Abstract:
OBJECTIVES:There have been no published recommendations about staffing needs for a heart failure (HF) clinic or an office setting focused on heart transplant. The goal of this survey was to understand the current staffing environment of HF, transplant, and mechanical circulatory support device (MCSD) programs in the United States and abroad. This report identifies current staffing patterns but does not endorse a particular staffing model. METHODS:An online survey, jointly sponsored by the American College of Cardiology Foundation (ACCF), American Heart Association (AHA), and the Heart Failure Society of America (HFSA), was sent to the members of all 3 organizations who had identified themselves as interested in HF, heart transplant, or both, between March 12, 2009, and May 12, 2009. RESULTS:The overall response rate to the 1,823 e-mail surveys was 23%. There were 257 unique practices in the United States (81% of total sites) and 58 international sites (19%); approximately 30% of centers were in a cardiovascular group practice and 30% in a medical school hospital setting. The large majority of practices delivered HF care in both an inpatient and outpatient environment, and slightly more centers were implanting MCSDs (47%) than performing cardiac transplantation (39%). Most practices (43%) were small, with <4 staff members, or small- to medium-sized (34%), with 4 to 10 staff members, with only 23% being medium (11-20 staff) or large programs (>20 staff). On average, a U.S. HF practice cared for 1,641 outpatients annually. An average HF program with transplant performed 10 transplants. Although larger programs were able to perform more transplants and see more outpatient HF visits, their clinician staffing volume tended to double for approximately every 500 to 700 additional HF visits annually. The average staffing utilization was 2.65 physician full-time equivalents (FTEs), 2.21 nonphysician practitioner (nurse practitioner or physician assistant) FTEs, and 2.61 nurse coordinator FTEs annually. CONCLUSIONS:The HF patient population is growing in number in the United States and internationally, and the clinicians who provide the highly skilled and time-consuming care to this population are under intense scrutiny as a result of focused quality improvement initiatives and reduced financial resources. Staffing guidelines should be developed to ensure that an adequate number of qualified professionals are hired for a given practice volume. These survey results are an initial step in developing such standards.
journal_name
J Card Failjournal_title
Journal of cardiac failureauthors
Jessup M,Albert NM,Lanfear DE,Lindenfeld J,Massie BM,Walsh MN,Zucker MJ,ACCF Heart Failure and Transplant Committee.,AHA Heart Failure and Transplantation Committee.,Heart Failure Society of America.doi
10.1016/j.cardfail.2011.04.001subject
Has Abstractpub_date
2011-05-01 00:00:00pages
349-58issue
5eissn
1071-9164issn
1532-8414pii
S1071-9164(11)00145-Xjournal_volume
17pub_type
杂志文章,多中心研究abstract:BACKGROUND:Some of the most frequent manifestations of heart involvement in human immunodeficiency virus (HIV) infection include right and left ventricular dysfunction. The pathogenesis remains obscure. METHODS AND RESULTS:This prospective clinical and echocardiographic study involved 181 patients at all stages of HIV...
journal_title:Journal of cardiac failure
pub_type: 临床试验,杂志文章
doi:10.1016/s1071-9164(98)90504-8
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Genetic heterogeneity at the endothelial nitric oxide synthase (NOS3) locus influences heart failure outcomes. The prevalence of NOS3 variants differs in black and white cohorts, but the impact of these differences is unknown. METHODS AND RESULTS:Subjects (n = 352) in the Genetic Risk Assessment of Heart Fa...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.cardfail.2008.10.028
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:A greater understanding of how beliefs and perceptions inform LVAD placement refusals can help ensure that standards for informed decision making are met. We report on the factors that influence refusal and what accounts for changes in decliners' decision-making process when, and if, that occurs. METHOD AND...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2015.06.008
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:To determine the feasibility of peripheral intravenous volume analysis (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF). METHODS:Venous waveforms were captured from a peripheral intravenous catheter in subjects admitt...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2018.05.003
更新日期:2018-08-01 00:00:00
abstract::Contracting myocytes are highly variable in size and generally resemble elliptical cylinders in shape. Although their arrangement within the ventricular wall is rather complex, their length runs in a tangential manner, and their transverse axis runs transmurally. Consequently, it was proposed many years ago that chang...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2002.129280
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) has been shown to improve heart failure (HF) symptoms and survival. We hypothesized that a greater improvement in left-ventricular ejection fraction (LVEF) after CRT is associated with greater survival benefit. METHODS AND RESULTS:In 693 patients across 2 internationa...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究
doi:10.1016/j.cardfail.2014.03.001
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Limited data exist on outcomes in patients ≥70 years of age supported with the use of continuous-flow left ventricular assist devices (LVADs). METHODS:Data on 1149 continuous-flow LVAD recipients was queried from the Mechanical Circulatory Support Research Network. Groups were assigned based on age: ≥70 yea...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2016.10.004
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Coronary angiography (CA) is usually performed in patients with reduced left ventricular ejection fraction (LVEF) to search ischemic cardiomyopathy. Our aim was to examine the agreement between CA and cardiovascular magnetic resonance (CMR) imaging among a cohort of patients with unexplained reduced LVEF, an...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2020.09.005
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Ventilatory efficiency, commonly assessed by the minute ventilation (VE)-carbon dioxide production (VCO2) slope, has proven to be a strong prognostic marker in the heart failure (HF) population. Recently, the oxygen uptake efficiency slope (OUES) has demonstrated prognostic value, but additional comparisons ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究
doi:10.1016/j.cardfail.2007.03.004
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:The role of matrix metalloproteinases (MMPs) polymorphisms on heart failure (HF) susceptibility, phenotypic characteristics, and prognosis has been poorly explored. METHODS AND RESULTS:We studied 313 HF patients with left ventricular systolic dysfunction and 367 healthy control subjects. Genotyping of MMP-1...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2010.09.017
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:In chronic heart failure (HF), diuretic doses increase as the disease progresses, often after hospitalization for instability, and have been associated with worsening renal function and increased mortality. METHODS AND RESULTS:A prospective observational analysis of 183 patients in an advanced HF clinic stra...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2008.01.015
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Some controlled clinical trials showed a beneficial effect of beta-blockers on symptoms, exercise tolerance, and left ventricular function in dilated cardiomyopathy. The purpose of this study was to investigate if there are clinical variables at baseline that could predict a favorable response to long-term m...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/s1071-9164(96)80027-3
更新日期:1996-06-01 00:00:00
abstract::Heart failure is a major public health problem and is increasing in incidence throughout the industrialized world. Despite recent advances in pharmacotherapy, the overall mortality remains high and largely unchanged. Ultrafiltration has received increased attention in the treatment of acute decompensated congestive he...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2008.07.230
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:The role of anticoagulation in patients with chronic heart failure has long been an area of interest and controversy. Traditionally the goal of anticoagulation has been to prevent embolic events, but recent trials also demonstrated that oral anticoagulation also prevents vascular events in patients with prio...
journal_title:Journal of cardiac failure
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.cardfail.2004.02.006
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Fulminant myocarditis (FM) is a rare but life-threatening disease. Intravenous immunoglobulin (IVIG) is not recommended for acute or chronic myocarditis in Western nations owing to the lack of rigorous evidence, but it is widely used in other countries, including Japan. This nationwide retrospective cohort s...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2015.01.004
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:There are little data on the optimization of high-intensity aerobic interval exercise (HIIE) protocols in patients with chronic heart failure (CHF). Therefore, we compared acute cardiopulmonary responses to 4 different HIIE protocols to identify the optimal one. METHODS AND RESULTS:Twenty men with stable sy...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.cardfail.2011.10.010
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Treatment-seeking delays for heart failure (HF) symptoms are significantly high. However, earlier studies did not closely examine race as a characteristic that could potentially influence delay times. The purpose of this study was (1) to describe racial differences in treatment-seeking delays for HF symptoms...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2002.129234
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Gamma-glutamyltransferase (GGT) and total bilirubin (T-Bil) are elevated and of prognostic significance in chronic heart failure (CHF). This study sought to compare these novel cardiovascular risk markers in CHF. METHODS AND RESULTS:We evaluated 1,087 ambulatory patients from our heart failure program. Long...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2011.02.012
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The present study examined the influence of rapid intravenous fluid loading (RFL) on airway structure and pulmonary vascular volumes using computed tomography imaging and the subsequent impact on pulmonary function in healthy adults (n = 16). METHODS AND RESULTS:Total lung capacity (DeltaTLC = -6%), forced ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2009.08.005
更新日期:2010-02-01 00:00:00
abstract::Since the introduction of biomarkers in the late 1980s, considerable research has been dedicated to their validation and application. As a result, many biomarkers are now commonly used in clinical practice. However, the role of biomarkers in the prediction of right ventricular failure (RVF) and in the prognostication ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2019.09.007
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Numerous models predicting the risk of incident heart failure (HF) have been developed; however, evidence of their methodological rigor and reporting remains unclear. This study critically appraises the methods underpinning incident HF risk prediction models. METHODS AND RESULTS:EMBASE and PubMed were searc...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2017.03.005
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Coronary artery disease is the most common cause of heart failure (HF) in developed countries. The aim of this study was to elucidate the mechanisms of reduction of arrhythmias after sacubitril/valsartan (LCZ696) therapy in a myocardial infarction (MI)-HF rabbit model. METHODS AND RESULTS:Chronic MI in rabb...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2020.03.007
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Evidence regarding the association of anger proneness with incidence of heart failure is lacking. METHODS AND RESULTS:Anger proneness was ascertained among 13,171 black and white participants of the Atherosclerosis Risk in Communities (ARIC) study cohort with the use of the Spielberger Trait Anger Scale. In...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2014.09.010
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Reduced left ventricular systolic function predicts worse outcomes. However, the optimal threshold for "normal" left ventricular ejection fraction (LVEF) is uncertain. In general, LVEF ≥ 55% is considered to be "normal" by guidelines, with a low normal designation for LVEF being 50%-55%. We assessed the prog...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2016.03.013
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Heart failure with preserved ejection fraction (HFpEF) has been increasingly recognized as a leading cause of pulmonary hypertension (HFpEF-PH). It remains unknown how HFpEF-PH fares in relation to systolic HF (reduced ejection fraction)-induced PH (HFrEF-PH). Therefore, we sought to determine the long-term ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究
doi:10.1016/j.cardfail.2014.05.003
更新日期:2014-07-01 00:00:00
abstract::Clinical trials designed to evaluate the effect of drugs and devices on the symptoms and clinical status in chronic heart failure have frequently produced conflicting, inconclusive, or misleading results. These difficulties can be explained by the fact that previous studies have relied on efficacy measures that have i...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2001.25652
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Left ventricular assist device (LVAD) support as bridge to recovery (BTR) is uncommon for subjects with chronic heart failure. Myocardial recovery is more evident in recent onset nonischemic cardiomyopathy (ROCM); however, the prevalence of BTR in this subset has not been addressed. METHODS AND RESULTS:We e...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2012.08.001
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:A hallmark characteristic of heart failure (HF) is reduced physical activity (PA) patterns. The relationship between key cardiopulmonary exercise testing (CPX) variables and PA patterns has not been investigated. Therefore, we evaluated PA patterns in patients with ischemic HF and its relationship to peak ox...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2013.08.002
更新日期:2013-09-01 00:00:00
abstract::Simultaneous dysfunction of the heart and the kidney represents a distinct spectrum of disease states composed of complex clinical scenarios with adverse outcomes. Worsening renal function (WRF) in the setting of acute decompensated heart failure (ADHF) is one such clinical setup for which the underlying mechanisms ar...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2014.09.005
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Fatigue is a prominent and poorly understood symptom of heart failure with reduced ejection fraction (HFrEF). The purpose of this study was to determine whether fatigue correlated with immune biomarkers and prognosis. METHODS/RESULTS:In patients with HFrEF (N = 59) and healthy controls (N = 25), we prospect...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2012.07.003
更新日期:2012-09-01 00:00:00