrone B, Redon J, Sattar N, Smulders Y, and Tiberi M
- Subjects
- Cardiology economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Cardiovascular Diseases epidemiology, Consensus, Cost-Benefit Analysis, Health Care Costs, Heart Disease Risk Factors, Humans, Preventive Health Services economics, Prognosis, Protective Factors, Risk Assessment, Cardiology standards, Cardiovascular Diseases prevention & control, Preventive Health Services standards
- Abstract
European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regularly updated, most recently in 2016, by the Sixth European Joint Task Force. Given the amount of new information that has become available since then, components from the task force and experts from the European Association of Preventive Cardiology of the European Society of Cardiology were invited to provide a summary and critical review of the most important new studies and evidence since the latest guidelines were published. The structure of the document follows that of the previous document and has six parts: Introduction (epidemiology and cost effectiveness); Cardiovascular risk; How to intervene at the population level; How to intervene at the individual level; Disease-specific interventions; and Settings: where to intervene? In fact, in keeping with the guidelines, greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered. Finally, the presence of several gaps in the knowledge is highlighted.
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- 2020
- Full Text
- View/download PDF
27. Levels of evidence in the European Society of Cardiology Guidelines: Gaps in knowledge?
- Author
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Piepoli MF and Ceconi C
- Subjects
- Humans, Societies, Medical, Cardiology
- Published
- 2019
- Full Text
- View/download PDF
28. Editor's presentation: 'Accreditation and certification. A step towards optimising quality'.
- Author
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Piepoli MF
- Subjects
- Europe, Humans, Accreditation organization & administration, Cardiology, Cardiovascular Diseases therapy, Certification organization & administration, Delivery of Health Care standards, Quality Improvement
- Published
- 2019
- Full Text
- View/download PDF
29. Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology.
- Author
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Seferovic PM, Ponikowski P, Anker SD, Bauersachs J, Chioncel O, Cleland JGF, de Boer RA, Drexel H, Ben Gal T, Hill L, Jaarsma T, Jankowska EA, Anker MS, Lainscak M, Lewis BS, McDonagh T, Metra M, Milicic D, Mullens W, Piepoli MF, Rosano G, Ruschitzka F, Volterrani M, Voors AA, Filippatos G, and Coats AJS
- Subjects
- Europe, Evidence-Based Medicine, Humans, Cardiology methods, Disease Management, Heart Failure therapy
- Abstract
The European Society of Cardiology (ESC) has published a series of guidelines on heart failure (HF) over the last 25 years, most recently in 2016. Given the amount of new information that has become available since then, the Heart Failure Association (HFA) of the ESC recognized the need to review and summarise recent developments in a consensus document. Here we report from the HFA workshop that was held in January 2019 in Frankfurt, Germany. This expert consensus report is neither a guideline update nor a position statement, but rather a summary and consensus view in the form of consensus recommendations. The report describes how these guidance statements are supported by evidence, it makes some practical comments, and it highlights new research areas and how progress might change the clinical management of HF. We have avoided re-interpretation of information already considered in the 2016 ESC/HFA guidelines. Specific new recommendations have been made based on the evidence from major trials published since 2016, including sodium-glucose co-transporter 2 inhibitors in type 2 diabetes mellitus, MitraClip for functional mitral regurgitation, atrial fibrillation ablation in HF, tafamidis in cardiac transthyretin amyloidosis, rivaroxaban in HF, implantable cardioverter-defibrillators in non-ischaemic HF, and telemedicine for HF. In addition, new trial evidence from smaller trials and updated meta-analyses have given us the chance to provide refined recommendations in selected other areas. Further, new trial evidence is due in many of these areas and others over the next 2 years, in time for the planned 2021 ESC guidelines on the diagnosis and treatment of acute and chronic heart failure., (© 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology.)
- Published
- 2019
- Full Text
- View/download PDF
30. E-health in self-care of heart failure patients: promises become reality.
- Author
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Piepoli MF
- Subjects
- Humans, Self Care, Cardiology, Heart Failure, Telemedicine
- Published
- 2019
- Full Text
- View/download PDF
31. Exercise training in patients with ventricular assist devices: a review of the evidence and practical advice. A position paper from the Committee on Exercise Physiology and Training and the Committee of Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology.
- Author
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Adamopoulos S, Corrà U, Laoutaris ID, Pistono M, Agostoni PG, Coats AJS, Crespo Leiro MG, Cornelis J, Davos CH, Filippatos G, Lund LH, Jaarsma T, Ruschitzka F, Seferovic PM, Schmid JP, Volterrani M, and Piepoli MF
- Subjects
- Europe, Heart Failure physiopathology, Humans, Cardiology, Exercise physiology, Exercise Therapy methods, Heart Failure rehabilitation, Heart-Assist Devices, Practice Guidelines as Topic, Societies, Medical
- Abstract
Exercise training (ET) and secondary prevention measures in cardiovascular disease aim to stimulate early physical activity and to facilitate recovery and improve health behaviours. ET has also been proposed for heart failure patients with a ventricular assist device (VAD), to help recovery in the patient's functional capacity. However, the existing evidence in support of ET in these patients remains limited. After a review of current knowledge on the causes of the persistence of limitation in exercise capacity in VAD recipients, and concerning the benefit of ET in VAD patients, the Heart Failure Association of the European Society of Cardiology has developed the present document to provide practical advice on implementing ET. This includes appropriate screening to avoid complications and then starting with early mobilisation, ET prescription is individualised to meet the patient's needs. Finally, gaps in our knowledge are discussed., (© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.)
- Published
- 2019
- Full Text
- View/download PDF
32. Editor's presentation.
- Author
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Piepoli MF
- Subjects
- Heart Diseases diagnosis, Heart Diseases physiopathology, Humans, Cardiology, Heart Diseases therapy, Preventive Health Services
- Published
- 2019
- Full Text
- View/download PDF
33. Tireless cardiologists needed for (very) tired patients: The case of heart failure.
- Author
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Emdin M, Passino C, and Piepoli MF
- Subjects
- Cardiologists, Heart, Humans, Cardiac Rehabilitation, Cardiology, Heart Failure
- Published
- 2018
- Full Text
- View/download PDF
34. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology.
- Author
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Seferović PM, Petrie MC, Filippatos GS, Anker SD, Rosano G, Bauersachs J, Paulus WJ, Komajda M, Cosentino F, de Boer RA, Farmakis D, Doehner W, Lambrinou E, Lopatin Y, Piepoli MF, Theodorakis MJ, Wiggers H, Lekakis J, Mebazaa A, Mamas MA, Tschöpe C, Hoes AW, Seferović JP, Logue J, McDonagh T, Riley JP, Milinković I, Polovina M, van Veldhuisen DJ, Lainscak M, Maggioni AP, Ruschitzka F, and McMurray JJV
- Subjects
- Comorbidity trends, Europe, Global Health, Humans, Prevalence, Survival Rate trends, Cardiology, Diabetes Mellitus, Type 2 epidemiology, Heart Failure epidemiology, Societies, Medical
- Abstract
The coexistence of type 2 diabetes mellitus (T2DM) and heart failure (HF), either with reduced (HFrEF) or preserved ejection fraction (HFpEF), is frequent (30-40% of patients) and associated with a higher risk of HF hospitalization, all-cause and cardiovascular (CV) mortality. The most important causes of HF in T2DM are coronary artery disease, arterial hypertension and a direct detrimental effect of T2DM on the myocardium. T2DM is often unrecognized in HF patients, and vice versa, which emphasizes the importance of an active search for both disorders in the clinical practice. There are no specific limitations to HF treatment in T2DM. Subanalyses of trials addressing HF treatment in the general population have shown that all HF therapies are similarly effective regardless of T2DM. Concerning T2DM treatment in HF patients, most guidelines currently recommend metformin as the first-line choice. Sulphonylureas and insulin have been the traditional second- and third-line therapies although their safety in HF is equivocal. Neither glucagon-like preptide-1 (GLP-1) receptor agonists, nor dipeptidyl peptidase-4 (DPP4) inhibitors reduce the risk for HF hospitalization. Indeed, a DPP4 inhibitor, saxagliptin, has been associated with a higher risk of HF hospitalization. Thiazolidinediones (pioglitazone and rosiglitazone) are contraindicated in patients with (or at risk of) HF. In recent trials, sodium-glucose co-transporter-2 (SGLT2) inhibitors, empagliflozin and canagliflozin, have both shown a significant reduction in HF hospitalization in patients with established CV disease or at risk of CV disease. Several ongoing trials should provide an insight into the effectiveness of SGLT2 inhibitors in patients with HFrEF and HFpEF in the absence of T2DM., (© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.)
- Published
- 2018
- Full Text
- View/download PDF
35. Heart and brain interaction in patients with heart failure: overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association.
- Author
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Doehner W, Ural D, Haeusler KG, Čelutkienė J, Bestetti R, Cavusoglu Y, Peña-Duque MA, Glavas D, Iacoviello M, Laufs U, Alvear RM, Mbakwem A, Piepoli MF, Rosen SD, Tsivgoulis G, Vitale C, Yilmaz MB, Anker SD, Filippatos G, Seferovic P, Coats AJS, and Ruschitzka F
- Subjects
- Disease Progression, Humans, Brain physiopathology, Cardiology, Cognition physiology, Consensus, Heart Failure classification, Heart Failure physiopathology, Hemodynamics physiology, Societies, Medical
- Abstract
Heart failure (HF) is a complex clinical syndrome with multiple interactions between the failing myocardium and cerebral (dys-)functions. Bi-directional feedback interactions between the heart and the brain are inherent in the pathophysiology of HF: (i) the impaired cardiac function affects cerebral structure and functional capacity, and (ii) neuronal signals impact on the cardiovascular continuum. These interactions contribute to the symptomatic presentation of HF patients and affect many co-morbidities of HF. Moreover, neuro-cardiac feedback signals significantly promote aggravation and further progression of HF and are causal in the poor prognosis of HF. The diversity and complexity of heart and brain interactions make it difficult to develop a comprehensive overview. In this paper a systematic approach is proposed to develop a comprehensive atlas of related conditions, signals and disease mechanisms of the interactions between the heart and the brain in HF. The proposed taxonomy is based on pathophysiological principles. Impaired perfusion of the brain may represent one major category, with acute (cardio-embolic) or chronic (haemodynamic failure) low perfusion being sub-categories with mostly different consequences (i.e. ischaemic stroke or cognitive impairment, respectively). Further categories include impairment of higher cortical function (mood, cognition), of brain stem function (sympathetic over-activation, neuro-cardiac reflexes). Treatment-related interactions could be categorized as medical, interventional and device-related interactions. Also interactions due to specific diseases are categorized. A methodical approach to categorize the interdependency of heart and brain may help to integrate individual research areas into an overall picture., (© 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.)
- Published
- 2018
- Full Text
- View/download PDF
36. Role of cardiopulmonary exercise testing in clinical stratification in heart failure. A position paper from the Committee on Exercise Physiology and Training of the Heart Failure Association of the European Society of Cardiology.
- Author
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Corrà U, Agostoni PG, Anker SD, Coats AJS, Crespo Leiro MG, de Boer RA, Harjola VP, Hill L, Lainscak M, Lund LH, Metra M, Ponikowski P, Riley J, Seferović PM, and Piepoli MF
- Subjects
- Europe, Heart Failure diagnosis, Humans, Cardiology, Exercise Test methods, Exercise Tolerance physiology, Heart Failure physiopathology, Practice Guidelines as Topic standards, Societies, Medical, Stroke Volume physiology
- Abstract
Traditionally, the main indication for cardiopulmonary exercise testing (CPET) in heart failure (HF) was for the selection of candidates to heart transplantation: CPET was mainly performed in middle-aged male patients with HF and reduced left ventricular ejection fraction. Today, CPET is used in broader patients' populations, including women, elderly, patients with co-morbidities, those with preserved ejection fraction, or left ventricular assistance device recipients, i.e. individuals with different responses to incremental exercise and markedly different prognosis. Moreover, the diagnostic and prognostic utility of symptom-limited CPET parameters derived from submaximal tests is more and more considered, since many patients are unable to achieve maximal aerobic power. Repeated tests are also being used for risk stratification and evaluation of intervention, so that these data are now available. Finally, patients, physicians and healthcare decision makers are increasingly considering how treatments might impact morbidity and quality of life rather than focusing more exclusively on hard endpoints (such as mortality) as was often the case in the past. Innovative prognostic flowcharts, with CPET at their core, that help optimize risk stratification and the selection of management options in HF patients, have been developed., (© 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.)
- Published
- 2018
- Full Text
- View/download PDF
37. Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology.
- Author
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Gorter TM, van Veldhuisen DJ, Bauersachs J, Borlaug BA, Celutkiene J, Coats AJS, Crespo-Leiro MG, Guazzi M, Harjola VP, Heymans S, Hill L, Lainscak M, Lam CSP, Lund LH, Lyon AR, Mebazaa A, Mueller C, Paulus WJ, Pieske B, Piepoli MF, Ruschitzka F, Rutten FH, Seferovic PM, Solomon SD, Shah SJ, Triposkiadis F, Wachter R, Tschöpe C, and de Boer RA
- Subjects
- Europe, Humans, Cardiology, Heart Failure complications, Heart Failure diagnosis, Heart Failure physiopathology, Practice Guidelines as Topic, Societies, Medical, Stroke Volume physiology, Ventricular Dysfunction, Right diagnosis, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right physiopathology
- Abstract
There is an unmet need for effective treatment strategies to reduce morbidity and mortality in patients with heart failure with preserved ejection fraction (HFpEF). Until recently, attention in patients with HFpEF was almost exclusively focused on the left side. However, it is now increasingly recognized that right heart dysfunction is common and contributes importantly to poor prognosis in HFpEF. More insights into the development of right heart dysfunction in HFpEF may aid to our knowledge about this complex disease and may eventually lead to better treatments to improve outcomes in these patients. In this position paper from the Heart Failure Association of the European Society of Cardiology, the Committee on Heart Failure with Preserved Ejection Fraction reviews the prevalence, diagnosis, and pathophysiology of right heart dysfunction and failure in patients with HFpEF. Finally, potential treatment strategies, important knowledge gaps and future directions regarding the right side in HFpEF are discussed., (© 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.)
- Published
- 2018
- Full Text
- View/download PDF
38. 'heartfailurematters.org', an educational website for patients and carers from the Heart Failure Association of the European Society of Cardiology: objectives, use and future directions.
- Author
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Wagenaar KP, Rutten FH, Klompstra L, Bhana Y, Sieverink F, Ruschitzka F, Seferovic PM, Lainscak M, Piepoli MF, Broekhuizen BDL, Strömberg A, Jaarsma T, Hoes AW, and Dickstein K
- Subjects
- Humans, Cardiology education, Caregivers education, Education, Professional methods, Heart Failure therapy, Internet, Patient Education as Topic methods
- Abstract
Aims: In 2007, the Heart Failure Association of the European Society of Cardiology (ESC) launched the information website heartfailurematters.org (HFM site) with the aim of creating a practical tool through which to provide advice and guidelines for living with heart failure to patients, their carers, health care professionals and the general public worldwide. The website is managed by the ESC at the European Heart House and is currently available in nine languages. The aim of this study is to describe the background, objectives, use, lessons learned and future directions of the HFM site., Methods and Results: Data on the number of visitor sessions on the site as measured by Google Analytics were used to explore use of the HFM site from 2010 to 2015. Worldwide, the annual number of sessions increased from 416 345 in 2010 to 1 636 368 in 2015. Most users (72-75%) found the site by using a search engine. Desktops and, more recently, smartphones were used to visit the website, accounting for 50% and 38%, respectively, of visits to the site in 2015., Conclusions: Although its use has increased, the HFM site has not yet reached its full potential: fewer than 2 million users have visited the website, whereas the number of people living with heart failure worldwide is estimated to be 23 million. Uptake and use could be further improved by a continuous process of qualitative assessment of users' preferences, and the provision of professional helpdesk facilities, comprehensive information technology, and promotional support., (© 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.)
- Published
- 2017
- Full Text
- View/download PDF
39. [2016 European guidelines on cardiovascular disease prevention in clinical practice. The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts. Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation].
- Author
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Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, and Verschuren WMM
- Subjects
- Body Mass Index, Delivery of Health Care standards, Diabetes Mellitus, Type 2 prevention & control, Europe, Humans, Hypercholesterolemia prevention & control, Hypertension prevention & control, Obesity prevention & control, Risk Assessment, Risk Factors, Smoking adverse effects, Smoking Prevention, Societies, Medical, Cardiology standards, Cardiovascular Diseases prevention & control
- Published
- 2017
- Full Text
- View/download PDF
40. We are standing on the shoulders of giants. The European Journal of Preventive Cardiology in the years to come: A salutation from the incoming Editor-in-Chief.
- Author
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Piepoli MF
- Subjects
- History, 20th Century, History, 21st Century, Humans, Biomedical Research history, Cardiology history, Editorial Policies, Periodicals as Topic history, Preventive Medicine history
- Published
- 2017
- Full Text
- View/download PDF
41. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC).
- Author
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Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip GY, Lyon AR, Lopez Fernandez T, Mohty D, Piepoli MF, Tamargo J, Torbicki A, Suter TM, Zamorano JL, Aboyans V, Achenbach S, Agewall S, Badimon L, Barón-Esquivias G, Baumgartner H, Bax JJ, Bueno H, Carerj S, Dean V, Erol Ç, Fitzsimons D, Gaemperli O, Kirchhof P, Kolh P, Lancellotti P, Lip GY, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Roffi M, Torbicki A, Vaz Carneiro A, and Windecker S
- Subjects
- Antineoplastic Agents therapeutic use, Cardiotoxicity, Congresses as Topic, Europe, Humans, Antineoplastic Agents adverse effects, Cardiology, Heart Diseases chemically induced, Neoplasms drug therapy, Practice Guidelines as Topic, Societies, Medical
- Published
- 2017
- Full Text
- View/download PDF
42. Challenges in secondary prevention after acute myocardial infarction: A call for action.
- Author
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Piepoli MF, Corrà U, Dendale P, Frederix I, Prescott E, Schmid JP, Cupples M, Deaton C, Doherty P, Giannuzzi P, Graham I, Hansen TB, Jennings C, Landmesser U, Marques-Vidal P, Vrints C, Walker D, Bueno H, Fitzsimons D, and Pelliccia A
- Subjects
- Global Health, Humans, Life Style, Morbidity trends, Myocardial Infarction epidemiology, Risk Factors, Cardiology methods, Myocardial Infarction prevention & control, Secondary Prevention methods
- Abstract
Worldwide, each year more than 7 million people experience myocardial infarction, in which one-year mortality rates are now in the range of 10%, but vary with patient characteristics. The consequences are even more dramatic: among patients who survive, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of ischaemic heart disease. The people behind these numbers spur this call for action. Prevention after myocardial infarction is crucial to reduce risk and suffering. Evidence-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings are endorsed.
- Published
- 2016
- Full Text
- View/download PDF
43. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC).
- Author
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Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip GYH, Lyon AR, Lopez Fernandez T, Mohty D, Piepoli MF, Tamargo J, Torbicki A, and Suter TM
- Subjects
- Advisory Committees, Antineoplastic Agents adverse effects, Cancer Survivors, Cardiotoxicity diagnosis, Humans, Immunotherapy adverse effects, Radiotherapy adverse effects, Vascular Endothelial Growth Factor A antagonists & inhibitors, Cardiology, Cardiotoxicity etiology, Cardiotoxicity therapy, Neoplasms therapy, Societies, Medical
- Published
- 2016
- Full Text
- View/download PDF
44. The European Society of Cardiology Heart Failure Association Annual Congress.
- Author
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Maggioni AP and Piepoli MF
- Subjects
- Europe, Heart Failure therapy, History, 20th Century, History, 21st Century, Humans, Cardiology history, Congresses as Topic history, Heart Failure history, Societies, Medical history
- Published
- 2016
- Full Text
- View/download PDF
45. [2016 European Guidelines on cardiovascular disease prevention in clinical practice].
- Author
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Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney M, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FD, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, and Binno S
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- Europe, Female, Humans, Male, Cardiology, Cardiovascular Diseases prevention & control, Societies, Medical
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- 2016
- Full Text
- View/download PDF
46. Exercise programs for LVAD supported patients: A snapshot from the ESC affiliated countries.
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Ben Gal T, Piepoli MF, Corrà U, Conraads V, Adamopoulos S, Agostoni P, Piotrowicz E, Schmid JP, Seferovic PM, Ponikowski P, Filippatos G, and Jaarsma T
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- Cardiology standards, Europe epidemiology, Exercise Therapy trends, Follow-Up Studies, Heart Failure diagnosis, Humans, Cardiology methods, Exercise Therapy methods, Heart Failure epidemiology, Heart Failure therapy, Societies, Medical standards, Surveys and Questionnaires
- Abstract
Background: To contribute to the protocol development of exercise training in LVAD supported patients by reviewing the exercise programs for those patients in the ESC affiliated countries., Methods: A subset of data from 77 (26 countries) LVAD implanting centers that participated in the Extra-HF survey (170 centers) was analyzed., Results: Of the 77 LVAD implanting centers, 45 (58%) reported to have a functioning exercise training program (ETP) for LVAD patients. In 21 (47%) of the 45 ETP programs in LVAD implanting centers, patients begin their ETP during their in-hospital post-operative recovery period. Most centers (71%) have an early post-discharge program for their patients, and 24% of the centers offer a long-term maintenance program. The professionals involved in the ETPs are mainly physiotherapists (73%), psychologists, cardiac rehab nurses (22%), or cardiologists specialized in rehabilitation (22%). Not all programs include the treating cardiologist or surgeons. Most of the ETPs (84%) include aerobic endurance training, mostly cycling (73%), or walking (62%) at low intensity intervals. Some programs apply resistance training (47%), respiratory muscle training (55%), or balance training (44%). Reasons for the absence of ETPs are referral of patients to another center (14 centers) and lack of resources (11 centers)., Conclusion: There is a great variance in ETPs in LVAD implanting centers. Not all the implanting centers have an ETP, and those that do have adopted a local protocol. Clear guidance on ETP supplied by LVAD implanting centers to LVAD supported patients and more evidence for optimal modalities are needed., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
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- 2015
- Full Text
- View/download PDF
47. [Telecardiology: perspectives and limitations].
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Locati EH and Piepoli MF
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- Cardiovascular Diseases diagnosis, Cardiovascular Diseases therapy, Cost-Benefit Analysis, Home Nursing, Humans, Information Dissemination, Referral and Consultation, Cardiology trends, Telemedicine economics, Telemedicine methods, Telemedicine trends
- Published
- 2004
48. Education and certification on heart failure of the Heart Failure Association of the European Society of Cardiology
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Mullens, Wilfried, Coats, Andrew J.S., Seferović, Petar M., Metra, Marco I., Mebazaa, Alexandre, Ruschitzka, Frank T., Filippatos, Gerasimos S., Volterrani, Maurizio, Ponikowski, Piotr P., Jankowska, Ewa Anita, Chioncel, Ovidiu, McDonagh, Theresa A., Piepoli, Massimo F., Milicic, Davor, Thum, Thomas, Hill, Loreena Michelle, Abdelhamid, Magdy, Adamopoulos, Stamatis, Belenkov, Yuri, Ben-Gal, Tuvia, Böhm, Michael, Cohen-Solal, Alain, Gustafsson, Finn, Jaarsma, Tiny, Moura, Brenda, Rakisheva, Amina, Ristic, Arsen D., Bayes-Genis, Antonio, Van Linthout, Sophia, Anker, Stefan D., Tocchetti, Carlo Gabriele, Lopatin, Yuri, Lund, Lars, Savarese, Gianluigi, Čelutkienė, Jelena, Cowie, Martin, Lambrinou, Ekaterini, Ray, Robin, Lainscak, Mitja, Skouri, Hadi, Wallner, Markus, Rosano, Giuseppe M C, Mullens, Wilfried, Coats, Andrew, Seferovic, Petar, Metra, Marco, Mebazaa, Alexandre, Ruschitzka, Frank, Filippatos, Gerasimo, Volterrani, Maurizio, Ponikowski, Piotr, Jankowska, Ewa A, Chioncel, Ovidiu, Mcdonagh, Theresa A, Piepoli, Massimo F, Milicic, Davor, Thum, Thoma, Hill, Loreena, Abdelhamid, Magdy, Adamopoulos, Stamati, Belenkov, Yuri, Gal, Tuvia Ben, Böhm, Michael, Cohen-Solal, Alain, Gustafsson, Finn, Jaarsma, Tiny, Moura, Brenda, Rakisheva, Amina, Ristic, Arsen, Bayes-Genis, Antonio, Van Linthout, Sophia, Anker, Stefan D, Tocchetti, Carlo Gabriele, Lopatin, Yury, Lund, Lar, Savarese, Gianluigi, Čelutkienė, Jelena, Cowie, Martin, Lambrinou, Ekaterini, Ray, Robin, Lainscak, Mitja, Skouri, Hadi, Wallner, Marku, and Rosano, Giuseppe M C
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Heart Failure ,Certification ,Europe ,Humans ,Societies, Medical ,Cardiology ,Quality of patient-centred ,Heart failure ,Medical and Health Sciences ,Comprehensive educational programme ,Medical ,Quality of care centres ,Clinical Medicine ,Societies - Abstract
Heart failure (HF) is a devastating chronic and disabling disease with a wide variety of pharmaceutical and device treatment options which are becoming increasingly complex to implement. According to the Heart Failure Association (HFA) Atlas, a subspeciality resource aimed at sourcing contemporary data concerning the epidemiology and healthcare resources for HF, HF is prevalent in17.20 patients per1000 persons, accounting for 2671HFhospitalizations per million inhabitants annually in Europe.1HFpatients also suffer from a high prevalence of non-cardiac comorbidities, which adds complexity to their HF treatment and can negatively impact prognosis.2As a result, HF-related healthcare expenditure continues to rise, and healthcare organizations are becoming faced with the impossible challenge to provide the necessary financial and logistical support to this growing number of patients. In order to address these challenges, the HFA recently outlined the development of quality of care centres (QCC), in order to encourage multidisciplinary management of HF that will improve quality of care and survival.3However, there remains a significant unmet need to train sufficient multidisciplinary teams lead by HF specialists to take care of this expanding group of HF patients. In order to ensure that the next generation of medically-qualified HF specialists will receive high-quality training, this consensus statement of the HFA outlines the requirements for a European training and certification programme for such specialists. The primary goal of this comprehensive educational programme is to increase the quality of patient-centred care related to HF.
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- 2022
49. Preventing heart failure: a position paper of the Heart Failure Association in collaboration with the European Association of Preventive Cardiology.
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Piepoli, Massimo F., Adamo, Marianna, Barison, Andrea, Bestetti, Reinaldo B., Biegus, Jan, Böehm, Michael, Butler, Javed, Carapetis, Jonathan, Ceconi, Claudio, Chioncel, Ovidiu, Coats, Andrew, Crespo‐Leiro, Maria G., de Simone, Giovanni, Drexel, Heinz, Emdin, Michele, Farmakis, Dimitros, Halle, Martin, Heymans, Stephane, Jaarsma, Tiny, and Jankowska, Ewa
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- *
PATIENT readmissions , *RATINGS of hospitals , *CARDIOLOGY , *HEART failure - Abstract
The heart failure epidemic is growing and its prevention, in order to reduce associated hospital readmission rates and its clinical and economic burden, is a key issue in modern cardiovascular medicine. The present position paper aims to provide practical evidence-based information to support the implementation of effective preventive measures. After reviewing the most common risk factors, an overview of the population attributable risks in different continents is presented, to identify potentially effective opportunities for prevention and to inform preventive strategies. Finally, potential interventions that have been proposed and have been shown to be effective in preventing heart failure are listed. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
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50. The metabolic exercise test data combined with Cardiac And Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study
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Corrà, Ugo, Agostoni, Piergiuseppe, Giordano, Andrea, Cattadori, Gaia, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Federica, Re, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magri', Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Mezzani, Alessandro, Scrutinio, Domenico, Di Lenarda, Andrea, Ricci, Roberto, Apostolo, Anna, Iorio, Anna Maria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, Giannuzzi, Pantaleo, Piepoli, Massimo F., MECKI ScoreResearch Group, Other Members of the MECKI Score research Group, Antonioli, L., Segurini, C., Bertella, E., Farina, S., Bovis, F., Pietrucci, F., Malfatto, G., Roselli, T., Buono, A., Calabrò, R., De Maria, R., Santoro, D., Campanale, S., Caputo, D., Bertipaglia, D., Berton, E., Corrà, Ugo, Agostoni, Piergiuseppe, Giordano, Andrea, Cattadori, Gaia, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magrì, Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Mezzani, Alessandro, Scrutinio, Domenico, DI LENARDA, Andrea, Ricci, Roberto, Apostolo, Anna, Iorio, Anna Maria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, Giannuzzi, Pantaleo, Piepoli, Massimo F., Corra, U., Agostoni, P., Giordano, A., Cattadori, G., Battaia, E., La Gioia, R., Scardovi, A. B., Emdin, M., Metra, M., Sinagra, G., Limongelli, G., Raimondo, R., Re, F., Guazzi, M., Belardinelli, R., Parati, G., Magri, D., Fiorentini, C., Cicoira, M., Salvioni, E., Giovannardi, M., Veglia, F., Mezzani, A., Scrutinio, D., Di Lenarda, A., Ricci, R., Apostolo, A., Iorio, A. M., Paolillo, S., Palermo, P., Contini, M., Vassanelli, C., Passino, C., Giannuzzi, P., Piepoli, M. F., Corrà, U, Agostoni, P, Giordano, A, Cattadori, G, Battaia, E, La Gioia, R, Scardovi, A, Emdin, M, Metra, M, Sinagra, G, Limongelli, G, Raimondo, R, Re, F, Guazzi, M, Belardinelli, R, Parati, G, Magrì, D, Fiorentini, C, Cicoira, M, Salvioni, E, Giovannardi, M, Veglia, F, Mezzani, A, Scrutinio, D, Di Lenarda, A, Ricci, R, Apostolo, A, Iorio, A, Paolillo, S, Palermo, P, Contini, M, Vassanelli, C, Passino, C, Giannuzzi, P, and Piepoli, M
- Subjects
Male ,medicine.medical_treatment ,Predictive Value of Test ,030204 cardiovascular system & hematology ,Kidney Function Tests ,Severity of Illness Index ,0302 clinical medicine ,score ,030212 general & internal medicine ,Heart transplantation ,education.field_of_study ,Ejection fraction ,Heart Function Test ,Stroke volume ,Middle Aged ,Prognosis ,Predictive value of tests ,Heart Function Tests ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Human ,medicine.medical_specialty ,Prognosi ,Population ,Renal function ,Heart failure ,Prognosis, score ,Lower risk ,Follow-Up Studie ,03 medical and health sciences ,Oxygen Consumption ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,medicine (all) ,education ,Aged ,Kidney Function Test ,business.industry ,heart failure ,prognosis, score ,aged ,exercise test ,female ,follow-up studies ,heart function tests ,heart transplantation ,humans ,kidney function tests ,male ,middle aged ,oxygen consumption ,predictive value of tests ,prognosis ,severity of illness index ,stroke volume ,cardiology and cardiovascular medicine ,Stroke Volume ,medicine.disease ,Exercise Test ,Follow-Up Studies ,Heart Failure ,Heart Transplantation ,business - Abstract
Background The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet in Renal Disease (MDRD) equation, left ventricle ejection fraction (LVEF), percentage of predicted peak oxygen consumption (VO2) and VE/VCO2 slope. Objectives MECKI score must be generalizable to be considered useful: therefore, its performance was validated in a new sequence of HF patients. Methods Both the development (MECKI-D) and the validation (MECKI-V) cohorts were composed of consecutive HF patients with LVEF < 40% able to perform a symptom-limited cardiopulmonary exercise testing. The CVM or uHT rates were analyzed at one, two and three years in both cohorts: all patients with a censoring time shorter than the scheduled follow-up were excluded, while those with events occurring after 1, 2 and 3 years were considered as censored. Results MECKI-D and MECKI-V consisted of 2009 and 992 patients, respectively. MECKI-V patients had a higher LVEF, higher peak VO2 and lower VE/VCO2 slope, higher prescription of beta-blockers and device therapy: after the 3-year follow-up, CVM or uHT occurred in 206 (18%) MECKI-D and 44 (13%) MECKI-V patients (p < 0.000), respectively. MECKI-V AUC values at one, two and three years were 0.81 ± 0.04, 0.76 ± 0.04, and 0.80 ± 0.03, respectively, not significantly different from MECKI-D. Conclusions MECKI score preserves its predictive ability in a HF population at a lower risk.
- Published
- 2016
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