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Nauli SE, Prima Putri VK, Arifianto H, Prameswari HS, Lubis AC, Zulkarnain E, Hasanah DY, Dewi Yamin PP, Dewi TI. Heart Failure With Preserved Ejection Fraction: Current Status of Daily Clinical Practice in Indonesia. Cureus 2023; 15:e38086. [PMID: 37257168 PMCID: PMC10209474 DOI: 10.7759/cureus.38086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Heart failure (HF) is a clinical syndrome with symptoms and/or signs caused by a structural and/or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion. Among HF types, HF with preserved ejection fraction (HFpEF) is the commonest form. However, the diagnosis and management of HFpEF are challenging. In addition, the perception of healthcare professionals (HCPs) towards the diagnosis and management of HFpEF patients differs due to the existing gap between the guidelines and daily clinical practice. Therefore, an online survey was conducted to understand the HCPs' knowledge and practice gaps in the diagnosis, treatment, and management of patients with HFpEF. Methods A total of 160 respondents, i.e., cardiologists, internists, and cardiology residents from different community-based practices and hospitals across Indonesia participated in an online continuing medical education (CME) survey. A questionnaire was formulated to assess awareness, current practice patterns, challenges, and confidence of the HCPs related to the HFpEF. Results HCPs stated that diagnosis of HF is the prime responsibility of cardiologists and general physicians but not of general internists. According to the HCPs, reduction in mortality, reduction in hospitalization, and improved quality of life are the most important goals of HF treatment. The perceived prevalence of HFpEF is estimated to be 30-60% and mortality rates of HFpEF and HF with reduced ejection fraction (HFrEF) are similar. Further, mixed types of responses with different combinations of diagnosis, treatment, and prevention, were obtained when HCPs were asked about the challenges faced in HFpEF. Among the therapies, angiotensin-converting enzyme (ACE) inhibitors, mineralocorticoid receptor antagonists (MRA), beta-blockers, and diuretics are frequently used for the treatment of HF. Conclusion The perception of the HCPs toward the diagnosis and management of HFpEF may affect optimal care. Based on our findings, the cardiologists are well aware of the current situation of HF in Indonesia and treat patients with HFpEF effectively.
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Affiliation(s)
- Siti E Nauli
- Department of Cardiology, Tangerang District Hospital, Tangerang, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
| | - Vebiona K Prima Putri
- Department of Cardiology, Awal Bros Hospital, Pekanbaru, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
| | - Habibie Arifianto
- Department of Cardiology, Universitas Sebelas Maret Hospital, Surakarta, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
| | - Hawani S Prameswari
- Department of Cardiology, Hasan Sadikin General Hospital, Bandung, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
| | - Anggia C Lubis
- Department of Cardiology, Haji Adam Malik General Hospital, Medan, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
| | - Edrian Zulkarnain
- Department of Cardiology, Mohammad Hoesin General Hospital, Palembang, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
| | - Dian Y Hasanah
- Department of Cardiology, National Cardiovascular Center Harapan Kita, West Jakarta, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
| | - Paskariatne P Dewi Yamin
- Department of Cardiology, Gatot Soebroto Central Army Hospital, Central Jakarta, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
| | - Triwedya I Dewi
- Department of Cardiology, Hasan Sadikin General Hospital, Bandung, IDN
- Working Group on Heart Failure and Cardiometabolic Disease, Indonesian Heart Association, West Jakarta, IDN
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