For this monthâ€™s Current Concept feature, we would like to explain a term from cardiology that is likely to become more prominent:
â€œHeart failure with preserved ejection fractionâ€ (abbreviated as HFpEF and pronounced â€œheff-peffâ€).
Javed Butler, MD, an Emory expert on heart failure and deputy chief science officer for the American Heart Association, laid out in a recent seminar why this category of patients is so important. Look for more from him on this topic in the future.
- The number of HFpEF patients is growing and they now make up the majority of patients with heart failure in the United States.
- No treatments have been proven to benefit them, in terms of reducing mortality.* In clinical studies, medications such as ACE inhibitors, angiotensin receptor blockers and beta-blockers have not helped.
- Once hospitalized, HFpEF patients have a high rate of readmission to the hospital within 30 days. The federal Medicare program is penalizing hospitals that have high rates of readmissions and heart failure is one of the largest contributors to readmissions.
The symptoms that drive people with HFpEF to the hospital are mainly fatigue and dyspnea, or shortness of breath, along with fluid in the lungs and swelling of the limbs. Along with heart failure, HFpEF patients often have conditions such as hypertension, anemia, diabetes, kidney disease or sleep apnea. Read more
Javed Butler, MD, MPH
A story in yesterdayâ€™s edition of the Washington Post claims that many Americans have poor health literacy. The Post cited a 2006 study by the U.S. Department of Education that found that 36 percent of adults have only basic or below-basic skills for dealing with health material. According to the report, this means about 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower.
Emory Healthcare heart transplant cardiologist, Javed Butler, MD, MPH, was included in yesterday’s Post article citing his experience with patients who have health literacy issues. “When we say ‘diet,’ we mean ‘food,’ but patients think we mean going on a diet,” said Butler. “And when we say ‘exercise,’ we may mean ‘walking,’ but patients think we mean ‘going to the gym.’ At every step there’s a potential for misunderstanding.”
Butler, a professor of medicine at the Emory School of Medicine and director of Heart Failure Research for Emory Healthcare is studying this issue and its impact on patients with heart failure. He recently reported some of his findings Nov. 17 at the American Heart Association Scientific Sessions conference in Chicago.
To read the entire Washington Post story, please click here.
Javed Butler, MD, MPH, and colleagues
Javed Butler, MD, MPH, director of heart failure research at Emory Healthcare and associate professor of medicine at Emory University School of Medicine, says heart failure is any condition in which the heart is unable to pump enough blood for the metabolic needs of the body, but that does not mean that the heart is not pumping or the heart has stopped working.
Heart disease is not a disease but a syndrome, so a whole family of different diseases can precede this condition. Diabetes, obesity, heart valve problems, lung disease, heart attack and irregular heartbeats are only some factors that can cause heart failure. “Pinning down the roots of heart failure can be confusing,” says Butler, who serves as deputy chief science advisor for the American Heart Association. “Unlike some heart problems, heart failure is not one disease. It has a few common causes, and a few less common, even rare, causes.”
Finding new ways to identify people at risk for developing heart failureâ€”before damage is doneâ€”is his raison d’etre and primary research focus, according to Emory Medicine magazine.