2023-10-27 15:47:05
by Health Editorial Staff
The focus on prevention and new therapies at a convention of hospital cardiologists in Milan. With a therapeutic scheme that includes new drugs, started after the age of 55, the patient could be guaranteed eight years of extra life; after the age of 65 six years more
Heart failure, a chronic disease on the rise, affects 15 million people in Europe, over one million Italians, of which approximately 20 percent are over 80 years old. In our country it is the main cause of hospitalization for people over 65 years of age.
If not adequately treated, heart failure worsens over time, resulting in death in 50 percent of patients within five years of diagnosis. To take stock of prevention and new therapies, the cardiologists of ANMCO – National Association of hospital cardiologists organized a national convention «ANMCO 2023 Heart Failure Centers» in Milan on 27 and 28 October.
The illness
Heart failure is caused by the inability of the heart to carry out the normal contractile pump function and to guarantee the correct blood supply to all organs which, therefore, receive insufficient quantities of oxygen for their metabolic needs leading to an accumulation of liquids in the lungs and tissues.
In the early stage the disease can be asymptomatic and not always easily diagnosable but. as time passes, the symptoms tend to worsen.
It is a particularly complex clinical syndrome that may expose you to an increased risk of life-threatening arrhythmias and sudden death.
New therapeutic scenarios
The president of ANMCO Fabrizio Oliva, director of Cardiology 1 of the Niguarda Hospital in Milan, explains: «Fortunately, innovation in the medical field is changing the scenario; in recent years, pharmacological therapies and the possibility of non-pharmacological intervention have been implemented in these patients with improved prognosis. If a therapeutic scheme, which includes new drugs, is started after the age of 55, the patient could be guaranteed an extra eight years of life compared to the previous therapy. After the age of 65, a difference of 6 years of additional life could be guaranteed – reports the cardiologist -. In heart failure the concept of “stability” is different from that of “severity”. The patient may be clinically stable, but simultaneously present a high degree of risk of both death and hospitalization; in practice there is no such thing as a low-risk patient: we could say that heart failure is a chronically acute pathology.”
Care paths
How to improve the quality of life of people with heart failure? «It is necessary to implement innovative care models that put the territory in closer contact with the hospital because, even if the patient requires more hospitalizations over the course of the year, the time he will spend at home or in any case in a setting territorial welfare – says Dr. Oliva –. This is why, in addition to optimizing therapy, we must think about organizational optimization for the inclusion of patients in care pathways in order to improve the management and prognosis of these patients, both in terms of hospital admissions and survival.
Imaging techniques
«Another relevant aspect – continues Dr. Oliva – is the definition of the risk of sudden cardiac death in the context of heart failure; in this, advanced imaging techniques can help, especially in the field of echocardiography. Furthermore, in recent years other methods have been added to echocardiography which are used more and more frequently in cardiology, such as magnetic resonance imaging. Over the past few years, a series of new pharmacological and non-pharmacological treatments have become available in the field of heart failure therapy. In the context of trials, some of these therapies have been shown to significantly improve patient outcomes, but in the real world there remain difficulties in their implementation.”
Telemedicine
«One of the aspects to be implemented in the near future, which will allow us to bring the hospital and the territory closer together and the various actors who will be able to guarantee multidisciplinary assistance, is telemedicine – intervenes the vice-president of ANMCO Alessandro Navazio, director of complex cardiology at the Santa Maria Nuova Hospital-IRCCS of Reggio Emilia – . Technology offers us many possibilities for patient care and assistance at home, but we must build organizational models so that the information collected is managed in the best possible way.”
Proximity of care and community homes
Another important aspect is the proximity of care, which should be possible with the creation of community houses in the area. «Innovative care models are needed that bring the family doctor, the cardiologist and all the other professional figures, including the nurse, into closer contact in the area to create a “link” and an effective and immediate response for the patient addressed to the National Health Service – underlines Dr. Navazio –. Today there are the conditions to guarantee patients with heart failure – and in general with chronic pathologies, often present in the same patient – assistance in terms of pharmacological and non-pharmacological therapy which can change the trajectory of the disease, guaranteeing better survival, reduction of hospitalizations and better quality of life. All this must be supported by innovative care models in which the patient can be taken care of in a multidisciplinary and personalized way. Mission 6 of the PNRR offers us this opportunity.”
October 27, 2023 (modified October 27, 2023 | 3:46 pm)
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