Feature

Q&A: HF Awareness Week spotlights recent advances in treatment, new research

Biykem Bozkurt

Sunday marked the start of national Heart Failure Awareness Week, a campaign with the aim of promoting not only heart health, but awareness of the sometimes-subtle signs and symptoms of HF.

In recognition, the Heart Failure Society of America has launched the Do Your Part, Know Your Heart initiative to improve awareness and educate individuals on how to better care for their heart health.

Healio corresponded with HFSA President Biykem Bozkurt, MD, PhD, FHFSA, FACC, FAHA, FESC, director of the Winters Center for Heart Failure, associate director of the Cardiovascular Research Institute, vice chair of medicine at Baylor College of Medicine and Medical Care Line executive at the DeBakey VA Medical Center, regarding the organization’s goals for Heart Failure Awareness Week, as well as the direction of future HF research.

 

What is the aim of Heart Failure Awareness Week?

Heart Failure Awareness Week is the time of the year where the Heart Failure Society of America asks the public and related organizations to take action to promote HF awareness, patient education and HF prevention. The Do Your Part, Know Your Heart campaign is an HF awareness initiative that encourages individuals to take an active role in maintaining their heart health. The campaign aims to promote self-health awareness by encouraging regular checkups, educating about the signs and symptoms of HF, providing information on diet and exercise and stressing the importance of regular screenings. Do Your Part, Know Your Heart seeks to make living with HF less of a challenge, and arms patients with the information and resources they need to take control of their heart health.

 

Why is this important?

Building HF awareness is important because over 6.5 million Americans are living with HF and over 960,000 new HF cases are diagnosed each year. Symptoms, including difficulty breathing, coughing, swelling of feet, ankles or legs, and fatigue, can be subtle and are often mistaken for other diagnoses or signs of aging. We feel that it’s critical to share information on these symptoms and risk factors and encourage people to visit their doctor if these symptoms arise. HF is preventable and treatable. It is critical to have a timely diagnosis and be initiated on appropriate treatment strategies and lifestyle modifications that can lead to better outcomes and a better quality of life.

 

What notable advances in HF research have come in the past year?

There are newer treatment strategies resulting in prevention of HF among patients who are at risk for HF, and improvement in outcomes in patients with HF. For example, there are significant benefits with SGLT2 inhibitors. The use of these medications among patients with diabetes has been associated with reduction in future development of HF; and recently, SGLT2 inhibitors have been reported to result in improvement in clinical outcomes among patients with established HF with reduced ejection fraction, even without diabetes.

There are also evolving treatment strategies with percutaneous transcatheter device interventions in patients with valvular heart disease, such as those with moderate to severe mitral regurgitation or severe aortic stenosis and with management of atrial fibrillation in patients with HF. There is a recent study that reported benefit with a novel oral soluble guanylate cyclase stimulating agent in patients with HFrEF.

These are exciting developments in our field. Of course, we also have advances in development of multidisciplinary heart teams for management of patients requiring percutaneous circulatory support devices and improvement in clinical outcomes and complications with newer durable mechanical circulatory support devices in patients with advanced HF.

 

What shortcomings in research or treatment still need to be addressed?

There are significant unmet needs in the field of HF. First, there is a need for improvement in public awareness of HF. Contrary to misperceptions, HF is common, preventable and treatable. It is not always an end-stage disease, and it does not mean the heart is falling apart or irreversibly failing. There are different types of HF, those ranging from diseases and injury to the heart muscle to systemic illnesses resulting in reduction in pumping function of the heart, called HFrEF; to HF with preserved pumping function or HF with preserved ejection fraction, in which the pumping may seemingly be preserved, but the heart may be stiff and not fill well. In this spectrum, patients may be at risk for HF, asymptomatic, mildly or moderately symptomatic or with advanced symptoms, which we categorize as stages of HF. Prognosis can vary according to symptoms and stages. In early stages, we need preventive and appropriate treatment strategies to be implemented by all clinicians. In patients with symptoms, there is a huge gap in optimization of guideline-directed therapies. Treatment needs to be optimized to recommended doses by all clinicians. In advanced stages, there is a need for specialist involvement. Throughout the journey, there is a need for timely assessment of patient’s goals, needs and preferences and tailoring therapies to these goals of care. We also need appropriate performance measures that are evidence-based and patient-centric. Current measures focus on administrative processes rather than patient’s journey or care. Finally, we need new and effective treatment strategies to be developed for HFpEF, as in this area we do not have any therapies associated with improvement in survival; and also we need screening strategies for patients at risk for development or worsening of HF and processes for individualization and precision of treatment to etiology, underlying pathophysiology, tolerability and preference. – by Scott Buzby

For more information:
Biykem Bozkurt, MD, PhD, FHFSA, FACC, FAHA, FESC, can be reached at 2002 Holcombe Blvd., Houston, TX 77030; email: bbozkurt@bcm.edu.

Disclosure: Bozkurt reports that she is a consultant for Amgen, Baxter Healthcare, Bristol-Myers Squibb, Relypsa, Respicardia Registry Steering Committee, Sanofi Aventis and scPharmaceuticals; serves on the clinical events committee for Abbott Vascular and the data safety monitoring committee of Anthem DSMC CCS; and is a senior associate editor for Circulation.

Biykem Bozkurt

Sunday marked the start of national Heart Failure Awareness Week, a campaign with the aim of promoting not only heart health, but awareness of the sometimes-subtle signs and symptoms of HF.

In recognition, the Heart Failure Society of America has launched the Do Your Part, Know Your Heart initiative to improve awareness and educate individuals on how to better care for their heart health.

Healio corresponded with HFSA President Biykem Bozkurt, MD, PhD, FHFSA, FACC, FAHA, FESC, director of the Winters Center for Heart Failure, associate director of the Cardiovascular Research Institute, vice chair of medicine at Baylor College of Medicine and Medical Care Line executive at the DeBakey VA Medical Center, regarding the organization’s goals for Heart Failure Awareness Week, as well as the direction of future HF research.

 

What is the aim of Heart Failure Awareness Week?

Heart Failure Awareness Week is the time of the year where the Heart Failure Society of America asks the public and related organizations to take action to promote HF awareness, patient education and HF prevention. The Do Your Part, Know Your Heart campaign is an HF awareness initiative that encourages individuals to take an active role in maintaining their heart health. The campaign aims to promote self-health awareness by encouraging regular checkups, educating about the signs and symptoms of HF, providing information on diet and exercise and stressing the importance of regular screenings. Do Your Part, Know Your Heart seeks to make living with HF less of a challenge, and arms patients with the information and resources they need to take control of their heart health.

 

Why is this important?

Building HF awareness is important because over 6.5 million Americans are living with HF and over 960,000 new HF cases are diagnosed each year. Symptoms, including difficulty breathing, coughing, swelling of feet, ankles or legs, and fatigue, can be subtle and are often mistaken for other diagnoses or signs of aging. We feel that it’s critical to share information on these symptoms and risk factors and encourage people to visit their doctor if these symptoms arise. HF is preventable and treatable. It is critical to have a timely diagnosis and be initiated on appropriate treatment strategies and lifestyle modifications that can lead to better outcomes and a better quality of life.

 

PAGE BREAK

What notable advances in HF research have come in the past year?

There are newer treatment strategies resulting in prevention of HF among patients who are at risk for HF, and improvement in outcomes in patients with HF. For example, there are significant benefits with SGLT2 inhibitors. The use of these medications among patients with diabetes has been associated with reduction in future development of HF; and recently, SGLT2 inhibitors have been reported to result in improvement in clinical outcomes among patients with established HF with reduced ejection fraction, even without diabetes.

There are also evolving treatment strategies with percutaneous transcatheter device interventions in patients with valvular heart disease, such as those with moderate to severe mitral regurgitation or severe aortic stenosis and with management of atrial fibrillation in patients with HF. There is a recent study that reported benefit with a novel oral soluble guanylate cyclase stimulating agent in patients with HFrEF.

These are exciting developments in our field. Of course, we also have advances in development of multidisciplinary heart teams for management of patients requiring percutaneous circulatory support devices and improvement in clinical outcomes and complications with newer durable mechanical circulatory support devices in patients with advanced HF.

 

What shortcomings in research or treatment still need to be addressed?

There are significant unmet needs in the field of HF. First, there is a need for improvement in public awareness of HF. Contrary to misperceptions, HF is common, preventable and treatable. It is not always an end-stage disease, and it does not mean the heart is falling apart or irreversibly failing. There are different types of HF, those ranging from diseases and injury to the heart muscle to systemic illnesses resulting in reduction in pumping function of the heart, called HFrEF; to HF with preserved pumping function or HF with preserved ejection fraction, in which the pumping may seemingly be preserved, but the heart may be stiff and not fill well. In this spectrum, patients may be at risk for HF, asymptomatic, mildly or moderately symptomatic or with advanced symptoms, which we categorize as stages of HF. Prognosis can vary according to symptoms and stages. In early stages, we need preventive and appropriate treatment strategies to be implemented by all clinicians. In patients with symptoms, there is a huge gap in optimization of guideline-directed therapies. Treatment needs to be optimized to recommended doses by all clinicians. In advanced stages, there is a need for specialist involvement. Throughout the journey, there is a need for timely assessment of patient’s goals, needs and preferences and tailoring therapies to these goals of care. We also need appropriate performance measures that are evidence-based and patient-centric. Current measures focus on administrative processes rather than patient’s journey or care. Finally, we need new and effective treatment strategies to be developed for HFpEF, as in this area we do not have any therapies associated with improvement in survival; and also we need screening strategies for patients at risk for development or worsening of HF and processes for individualization and precision of treatment to etiology, underlying pathophysiology, tolerability and preference. – by Scott Buzby

For more information:
Biykem Bozkurt, MD, PhD, FHFSA, FACC, FAHA, FESC, can be reached at 2002 Holcombe Blvd., Houston, TX 77030; email: bbozkurt@bcm.edu.

Disclosure: Bozkurt reports that she is a consultant for Amgen, Baxter Healthcare, Bristol-Myers Squibb, Relypsa, Respicardia Registry Steering Committee, Sanofi Aventis and scPharmaceuticals; serves on the clinical events committee for Abbott Vascular and the data safety monitoring committee of Anthem DSMC CCS; and is a senior associate editor for Circulation.