ArticleEuropean journal of heart failure2025
Knowledge and application of ESC/HFA guidelines in the management of advanced heart failure.
Article in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Duration of heart failure as a determinant of outcomes after left ventricular assist device implantation: an international multicenter study.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Phenotyping of Patients With Clinical Features of Advanced Heart Failure: A Latent Class Analysis of a Multicenter Registry of Patients Hospitalized With Heart Failure.Journal of the American Heart Association · 2026Article
- The Real-World Use of Guideline-Directed Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction Newly Initiated on Dapagliflozin: An EVOLUTION-HF CEE-BA Study (Results from the Baltic Cohort).Medicina (Kaunas, Lithuania) · 2026Article
- Indication for durable mechanical circulatory support: an expert opinion review.ESC heart failure · 2026Review
- Identifying and overcoming barriers to referral in advanced heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC.European journal of heart failure · 2025Review
- Rationale and design of the randomized 'early ventricular assist device'-Trial (VAD-DZHK3).ESC heart failure · 2025Article
- Treatment Inertia Among Elderly Patients with Chronic Heart Failure: A Qualitative Study.Patient preference and adherence · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsManagement of advanced heart failure (HF) remains challenging despite specific sections in the 2021 European Society of Cardiology/Heart Failure Association (ESC/HFA) guidelines, with delays in referrals exacerbating the issue. This study aimed to evaluate the awareness and implementation of these guidelines among cardiologists and identify barriers to effective referral. METHODS AND
resultsFrom June to October 2023, an online survey was disseminated through the ESC mailing list, targeting cardiologists across Europe. The survey investigated four areas: guideline awareness, healthcare network organization, clinical case management, and perceptions of mechanical circulatory support (MCS) outcomes. Respondents were categorized into heart failure cardiologists (HFCs), general cardiologists (GCs), and other participants (OPs). Among 497 respondents, 25% were heart HFCs, 40% were GCs, and 35% were OPs. A total of 84% of HFCs reported a high level of guideline knowledge, compared to 57% of GCs and 62% of OPs (p < 0.001). Additionally, 76% of HFCs 'regularly or always' used ESC/HFA criteria to identify advanced HF, compared to 44% of GCs and 48% of OPs (p < 0.001). Correct responses regarding the recommendation class for heart transplantation were 84%, 55%, and 60% (p < 0.0001), and for MCS as a bridge to transplantation, 69%, 65%, and 55% (p = 0.018) among HFCs, GCs, and OPs, respectively. Referring patients with severe HF to a tertiary centre team was found to be 'very difficult' or 'difficult' by 8.4% of HFCs, 19.6% of GCs, and 18.2% of OPs (p = 0.0005).
conclusionThe study highlights significant disparities in knowledge and application of advanced HF guidelines among cardiologists, revealing an opportunity for educational initiatives. The difficulty in referring patients to tertiary centres underscores the need to improve the referral pathway for advanced HF patients.
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