For some time, the heart failure community has been warning of an impending storm brewing before public health’s doorsteps and calling for greater management focus, despite rallying cries. With the aging U.S. population, the prevalence of heart failure is expected to increase in the coming years, and heart failure fellowships are filling at an alarming rate, leaving many in the field wondering if they are fully qualified. I’m worried we’re headed for a storm. wreaking havoc on public health.

Setting aside the concerns of those who fill fellowship slots, advanced heart failure and transplant specialists currently in clinical practice face increasing concerns as the population ages, especially as heart failure, which has a devastating impact on cognitive impairment. could have consequences. The American Heart Failure Association highlights this issue and how it affects the management of heart failure in its latest scientific statement.

The 17-page document, published on March 12, 2024, cites 142 references and is divided into five sections covering the following subjects: Risk factors for cognitive impairment; Impact of cognitive impairment; , managing cognitive impairments, and integrating cognitive impairments into decision-making. , knowledge gaps and implementation challenges. In addition to calling attention to the prevalence of cognitive impairment in this patient population, this document also provides an overview of recommended screening tools and practices based on contemporary literature.

This HCPLive peer-to-peer discussion will focus on perspectives from three subject matter experts: Eilan Gorodeski, MD, MPH, Parag Goyal, MD, MS, and James Fang, MD. The conversation will be moderated by Hwang, who is also president of the Heart Failure Association of America, and will guide Gorodeski and Goyal, who served as the lead co-authors of the statement, through a discussion about the writing process. We discuss key points, the complexities of heart failure management in cognitively impaired patients, and the role of the American Heart Failure Association and other professional organizations in helping clinicians incorporate changes and recommendations into these types of documents.

Discussion guest:

Eilan Gorodeski, MD, MPHdirector of the Center for Advanced Heart Failure and Transplantation at the University Hospital Health System’s Harrington Heart and Vascular Institute, chief of the division of advanced heart failure in the Department of Cardiovascular Medicine, and professor of medicine at Case Western Reserve University.

Parag Goyal, MD, M.S.co-author of the statement, associate professor of medicine, founding director of the Preserved Ejection Fraction Heart Failure Program, and director of the Cardiac Amyloidosis Program at Weill Cornell Medicine.

Dr. James Fang, President of the American Heart Failure Association, Chief of Cardiovascular Medicine at the University of Utah School of Medicine, and Director of the Cardiovascular Service Line at the University of Utah Health Care.

Gorodeski’s relevant disclosures include Dynamed Plus. Goyal-related disclosures include Agepha, Axon, and Sensorum Health. Disclosures related to Fang include Amgen, AstraZeneca, Boehringer Ingelheim, Novartis and others.

References:

1. ^{Bozkurt B, Ahmad T, Alexander KM et al. Heart failure epidemiology and outcome statistics: a report of the American Heart Failure Association. J card fail. 2023;29(10):1412-1451. doi:10.1016/j.cardfail.2023.07.006}
2. ^{Goyal P, DiDomenico RJ, Pressler SJ, Allen LA, Gorodeski EZ. Cognitive impairment in heart failure: American Heart Failure Association scientific statement. heart failure journal. Published online March 12, 2024. doi:10.1016/j.cardfail.2024.01.003}