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Heart failure – early diagnosis transforms lives (Promotional content from Roche Diagnostics Limited)

Heart Failure (HF) care in the UK is in need of change. There are astonishing figures around the misdiagnosis, late diagnosis, emergency hospital admissions and mortality rates for patients with HF. In this podcast, Dr Clare Taylor (GP with a research interest in heart failure) and Nick Hartshorne-Evans (CEO and founder of the Pumping Marvellous Foundation) discuss the importance of detecting HF early and how GPs can support this to ensure life-saving treatments are delivered sooner, emergency hospitalisations are prevented, and the quality and longevity of patients’ lives are improved.

 

Key references:

  1. NHS. Heart Failure. 2022. Available at: https://www.nhs.uk/conditions/heart-failure/ (accessed January 2023).
  2. British Heart Foundation. Heart failure: a blueprint for change. 2020. Available at: https://www.bhf.org.uk/-/media/files/health-intelligence/heart-failure-a-blueprint-for-change.pdf?rev=f89dedb7c933452e8086cc063ff98c26 (accessed January 2023).
  3. Roche Diagnostics and Pumping Marvellous. Heart failure: The hidden costs of late diagnosis. 2020. Available at: https://hfreport.Roche Diagnostics.com/image/6721401/Roche Diagnostics%20HF%20report%20portrait%20final.pdf (accessed January 2023).
  4. Roche Diagnostics. Breaking the cycle: Tackling late heart failure diagnosis in the UK. 2022. Available at: https://diagnostics.roche.com/gb/en/products/product-category/cardiac-cardiac-markers/heart-failure/heart-failure-report-page.html (accessed January 2023).
  5. NHS Digital. NHS diagnostic waiting times and activity data. 2022. Available at: https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2022/03/DWTA-Report-January-2022_C4LM7K.pdf (accessed January 2023).
  6. NHS England, National Cost Collection for the NHS, 2022. Available from: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/#ncc1819 (accessed January 2023)
  7. NICE [NG106]. Chronic heart failure in adults: diagnosis and management. 2018. Available at: https://www.nice.org.uk/guidance/ng106 (accessed January 2023).
  8. Manchester University NHS Foundation Trust. 2020. Division of Laboratory medicine. NT-proBNP. Available at: https://mft.nhs.uk/app/uploads/2020/09/NT-proBNP.pdf (accessed January 2023).
  9. Royal United Hospitals Bath. Clinical pathway for the assessment of breathlessness. 2011. Available at: https://www.ruh.nhs.uk/For_Clinicians/departments_ruh/Cardiology/documents/Assessment_of_Breathlessness_clinical_pathway_assessment_Handout.pdf (accessed January 2023)
  10. Bottle A. et al. Heart. 2018; 104:600–605.
  11. Community Hub – BEATHF Campaign. Pumping Marvellous – The Heart Failure Charity. Available at: https://pumpingmarvellous.org/community-hub/beathf-campaign/#:~:text=BEAT%20stands%20for%20Breathlessness%2C%20Exhaustion,should%20test%20for%20heart%20failure. (accessed January 2023)
  12. Conrad N et al. Lancet. 2018; 391; 572–580.
  13. Lang CC. Heart 2007;93:665–671.
  14. Lawson CA et al. Lancet Public Health. 2019; 4: e406–e420.
  15. Mamas MA. et al. Eur J Heart Failure. 2017;19:1095–1104.
  16. Roalfe AK. et al. Eur Heart J. 2021;43:881–91.
  17. Schwartz B et al. J Am Heart Assoc. 2021;10 : e021230.

 

Key take-away points:

  • The core symptoms of HF are non-specific: breathlessness, fatigue, and ankle/leg swelling.11
  • NICE guidelines advise the first step in the diagnostic pathway for a patient with suspected HF should be an NT-proBNP test, a blood test that can be ordered in primary care.
  • NT-proBNP is a peptide released by the myocardial cells when heart walls are under stress (e.g. in HF); NT-proBNP is a sensitive diagnostic marker for ruling out HF.
  • The importance of an early diagnosis and how the NT-proBNP test can be used to help aid in the diagnosis of people with potential HF.
  • Earlier diagnosis allows earlier access to evidence-based treatment, and reduced emergency hospital admissions, thereby improving patient outcomes.
  • Testing NT-proBNP levels in patients removes the likelihood of an unnecessary and costly echocardiogram referral.
  • For people without HF, early use of the NT-proBNP test can help rule out HF as a cause for their symptoms, speeding up access to echocardiograms for people who really need them.
  • Accurate diagnosis reduces repeat or unnecessary GP appointments for undiagnosed symptoms; allows specialist services to be used by only those who need them.
  • Comorbidities that often lead to HF being overlooked in primary care include respiratory comorbidities, renal dysfunction, anaemia, arthritis, cognitive dysfunction, and depression.
  • NT-proBNP test is widely available in England and results are typically available within 48–72 hours.
January 2023 NP-IE-00176

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