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A PRELIMINARY SURVEY OF BARRIERS FACED BY CARDIOLOGISTS IN THE DIAGNOSIS AND MANAGEMENT OF HEART FAILURE WITH PRESERVED EJECTION FRACTION IN OLDER ADULTS
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Abstract
Background: Heart failure with preserved ejection fraction (HFpEF) is a complex cardiovascular syndrome associated with a high burden of adverse clinical outcomes. However, the diagnosis and management of HFpEF remain challenging due to heterogeneous clinical phenotypes and limited evidence-based therapeutic options, particularly in older adults. Therefore, identifying and evaluating barriers to the diagnosis and treatment of HFpEF is essential to inform appropriate strategies for clinical training and practice. Objective: To survey cardiologists regarding perceived barriers to the diagnosis and management of HFpEF in older adults. Methods: A structured questionnaire was developed based on a comprehensive review of the relevant literature. The survey instrument consisted of 65 multiple-choice questions covering three main domains: (1) diagnosis of HFpEF, (2) management of HFpEF, and (3) geriatric syndromes in older patients with HFpEF. Results: A total of 30 physicians involved in clinical cardiology practice were surveyed, of whom 53.3% were male. The proportions of physicians with <5 years, 5–10 years, and >10 years of clinical experience were 66.7%, 23.3%, and 10.0%, respectively. Five issues achieved unanimous agreement (100% “Yes” responses): (1) early diagnosis of HFpEF facilitates optimization of treatment; (2) the lack of robust evidence from randomized clinical trials represents a major barrier to HFpEF management; (3) treatment should be individualized in HFpEF patients with concomitant geriatric syndromes; (4) dementia or cognitive impairment constitutes a significant obstacle in HFpEF management; and (5) prognostication in older patients with HFpEF remains challenging. Conclusion: This preliminary survey identified key barriers and challenges in the diagnosis and management of HFpEF in older adults. These findings may help inform future educational initiatives and contribute to improving the management of HFpEF in the aging population.
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Keywords
Heart failure with preserved ejection fraction; older adults; barriers.
References
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