2022 Heart Failure Summit Recap
The number of adults in the United States with heart failure continues to skyrocket, with an estimated 8 million individuals affected by 2030.[i] Heart failure hospitalizes close to 1 million people each year—and nearly 1 in 4 patients face readmission within 30 days of discharge.[ii] What can nurses do to help improve quality of life and reduce the burden on individuals, families, and institutions? This 2022 Heart Failure Summit Recap provides an overview of the latest guidelines and their application in clinical practice.
PCNA’s 3rd annual Heart Failure Summit involved the latest updates to heart failure management, and the interconnectedness of heart failure and cardiometabolic disorders. Presenters utilized case studies to share with participants about the latest guidelines for heart failure disease management, strategies to reduce hospital readmission, impacts of social determinants of health, combination therapy, and the benefits of cardiac rehabilitation programs. Check out the synopsis of the event below, and watch the recorded sessions by faculty members Christina Craigo, MSN, ACNP, AACC, and Anita Rich, DNP, RN, CHFN, CDCES in PCNA’s online learning library.
Christina Craigo, a Nurse Practitioner from Cedars-Sinai in Los Angeles, CA, focused on the new universal definitions of heart failure, updated guidelines for HFrEF and HFpEF, and how to work with patients with low health literacy that are at risk for rehospitalization. (Watch the recording here.)
With up to one-fourth of heart failure patient readmissions avoidable,[iii] it is incumbent on all healthcare professionals to be aware of the strategies and clinical practices that can be applied to help reduce rehospitalizations.
Attendees learned about the rationale behind the updated heart failure guidelines, which now span the entire spectrum of heart failure, and include terminology allowing for more precise communication about the disease. The four stages of heart failure (A through D) currently include primary prevention tactics for those at risk for heart failure, rather than focusing solely on late-stage management.
Additional stratification of the classes of heart failure now allows for more nuanced delineation based on left ventricular ejection fraction (LVEF) percentages. Additionally, current guideline-directed medical therapy (GDMT) is identified for all patients with current or prior heart failure—no matter the ejection fraction.
The presentation also included an overview of pharmacotherapies recommended for various classes of heart failure, as well as information on drugs that can worsen heart failure.
The final portion of the presentation focused on effective education about heart failure, and how patient outcomes can be improved when effective strategies are utilized to increase patient and family understanding at the time of hospital discharge. This is of particular importance when working with those who have low health literacy. Ensuring that adequate time is dedicated to patient education is a key factor: less than half of the time, heart failure patients receive 60 minutes of education about their disease.[iv]
Anita Rich, Heart Failure Coordinator and Diabetes Care and Education Specialist at Emory Johns Creek Hospital in Georgia, discussed the connections between cardiometabolic disorders and heart failure including pathophysiology, non-pharmacologic and pharmacologic management, behavior change strategies, and health disparities affecting those at risk for, or with, the disease. (Watch the recording here.)
Studies have shown that there are significant differences in the identification and treatment of heart failure for women and those of racial and ethnic minorities.[v],[vi] From increased rates of mortality following hospitalization for heart failure, and quality of life, to implicit as well as explicit biases in health care professional decision-making and representation in clinical trials, the impacts of these differences can impact both short- and long-term patient outcomes.
The rate of obesity worldwide continues to climb and is an important comorbid condition in those with heart failure. Visceral fat is a metabolically active tissue that produces various pro-inflammatory and pro-thrombotic cytokines, which can have a substantial impact on the physiology of those with overweight/obesity. Using a combination of behavior change, pharmacotherapies, and surgical techniques as needed, individuals with heart failure can reach and maintain a healthy weight and have a higher quality of life.
‘Diabesity’—combined adverse health effects from both obesity and diabetes—impacts up to 33% of patients with HFpEF.[vii] Just as obesity continues to climb globally, diabetes is also on a steep increase and is a contributor to the development of heart failure through a variety of mechanisms. In those over 65 with type 2 diabetes, once heart failure is established, mortality risk increases tenfold, and five-year survival drops to 12.5%.[viii]
More detailed information about these topics is available by watching the recorded sessions on PCNA’s online learning library.
This informative program highlights the impact that nurses play on quality of life and improved outcomes for patients with every stage of heart failure, thanks to the educator aspect of nurses’ roles and responsibilities to patients and their family members. Lifelong learning is essential to continuing to update healthcare professional knowledge and skills, with the goal of ensuring that patients and families receive the most up-to-date GDMT and education, and effective partnership with the healthcare team.
PCNA’s 4th annual Heart Failure Summit is slated for late 2023. PCNA is grateful to the 2022 Heart Failure Summit sponsors, Abbott Laboratories, Merck Sharpe & Dohme Corp., Novartis Pharmaceuticals Corporation, and Pfizer-Merck Alliance, for showing their support of the role that nurses play in the education and management of this vulnerable patient population.
[i] Virani SS, Alonso A, Aparicio HJ, et al; on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2021 update: a report from the American Heart Association. Circulation. 2021;143:e254–e743. doi: 10.1161/CIR.0000000000000950
[ii] Dharmarajan K, Hsieh AF, Lin Z., et al. Diagnoses and timing of 30-day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia. JAMA. 23 January 2013;309(4):355-63. doi: 10.1001/jama.2012.216476
[iii] Khan MS, Sreenivasan J, Lateef N, et al. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circulation: Heart Failure. 2021;14:e08335. doi: 10.1161/CIRCHEARTFAILURE.121.008335
[iv] Ranasinghe I., et al., (2014). Readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia among young and middle-aged adults: A retrospective observational cohort study PLOS Medicine, 11(9), e100173. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001737
[v] Mwansa H, Lewsey S, Mazimba S, Breathett K. Racial/Ethnic and Gender Disparities in Heart Failure with Reduced Ejection Fractino. Curr Heart Fail Rep. 2021;18(2):41-51. doi: 10.1007/s11897-021-00502-5
[vii] Ng A, Delgado V, Borlaug BA, Bax JJ. Diabesity: the combined burden of obesity and diabetes on heart disease and the role of imaging. Nature Reviews Cardiology. 2021;18:291-304.
[viii] Dunlay SM, Giverts MM, Aquilar D, et al. Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement from the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC/AHA/HFSA heart failure guideline update. Circ. 2019;140(7):e294-e234. doi: 10.1161/CIR.0000000000000691