“Medical research has made significant progress on heart failure in recent years but a lot of work still needs to be done to raise awareness among the population. Heart failure, in fact, represents the main cause of hospitalization in Italy among those over 65 years of age and involves hospital costs equal to 1.5% of healthcare spending. Technologies help, as in the case of some implantable electrostimulation devices and methods that allow for a heart transplant to be performed safely. At the beginning, the decompensation does not present itself with breathlessness or with swollen legs, but it can cause tiredness and asthenia which people of a certain age tend to consider physiological. In these cases, even the echocardiogram can be of little significance, while only the fingertip test for the evaluation of natriuretic peptides can reveal the presence of decompensation in an early stage.”. This is remembered by the Italian Association of Heart Failure Patients (AISC) which, to shine the spotlight on the importance of cardiovascular rehabilitation in the treatment process, is promoting a conference on 10 April at the IRCCS San Raffaele Montecompatri, entitled 'Rehabilitation in heart failure: a new model built on the patient's needs'.
“Today we have the possibility of adequately treating heart failure, reducing mortality and hospitalizations”, underlines Salvatore Di Somma, director of the Aisc/Aps Scientific Committee, cardiologist, professor of Internal Medicine at the Sapienza University of Rome and president of Great-Italy. “Among the new drugs – he continues -, it is worth highlighting the advent of the Sacubitril-Valsartan* association, in addition to beta-blockers and diuretics. Above all, for a few years now, Sglt2 inhibitors have been made available, hypoglycemic drugs used to control of blood sugar which, in international trials, have also proven effective in heart failure, reducing mortality and hospitalization. The great innovation of these latest drugs is that they are effective in all forms of heart failure, both in the fractional form reduced ejection, both in the form of heart failure with preserved ejection fraction. However, they are not replacement drugs, but additional to existing ones. This creates an additional problem for the patient who will have to add other pills every day, which is why it is important to make it aware of the benefits of taking them, as they improve life expectancy”.
The fundamental step for timely management is early diagnosis. “One of the obstacles – warns Di Somma – is the limited diffusion of the Nt-pro-Bnp or Bnp natriuretic peptide test. These are standard tests that are available in the emergency room to diagnose severe dyspnea, but are also useful for identifying patients with very subtle symptoms. For this reason, it is necessary to use the test with a simple finger prick even in local medicine. As the Italian Association of heart failure patients – announces the professor – we are creating a protocol that provides access to these tests also among general practitioners and pharmacies. This is the basis from which to start to reduce mortality and hospitalizations.”
The public consultation, activated by Agenas, for the drafting of the 'Guideline document containing indications for the promotion of participation and co-production of patients, citizens and the community in the context of community homes' ended a few days ago. . “In these situations – explains Di Somma – there will be general practitioners present 24 hours a day, outpatient specialists and nurses. In the area there will be one structure for every 40 thousand inhabitants. Heart failure is by definition a chronic disease, therefore it is necessary for community homes to become a territorial unit to optimize its management”.
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