IMR Press / RCM / Volume 22 / Issue 3 / DOI: 10.31083/j.rcm2203077
Open Access Review
The relevance of specific heart failure outpatient programs in the COVID era: an appropriate model for every disease
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1 Cardiology Unit, San Giovanni di Dio Hospital, 50142 Florence, Italy
2 Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, 53100 Siena, Italy
Academic Editor: Peter A. McCullough
Rev. Cardiovasc. Med. 2021, 22(3), 677–690; https://doi.org/10.31083/j.rcm2203077
Submitted: 31 May 2021 | Revised: 19 July 2021 | Accepted: 28 July 2021 | Published: 24 September 2021
Abstract

Heart Failure (HF) is characterized by an elevated readmission rate, with almost 50% of events occurring after the first episode over the first 6 months of the post-discharge period. In this context, the vulnerable phase represents the period when patients elapse from a sub-acute to a more stabilized chronic phase. The lack of an accurate approach for each HF subtype is probably the main cause of the inconclusive data in reducing the trend of recurrent hospitalizations. Most care programs are based on the main diagnosis and the HF stages, but a model focused on the specific HF etiology is lacking. The HF clinic route based on the HF etiology and the underlying diseases responsible for HF could become an interesting approach, compared with the traditional programs, mainly based on non-specific HF subtypes and New York Heart Association class, rather than on detailed etiologic and epidemiological data. This type of care may reduce the 30-day readmission rates for HF, increase the use of evidence-based therapies, prevent the exacerbation of each comorbidity, improve patient compliance, and decrease the use of resources. For all these reasons, we propose a dedicated outpatient HF program with a daily practice scenario that could improve the early identification of symptom progression and the quality-of-life evaluation, facilitate the access to diagnostic and laboratory tools and improve the utilization of financial resources, together with optimal medical titration and management.

Keywords
Heart failure
Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Ischemic cardiomyopathy
Valvular heart disease
COVID-19
Telemedicine
Heart failure outpatient programs
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