End Stage Heart Failure - Queensland Health

End Stage Heart Failure

Robyn Peters NP PAH HFS

27/10/2016

Heart Failure

Chronic, progressive disease ? major contributor to morbidity and mortality world-wide1

Most common cause of admissions in those >65 years1

QOL often worse than those with other chronic disease2

Cluster of symptoms and debilitation which worsens with each hospitalisation3

38% die within 1 year of diagnosis and 60% die within 5 years4

1. Stewart et al. 2010 Population impact of heart failure and the most common forms of cancer. Circ cardiovasc qual outcomes 2. Jaarsma et al. 2010 Quality of life and symptoms of depression in advanced heart failure patients and their partners. Curr Opin Support Palliat Care 3. Setoguchi et al. 2007 Repeated hospitalisations predict mortality in the community population with heart failure. Am Heart J 4. NHS information Centre. National Heart Failure Audit 2010

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27/10/2016

HF Terminology based on LVEF.

HFrEF ? Heart Failure with Reduced Ejection

Fraction

EF < 50%

Clear evidence of improved morbidity and mortality

with evidence 5b0%ased therap14i%es

36%

HFpEF ? Heart Failure with Preserved Ejection

Fraction

EF > 50%

Increased filling pressures

Increased Ventricular wall thickness

Ponikowski et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal 2016

Proportion of HFrEF and HFpEF

Definite HFrEF (LVEF ................
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