Recognition of the Large Ambulatory C2D Stage of Advanced Heart Failure-A Call to Action.
| Title: | Recognition of the Large Ambulatory C2D Stage of Advanced Heart Failure-A Call to Action. |
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| Authors: | Dunlay SM; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.; Pinney SP; Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, New York.; Lala A; Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, New York.; Stewart GC; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts.; McIlvennan C; Division of Cardiology, University of Colorado, Aurora.; Wong RP; National Heart, Lung, Blood Institute, Bethesda, Maryland.; Morris AA; Cardiovascular and Renal, Bayer US LLC, Whippany, New Jersey.; Pagani FD; Department of Cardiac Surgery, University of Michigan, Ann Arbor.; Allen LA; Division of Cardiology, Department of Medicine, University of Colorado, Aurora.; Breathett K; Division of Cardiovascular Medicine, Indiana University, Indianapolis.; Cogswell R; University of Minnesota, Minneapolis.; Colvin MM; University of Michigan, Ann Arbor, Detroit.; Cowger JA; Henry Ford Health, Detroit, Michigan.; Drakos SG; University of Utah Health & Nora Eccles Harrison Cardiovascular Research and Training Institute, Salt Lake City, Utah.; Gelfman LP; Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.; Kanwar MK; Cardiovascular Institute at Allegheny Health, Pittsburgh, Pennsylvania.; Kiernan MS; Tufts Medical Center, Boston, Massachusetts.; Kittleson MM; Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.; Lewis EF; Stanford University School of Medicine, Palo Alto, California.; Moazami N; Department of Cardiothoracic Surgery, NYU Langone, New York, New York.; Ogunniyi MO; Division of Cardiology, Department of Medicine, Emory University School of Medicine and Grady Heart Failure Program, Atlanta, Georgia.; Pandey A; Divisions of Cardiology and Geriatrics, Department of Internal Medicine, UT Southwestern, Dallas, Texas.; Rogers JG; Texas Heart Institute, Houston.; Schumacher KR; University of Michigan Congenital Heart Center, Ann Arbor, Michigan.; Slaughter MS; University of Louisville, Louisville, Kentucky.; Tedford RJ; Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston.; Teuteberg J; Division of Cardiovascular Medicine, Stanford University, Stanford, California.; Valantine HA; Stanford University, Stanford, California.; DeFilippis EM; Center for Advanced Cardiac Care, Division of Cardiology, Columbia University Irving Medical Center, New York, New York.; Dixon DD; Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee.; Golbus JR; Division of Cardiovascular Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor.; Gulati G; Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts.; Hanff TC; University of Utah School of Medicine, Salt Lake City.; Hsiao S; Stanford Health Care, Palo Alto Veteran Affairs Hospital, Palo Alto, California.; Lewsey SC; Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.; McCormick AD; University of Michigan Congenital Heart Center, Ann Arbor, Michigan.; Nayak A; Baylor University Medical Center, Dallas, Texas.; Fenton KN; National Heart, Lung, Blood Institute, Bethesda, Maryland.; Longacre LS; National Heart, Lung, Blood Institute, Bethesda, Maryland.; Shanbhag SM; National Heart, Lung, Blood Institute, Bethesda, Maryland.; Taddei-Peters WC; National Heart, Lung, Blood Institute, Bethesda, Maryland.; Stevenson LW; Department of Medicine, Vanderbilt University, Nashville, Tennessee. |
| Source: | JAMA cardiology [JAMA Cardiol] 2025 Apr 01; Vol. 10 (4), pp. 391-398. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101676033 Publication Model: Print Cited Medium: Internet ISSN: 2380-6591 (Electronic) NLM ISO Abbreviation: JAMA Cardiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Chicago, Illinois] : American Medical Association, [2016]- |
| MeSH Terms: | Heart Failure*/therapy ; Heart Failure*/physiopathology ; Heart Failure*/epidemiology ; Heart Failure*/diagnosis; Humans ; Disease Progression ; Congresses as Topic |
| Abstract: | Importance: The advanced ambulatory heart failure (HF) population comprises patients who have progressed beyond the pillars of recommended stage C HF therapies but can still find meaningful life-years ahead. Although these patients are commonly encountered in practice, national databases selectively capture the small groups accepted for heart transplant listing or left ventricular assist devices. The epidemiology, trajectories, and therapies for other ambulatory patients with advanced HF are poorly understood.; Observations: In December 2022, the National Heart, Lung and Blood Institute convened a team of experts to identify knowledge gaps and research priorities for the ambulatory population with limiting daily symptoms and transition toward refractory end-stage D HF, designated as stage C2D. This article summarizes the findings from that 3-day workshop. Workshop participants surveyed the initial challenges and knowledge gaps for (1) recognition of ambulatory C2D HF, (2) estimation of the magnitude of the affected population and identifiable subpopulations, and (3) physiologic phenotypes, such as low cardiac output, right HF, cardiorenal syndromes, congestive hepatopathy and frailty, which offer distinct targets for existing and emerging therapies. Social drivers of HF and patient preferences for quality/length of survival were highlighted as essential modifiers for personalization of therapies.; Conclusions and Relevance: Ten key points summarized workshop findings, with target cohorts for study proposed as a crucial next step. This workshop summary is intended as a call for action to address knowledge gaps and develop new strategies to improve outcomes in the large ambulatory population with C2D HF. |
| Entry Date(s): | Date Created: 20250205 Date Completed: 20250409 Latest Revision: 20250415 |
| Update Code: | 20260130 |
| DOI: | 10.1001/jamacardio.2024.5328 |
| PMID: | 39908057 |
| Database: | MEDLINE |
Journal Article