TY - JOUR T1 - Management of patients with heart failure treated in cardiology consultations: IC-BERG Study JO - Revista Clínica Española (English Edition) T2 - AU - Barrios,V. AU - Escobar,C. AU - Ortiz Cortés,C. AU - Cosín Sales,J. AU - Pascual Figal,D.A. AU - García-Moll Marimón,X. SN - 22548874 M3 - 10.1016/j.rceng.2019.10.007 DO - 10.1016/j.rceng.2019.10.007 UR - https://revclinesp.es/en-management-patients-with-heart-failure-articulo-S2254887420300254 AB - ObjectiveTo determine the perception and management of heart failure with reduced ejection fraction (HFrEF) by clinical cardiologists and to establish a consensus with recommendations. MethodsWe employed the modified Delphi method among a panel of 150 experts who answered a questionnaire that included 3 blocks: definition and perception of patients with “stable” HFrEF (15 statements), management of patients with “stable” HFrEF (51 statements) and recommendations for optimising the management and follow-up (9 statements). The level of agreement was assessed with a Likert 9-point scale. ResultsA consensus of agreement was reached on 49 statements, a consensus of disagreement was reached on 16, and 10 statements remained undetermined. There was consensus regarding the definition of “stable” HF (82%), that HFrEF had a silent nature that could increase the mortality risk for mildly symptomatic patients (96%) and that the drug treatment should be optimised, regardless of whether a patient with HFrEF remains stable in the same functional class (98.7%). In contrast, there was a consensus of disagreement regarding the notion that treatment with an angiotensin receptor-neprilysin inhibitor is justified only when the functional class worsens (90.7%). ConclusionsOur current understanding of “stable” HF is insufficient, and the treatment needs to be optimised, even for apparently stable patients, to decrease the risk of disease progression. ER -