This textbook gives an overarching approach to heart failure, from clinical practice to management of difficult and complex cases. Primarily it is written for heart failure specialists but it is also applicable to physicians with specific interest in heart failure.
C.01 Editorial board of a foreign/international collection of papers/book
COBISS.SI-ID: 768931Introduction: Heart failure (HF) is associated with frequent hospitalizations, high mortality and costs and is therefore an important public health issue. The prevalence of HF is estimated to be around 1-2% and increases with age. The crude rate of hospitalizations due to HF in Sweden is assessed to be around 200-300 per 100,000 persons and is increasing due to the ageing of the population. In Slovenia and central Europe epidemiologic data regarding HF hospitalizations and prevalence are scarce. Aims: In the proposed doctoral thesis we aim to study the burden of hospitalizations due to HF (coded as any or main cause, first, re-hospitalizations and mortality) stratified by sex, age and region. In the second part of the doctoral thesis we aim to evaluate HF prevalence in Murska Sobota and extrapolate the results to the whole country. Hypotheses: 1.) The crude hospitalization rate due to HF in Slovenia, between 2004 and 2012 is increasing. 2.) The standardized hospitalization rate due to HF in Slovenia, between 2004 and 2012 is unchanging. 3.) HF prevalence in residents from Murska Sobota aged 55 years or more is between 6% and 8%. Methods: We searched for hospitalization data from the Slovenian national Hospital Discharge Registry and National Death Registry for all HF hospitalizations (ICD-10 discharge codes: I50.1 – I50.9, I11.0, I13.0, I13.2, I42.0-I42.9) between 2004 and 2012. Crude and standardized hospitalization rates were calculated and stratified by admission year, sex, age-group and region. The effect of sex, age, comorbidities, admission year and region on mortality after HF hospitalization were evaluated using mixed effect logistic regression models. HF prevalence in Murska Sobota was assessed with a cross-sectional prevalence study, in which participants from the representative sample of the city Murska Sobota older than 55 years have been screened using serum N-terminal brain natriuretic peptide (NT-proBNP) levels. Everyone with NT-proBNP levels higher than 125 pg/mL and random control group with NT-proBNP levels lower than 125 pg/mL have had a detailed examination including transthoracic echocardiography. HF was diagnosed in accordance with the recent European Society of Cardiology guidelines. Results: During 2004-2012, 156,859 HF hospitalizations (55,522 main and 43,606 first HF hospitalizations) were recorded. The crude main and first HF hospitalization rates increased from 248 to 278 (12.1%, P(0.001) and from 514 to 530 (3.1%, P=0.100), respectively. The number of age-standardized main and first HF hospitalizations per 100,000 population decreased from 292 to 270 (7.5%, P=0.001) and from 553 to 551 (6.9%, P=0.083), respectively. In multiple mixed effect logistic regression models, no differences in mortality and readmission endpoints for statistical regions were observed, whereas men, older patients and patients with myocardial infarction, chronic kidney disease and cancer had significantly higher 30-day and 1-year mortality. Overall, 275 people participated in the study with a response rate of 47%. Of those that participated in the study, 139 (49%) had elevated NT-proBNP levels. With data from the diagnostic visit, 31 participants were diagnosed with HF, 64% with newly diagnosed HF. Amongst participants, diagnosed with HF, three had HF with reduced ejection fraction (EF), two HF with mid-range EF and 26 HF with preserved EF. The calculated prevalence of HF in residents of Murska Sobota aged 55 years or more was 11.3% (95% CI 7.8% - 15.6%) and rose steeply with higher age. When extrapolated to the entire population of Murska Sobota, estimated HF prevalence was 4.4% (95% CI 3.0% - 6.2%). Conclusions: In Slovenia, the crude HF hospitalization burden has increased while standardized HF hospitalization rates have decreased. There are no regional differences between mortality after HF hospitalizations. The extrapolated HF prevalence of 4.4% was higher than previously reported and more than half of the participants w
D.09 Tutoring for postgraduate students
COBISS.SI-ID: 4194789