Advanced heart failure with reduced ejection fraction

Abstract

Patients suffering advanced heart failure with reduced ejection fraction (HFrEF) account for a large portion of patients admitted to hospitals worldwide. Mortality and 30-day readmission rates for HFrEF are now a focus of value-based payment models, making management of this disease a priority for hospitals, physicians, and payers alike. Angiotensin-converting enzyme inhibitors have been the cornerstone of therapy for decades. However, with treatment, the prognosis for patients with advanced HFrEF remains poor. Fortunately, advances in medical therapy and mechanical support offer some patients improvement in both survival and quality of life. We review advances in short- and long-term mechanical support and explore changes to organ allocation for cardiac transplantation. In addition, we provide a guide to facilitate appropriate referral to an advanced heart failure team.

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    Faculty credentials/disclosure

    Dr. Hicks is interim medical director of advanced heart failure, mechanical circulatory support, and cardiac transplant at Baylor Scott & White in Temple, Texas, and the assistant program director for the cardiology fellowship. Dr. Velazco is director of the cardiothoracic intensive care unit at Baylor Scott & White Medical Center – Temple. Dr. Gohar is medical director of the advanced heart failure and mechanical circulatory support service, Baylor All Saints Medical Center, Fort Worth, Texas. Dr. Seliem is a board-certified interventional cardiologist completing a heart failure fellowship at Baylor University Medical Center at Dallas. Dr. Hall is chief of transplant cardiology, mechanical circulatory support, and advanced heart failure at Baylor University Medical Center at Dallas. Dr. Michel is chief of the division of cardiology at Baylor Scott & White Memorial Hospital, Temple, Texas. Dr. Hall disclosed relationships with Novartis (honorarium/speaker) and CareDx, Abbott, and Abiomed (honorarium/consultant), and Dr. Seliem disclosed a relationship with Abbott (honorarium/speaker). The other authors, reviewers, and editor have no conflicts of interest to disclose.

    Process

    Click the take course button, pay any relevant fee, take the quiz, complete the evaluation, and claim your CME credit.  You must achieve 100% on the quiz with unlimited attempts available.

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    Expiration date

    Credit eligibility for this article is set to expire on July 1, 2022.

    Target Audience

    All physicians and healthcare providers

    Learning Objectives

    After completing the article, the learner should be able to

    • Recognize the poor prognosis of patients with advanced heart failure
    • Distinguish between the different types of mechanical support used to treat patients
    • Select patients who would benefit from referral to advanced heart failure cardiologists
    Course summary
    Available credit: 
    • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2 Medical Knowledge
      Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 Medical Knowledge points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
    • 1.00 AMA PRA Category 1 Credit™
      The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
    • 1.00 Attendance
    Course opens: 
    07/06/2020
    Course expires: 
    07/01/2022
    Cost:
    $25.00
    Rating: 
    0

    Accreditation 

    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Designation

    AMA PRA Category 1 Credit

    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Available Credit

    • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2 Medical Knowledge
      Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 Medical Knowledge points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
    • 1.00 AMA PRA Category 1 Credit™
      The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
    • 1.00 Attendance

    Price

    Cost:
    $25.00
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