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Time to reconsider the person with shortness of breath

Navigating type 2 diabetes and heart failure in primary care

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Recorded: Monday, October 11, 2021; broadcast: Thursday, October 21, 2021


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Meet the faculty

  • Alice Cheng

    Dr. Cheng is an Endocrinologist at Trillium Health Partners and Unity Health Toronto and an Associate Professor at the University of Toronto. Read more

  • Lars Rydén (Chair)

    Lars Rydén is Senior Professor of Cardiology at the Karolinska Institute, Stockholm, Sweden. He is Dr h.c. at Katowice University, Poland, and Honorary Member of the Royal College of Physicians, UK and of several European Cardiac Societies. Read more

  • Kevin Saunders

    Dr. Kevin Saunders is a family physician in Winnipeg. He completed his medical training at the University of Manitoba in 1985 and has practiced in Winnipeg since then. Read more

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Full agenda


Agenda

Welcome and introduction

Case study

A person with diabetes presenting with shortness of breath previously attributed to being out of shape

Heart failure explained

  • Diagnosing heart failure
  • Types of heart failure
  • Epidemiology and disease course

Ask the Expert discussion and Q&A

What does this mean for the identification of heart failure, particularly heart failure with preserved ejection fraction, and its management in primary care?

EMPEROR-Preserved: The lessons learned

  • Overview of results
  • SGLT2 inhibitors in patients with heart failure

Ask the Expert discussion and Q&A

What do the lessons learned mean for the treatment of patients with heart failure, with and without diabetes, in primary care?

Closing comments
Faculty disclosures

Faculty disclosures

Lars Rydén

Advisory board/speaker: Bayer AG, Boehringer-Ingelheim, Eli-Lilly, Novo-Nordisk

Research support: Swedish Heart Lung Foundation, E Persson's Family Foundation, Private Foundations, Stockholm County Council, Boehringer-Ingelheim, Novo-Nordisk


Alice Cheng

Advisory board:  Abbott, Astra Zeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, Insulet, HLS Therapeutics, Janssen, Medtronic, Merck, Novartis, Novo Nordisk, Sanofi, Takeda

Speaking honoraria: Abbott, Astra Zeneca, Bausch, Bayer, Boehringer Ingelheim, Dexcom, Eisai, Eli Lilly, HLS Therapeutics, Insulet, Janssen, Medtronic, Merck, Novo Nordisk, Sanofi

Clinical trials:  Applied Therapeutics


Kevin Saunders

Grants/research support: BMS, B.I., Novo, Pfizer, Merck, A.Z., Novartis, Bayer, Sanofi

Speakers bureau/honoraria: Merck, B.I., Purdue, Servier, Amgen, Lilly, md Briefcase, CPD Network, ABPHE, McGill CPD Office, Janssen, Pfizer, Novo, A.Z., Bayer

Consulting fees: Pfizer, Janssen, BMS, Servier, B.I., Amgen, Merck, A.Z., Sanofi, Novo, Lilly

Patents: None

Other: None

References

References

McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J 2021;42;3599–3726
Permission provided by the European Cardiology Society to use slides as part of this webinar 

GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global regional and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1211–1226

Benjamin E, Muntner P, Alonso A, et al. Heart disease and stroke statistics–2019 update: A report from the American Heart Association. Circulation 2019;139:e56-e528

Mozaffarian D, Benjamin E, Go AS, et al. Heart disease and stroke statistics—2016 update. A report from the American Heart Association. Circulation 2016;133:e38-e360

Mamas MA, Sperrin M, Watson MC, et al. Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland. Eur J Heart Failure 2017;19:1095–1104

Blecker S, Paul M, Taksler G, et al. Heart failure-associated hospitalizations in the United States. J Am Coll Cardiol 2013;61:1259–1267

Ambrosy AP, Fonarow GC, Butler J, et al. The global health and economic burden of hospitalizations for heart failure: Lessons learned from hospitalized heart failure registries. J Am Coll Cardiol 2014;63:1123–1133

Azad N, Lemay G. Management of chronic heart failure in the older population. J Geriatr Cardiol 2014;11:329–337

Fonarow GC, Gattis Stough W, Abraham WT, et al. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: A report from the OPTIMIZE-HF registry. J Am Coll Cardiol 2007;50:768–777

Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5 year outcomes. J Am Coll Cardiol 2017;70:2476–2486

Bhatt DL, Verma S, Braunwald E. The DAPA-HF trial: A momentous victory in the war against heart failure. Cell Metab 2019;30:847–849

McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med 2019;381:1995–2008 

Packer M, Anker SD, Butler J, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med 2020;383:1413–1424

McDonald M, Virani S, Chan M, et al. CCS/CHFS Heart failure guidelines update: Defining a new pharmacologic standard of care for heart failure with reduced ejection fraction. Can J Cardiol 2021;37:531–546

Yusuf S, Pfeffer MA, Swedberg K, et al. Effect of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved trial. Lancet 2003;362:777–781

Massie BM, Carson PE, McMurray JJ, et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med 2008;359:2456–2467

Cleland JGF, Tendera M, Adamus J, et al. The perindopril in elderly people with chronic heart failure (PEP–CHF) study. Eur Heart J 2006;27:2338–2345

Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med 2014;370:1383–1392 

Solomon SD, McMurray JJV, Anand IS, et al. Angiotensin–neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med 2019;381:1609–1620 

Ahmed A, Rich MW, Fleg JL, et al. Effects of digoxin on morbidity and mortality in diastolic heart failure. The Ancillary Digitalis Investigation Group trial. Circulation 2006;114:397–403

Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med 2021;385:1451–1461

Bauersachs J. Heart failure drug treatment: the fantastic four. Eur Heart J 2021;42:681-683

Disclaimer

Disclaimer

Any information provided and opinions expressed do not necessarily reflect the views of Springer Healthcare Limited (part of the Springer Nature Group) or the Medicine Matters Editorial Board. Springer Healthcare Limited, Springer Nature Limited and its employees, agents and subcontractors are not responsible or in any way liable for the currency of the information, for any errors, omissions or inaccuracies, or for any consequences arising therefrom. Inclusion or exclusion of any product does not imply its use is either advocated or rejected. Use of trade names is for product identification only and does not imply endorsement. Please consult the latest prescribing information from the manufacturer before issuing prescriptions for any products mentioned.