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HF management in real-world clinical practice (s.2-p.1)

Ladies and gentleman. It’s my great honor and privilege to welcome everybody here for this revolutionary heart failure educational program. This is the first webinar in this series and together with me – my name is Ewa Jankowska. I work with Wroclaw Medical University. There is a group of excellence experts in the field of heart failure.

As you can see we have excellent experts coming from all over the world. We will be discussing real world evidence when we are regarding the epidemiology and treatment of patients with heart failure. Frankly to identify the gaps and during the second part of this webinar, we will present you the results of the two surveys that have been executed by a number of physicians and patients to try to identify the educational needs and guess. So without further delay I would like to invite Shelley zeroots a lot of Sloan and Mission who will discuss the real world heart failure management Global all of you.

Welcome to real world heart failure management – a global overview. I’m Shelley Zieroth from Winnipeg Canada and I’m going to speak to you about the new universal definition and classification of heart failure.These are my disclosures. Well, the universal definition and classification of heart failure was a joint endeavor by the heart failure society of America, the ESC heart failure association, and the Japanese heart failure society. I’m proud to say that the Canadian heart failure society also endorsed this and this was an important consensus document to provide a simple clinically relevant and conceptual comprehensive definition of heart failure, and it was chaired by the masterful Professor Biykem Bozkurt along with Andrew Coats and Professor Tsutsui.

This is the universal definition and classification of heart failure. It requires symptoms and/or signs of heart failure caused by structural and or functional cardiac abnormalities, including valvular heart disease and LVH for example, and it must be corroborated by at least one of the following, including elevated natural peptide levels or objective evidence of cardiogenic pulmonary or systemic congestion. You can see them defined on the left hand side of this panel as well.

These are the new heart failure stages including stage A those individuals at risk for heart failure. And this would include people with hypertension diabetes, obesity, cardiovascular disease, exposure to cardiotoxins, and a family history of heart failure as well.Then we progress to Stage B those individuals without symptoms but evidence of structural heart disease. Stage C – we see in many of our heart failure clinics those individuals with symptomatic heart failure and then finally – stage D; those individuals with the most severe refractory symptoms related to heart failure. I think this is an important element of the new universal definition: the classification by left ventricular ejection fraction.

We’re all very familiar with hefref being defined as an ejection fraction less than or equal to 40%mildly reduced injection fraction is getting a lot of attention these days and is defined as those individuals with an injection fraction between 41 and 49% half with an injection fraction of greater than or equal to 50%. Then heart failure with improved ejection fraction – something that we strive for in all of our hephraff patients is defined as those individuals with an ejection fraction at baseline of less than 40% who then have a sustained 10-point increase from baseline in their injection fraction on a second measurement, and with that I’m going to turn it over to Professor Lund who will be speaking to you about global epidemiology and the burden of heart failure.