Theme of Heart Failure Congress 2011
The Congress is arranged as an educational event and topics were presented in several different sessions in which co-morbidities constituted a major topic. There are no trials or studies as such on co-morbidities because most of the studies on heart failure, generally speaking, exclude patients with co-morbidities. So the theme was addressed at this meeting in several educational sessions dealing with common co-morbidities which are a key element in clinical guidelines.
Highlights of Heart Failure Congress 2011
Several co-morbidities were discussed separately. One of the most important is atrial fibrillation. The session on atrial fibrillation was a comprehensive discussion about how to manage the heart failure patient with atrial fibrillation including pharmacological and non-pharmacological (i.e. interventional ablation therapy) treatments. There was a meeting about heart failure patients with anemia and iron deficiency which is another important co-morbidity. There were several lectures in sessions dealing with heart failure and renal dysfunction, the so-called cardio-renal syndrome, again often complicating heart failure, and heart failure patients with diabetes. We also addressed problems associated with the heart failure patient with concomitant mitral insufficiency. There was an interesting satellite symposium on that simply because we are having more and more promising options with such patients including the mitral valve clip which is a good option in carefully selected patients. In a separate session which was something of a highlight, we addressed how to deal with a patient with heart failure of ischemic origin. Once again, co-morbidities are the most common underlying etiology of heart failure so for these individual co-morbidity, the most important were addressed in the sessions or in special lectures.
Two telemedicine trials
The TIM-HF trial is a telemedicine trial which is a neutral trial but brings up the issue of telemedicine and how to optimally manage patients with heart failure using telemedicine. This is an extremely important issue in the current era of new technological development and improvement. It showed that the problem of telemedicine is properly applied in the current treatment of heart failure patients is really a challenging task. We have more and more data on that and current treatments are still not satisfactory regarding telemedicine and we don’t know why most of the telemedicine trials simply don’t work as well as we would expect. TIM-HF is one of the studies addressing this issue. This is another important area we are investigating.
The TEHAF-study was the second study on this topic of telemonitoring using a nurse-oriented system. This study showed that readmission of patients with a heart failure history can be reduced with this approach. Overall this has potential, but the most important issue is in what direction or which signals need to be monitored and analyzed by the care-givers.