Heart failure poses a significant public health challenge due to its high prevalence and the substantial human and financial costs it generates. Furthermore, the lack of clear screening guidelines and challenges in accessing care and multi-professional coordination, contribute to diagnostic delays, leading more patients to seek care in more severe clinical states and requiring direct admission to emergency departments. There is therefore also a major organizational challenge in better managing the entry of patients into the healthcare system. This necessitates the development of structured heart failure screening strategies. The 2021 European Society of Cardiology (ESC 2021) guidelines on heart failure screening prioritize the identification of at-risk individuals and the early detection of disease manifestations. They suggest that, in high-risk groups, tests such as echocardiography and biomarker measurement (NT-proBNP) should be used to detect heart failure at an early stage, even in the absence of symptoms. The guidelines also delineate specific biomarker thresholds and propose organizational frameworks with defined timelines to facilitate systematic screening. The implementation of a heart failure screening pathway within primary care involving multi-professional cooperation is therefore warranted. Stratifying screening based on risk factors and symptomatology is expected to enhance the positive predictive value of the screening process. Furthermore, evaluating the efficacy of this pathway is crucial for establishing a standardized, reproducible clinical protocol suitable for routine primary care practice. This study is a prospective, multicenter, observational study conducted within the context of routine clinical care.
Study Type
OBSERVATIONAL
Enrollment
216
Heart failure screening pathway in general medicine consultations (questionnaire, NT-proBNP level, echocardiographic examination)
Maison de Santé Pluridisciplinaire La Cadière d'Azur
La Cadière-d'Azur, Var, France
Maison de Santé Pluridisciplinaire La Farlède
La Farlède, Var, France
Maison de Santé Pluridisciplinaire Caduceus
La Seyne-sur-Mer, Var, France
Maison de Santé Pluridisciplinaire Beaussetanne
Le Beausset, Var, France
Maison de Santé Pluridisciplinaire Vallée du Gapeau - Sollies-Pont
Solliès-Pont, Var, France
Maison de Santé Pluridisciplinaire Toulon City
Toulon, Var, France
Rate of patients with a confirmed diagnosis of heart failure
i.e. patients with at least one "yes" box checked in "step 1" and "step 2" of the questionnaire, with an NT-proBNP level ≥ 125 pg/ml, and an echocardiographic examination performed by the cardiologist confirming a diagnosis of HF according to the 2021 ESC guidelines.
Time frame: 2 months
Rate of patients with an unconfirmed diagnosis of heart failure
i.e. all of the following patients: * Patients with no "yes" boxes checked in steps 1 and 2 of the questionnaire OR one or more "yes" boxes checked but in only one of steps 1 or 2. * Patients with at least one "yes" box checked in "step 1" and "step 2" of the questionnaire but with an NT-proBNP level \< 125 pg/ml.
Time frame: 2 months
Rate of patients with an indeterminate diagnosis of heart failure
Absence of all diagnostic criteria.
Time frame: 2 months
Risk factors for heart failure
Time frame: Day 1
Presence of dyspnea
Evaluation of the main symptoms of heart failure.
Time frame: Day 1
Weight gain
Evaluation of the main symptoms of heart failure.
Time frame: Day 1
Presence of edema
Evaluation of the main symptoms of heart failure.
Time frame: Day 1
Presence of fatigue
Evaluation of the main symptoms of heart failure.
Time frame: Day 1
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