Author + information
- Received August 7, 2013
- Revision received October 22, 2013
- Accepted November 12, 2013
- Published online April 1, 2014.
- Andrew P. Ambrosy, MD∗,
- Gregg C. Fonarow, MD†,
- Javed Butler, MD, MPH‡,
- Ovidiu Chioncel, MD§,
- Stephen J. Greene, MD‖,
- Muthiah Vaduganathan, MD, MPH¶,
- Savina Nodari, MD#,
- Carolyn S.P. Lam, MBBS∗∗,
- Naoki Sato, MD††,
- Ami N. Shah, MD‖ and
- Mihai Gheorghiade, MD‖∗ ()
- ∗Department of Medicine, Stanford University School of Medicine, Palo Alto, California
- †Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, Los Angeles, California
- ‡Division of Cardiology, Emory University, Atlanta, Georgia
- §Institute of Emergency for Cardiovascular Diseases Prof. C.C. Iliescu, Cardiology 1, Bucharest, Romania
- ‖Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- ¶Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- #Department of Cardiology, University of Brescia, Brescia, Italy
- ∗∗National University Health Centre, Singapore
- ††Internal Medicine, Cardiology, and Intensive Care Medicine, Nippon Medical School Musashi-Kosugi Hospital, Kanagawa, Japan
- ↵∗Reprint requests and correspondence:
Dr. Mihai Gheorghiade, Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, 201 East Huron, Galter 3-150, Chicago, Illinois 60601.
Heart failure is a global pandemic affecting an estimated 26 million people worldwide and resulting in more than 1 million hospitalizations annually in both the United States and Europe. Although the outcomes for ambulatory HF patients with a reduced ejection fraction (EF) have improved with the discovery of multiple evidence-based drug and device therapies, hospitalized heart failure (HHF) patients continue to experience unacceptably high post-discharge mortality and readmission rates that have not changed in the last 2 decades. In addition, the proportion of HHF patients classified as having a preserved EF continues to grow and may overtake HF with a reduced EF in the near future. However, the prognosis for HF with a preserved EF is similar and there are currently no available disease-modifying therapies. HHF registries have significantly improved our understanding of this clinical entity and remain an important source of data shaping both public policy and research efforts. The authors review global HHF registries to describe the patient characteristics, management, outcomes and their predictors, quality improvement initiatives, regional differences, and limitations of the available data. Moreover, based on the lessons learned, they also propose a roadmap for the design and conduct of future HHF registries.
Dr. Fonarow has received research support from the National Heart, Lung, and Blood Institute (significant), Agency for Healthcare Research and Quality (significant), and Gambro (significant); and is a consultant for Novartis (significant), Medtronic (modest), and Johnson & Johnson (modest). Dr. Butler has received research support from the National Institutes of Health, Health Resources and Services Administration, European Commission, Amgen, Medtronic, Novartis, and Otsuka; and is a consultant for Alere, Bayer, BG Medicine, Celladon, CardioMEMS, Gambro, Medpace, Ono, Reate, Takeda, and Trevena. Dr. Lam has received research support from Boston Scientific, Medtronic, Vifor Pharma, and the National Medical Research Council of Singapore; and is a consultant for Bayer and Novartis. Dr. Sato has received research support from Roche Diagnostics Japan and Otsuka; and is a consultant for Novartis. Dr. Gheorghiade is a consultant for Abbott Laboratories, Astellas, AstraZeneca, Bayer Schering Pharma, Bayer HealthCare, Cardiorentis, CorThera, Cytokinetics, CytoPherx, DebioPharm, Errekappa Terapeutici, GlaxoSmithKline, Ikaria, Intersection Medical, Johnson & Johnson, Medtronic, Merck, Novartis Pharma, Ono Pharma USA, Otsuka Pharmaceuticals, Palatin Technologies, Pericor Therapeutics, Protein Design Laboratories, sanofi-aventis, Sigma Tau, Solvay Pharmaceuticals, Sticares InterACT, Takeda Pharmaceuticals, and Trevena Therapeutics. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 7, 2013.
- Revision received October 22, 2013.
- Accepted November 12, 2013.
- 2014 American College of Cardiology Foundation
- Patient Demographics and Clinical Characteristics
- Initial Clinical Presentation and Classification
- Laboratory, Electrocardiography, and Echocardiography Findings
- Inpatient Management
- Utilization of Evidence-Based Therapies
- In-Hospital and Post-Discharge Outcomes
- Predictors of Morbidity and Mortality
- Impact of Quality Improvement Initiatives
- Limitations of Existing Data and Future Directions