PMID- 25733185
OWN - NLM
STAT- MEDLINE
DCOM- 20160225
LR  - 20200225
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 38
IP  - 4
DP  - 2015 Apr
TI  - Treatment of heart failure in real-world clinical practice: findings from the 
      REFLECT-HF registry in patients with NYHA class II symptoms and a reduced 
      ejection fraction.
PG  - 200-7
LID - 10.1002/clc.22375 [doi]
AB  - BACKGROUND: Optimal medical therapy (OMT) for patients with chronic heart failure 
      and a reduced ejection fraction (HF-REF) includes angiotensin-converting enzyme 
      inhibitors/angiotensin receptor blockers, beta-blockers, and mineralocorticoid 
      receptor antagonists, plus a diuretic. HYPOTHESIS: We hypothesized that OMT is 
      less often prescribed in HF-REF patients (</=35%) with New York Heart Association 
      (NYHA) class II symptoms compared with those with NYHA class III/IV symptoms. 
      METHODS: This was a cross-sectional, observational, multicenter survey of 
      hospital-based cardiologists, office-based cardiologists, and general 
      practitioners in Germany. RESULTS: Out of a total of 384 patients enrolled, 144 
      had REF </=35%. Patients with REF had NYHA class II symptoms in 39.6% (n = 57) and 
      NYHA class III/IV symptoms in 60.4% (n = 87). The REF/NYHA class II group had a 
      higher proportion of males than the REF/NYHA class III/IV group. For 
      angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and 
      beta-blockers, prescription rates were high and comparable between groups. However, 
      prescription rates for mineralocorticoid receptor antagonists were lower compared 
      with other guideline-recommended treatments. Multivariate analyses indicated that 
      OMT prescription was reduced for older patients and increased for patients cared 
      for by an office-based cardiologist. CONCLUSIONS: Given the high proportion of 
      patients with reduced left ventricular systolic function but only minor symptoms, 
      HF-REF appears to be underdiagnosed, and a higher proportion of patients than are 
      currently recognized could potentially be candidates for OMT.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Bohm, Michael
AU  - Bohm M
AD  - Internal Medicine Clinic III, Saarland University Medical Center, Homburg/Saar, 
      Germany.
FAU - Tschope, Carsten
AU  - Tschope C
FAU - Wirtz, Jost Henner
AU  - Wirtz JH
FAU - Lokies, Jan
AU  - Lokies J
FAU - Turgonyi, Eva
AU  - Turgonyi E
FAU - Bramlage, Peter
AU  - Bramlage P
FAU - Lins, Katharina
AU  - Lins K
FAU - Strunz, Anke M
AU  - Strunz AM
FAU - Tebbe, Ulrich
AU  - Tebbe U
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20150302
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Adrenergic beta-Agonists)
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Diuretics)
SB  - IM
MH  - Adrenergic beta-Agonists/*therapeutic use
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiotensin Receptor Antagonists/*therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Cross-Sectional Studies
MH  - Diuretics/*therapeutic use
MH  - Female
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Physicians
MH  - Registries
MH  - Stroke Volume/*physiology
MH  - Surveys and Questionnaires
PMC - PMC6710999
EDAT- 2015/03/04 06:00
MHDA- 2016/02/26 06:00
PMCR- 2015/03/02
CRDT- 2015/03/04 06:00
PHST- 2014/10/03 00:00 [received]
PHST- 2014/11/18 00:00 [revised]
PHST- 2014/11/22 00:00 [accepted]
PHST- 2015/03/04 06:00 [entrez]
PHST- 2015/03/04 06:00 [pubmed]
PHST- 2016/02/26 06:00 [medline]
PHST- 2015/03/02 00:00 [pmc-release]
AID - CLC22375 [pii]
AID - 10.1002/clc.22375 [doi]
PST - ppublish
SO  - Clin Cardiol. 2015 Apr;38(4):200-7. doi: 10.1002/clc.22375. Epub 2015 Mar 2.