Analysis of heart failure management at the Heart Failure and Transplantation Clinics of the Cardiovascular Center of Puerto Rico and the Caribbean.
BACKGROUND
Disease management programs (DMP) have been shown to be effective in management of patients with heart failure (HF).


OBJECTIVE
To describe the experience at the Heart Failure and Transplantation Clinic of the Cardiovascular Center of Puerto Rico and the Caribbean (HFTC-CCPRC) implementing a model of DMP to a Hispanic population afflicted by HF.


METHODS
A retrospective study was performed. Medical records from patients referred to the HFTC-CCPRC from 1999 to 2005 were selected for review. Information regarding drug regimen, New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) determinations by echocardiography or scintigraphic ventriculography, left ventricular dimensions measurements, maximal oxygen consumption (MVO2 max) determination, hospitalizations, and death cases were obtained from the initial evaluation and at 3, 6, and 12 months post-intervention at the HFTC-CCPRC.


RESULTS
A total of 633 records were screened, from which 244 had complete information for analysis. After 12 months of treatment at the HFTC-CCPRC, NYHA functional class had decreased from 2.70 + 0.59 to 2.13 +/- 0.53 (p < 0.01). LVEF had also increased from 21.0 +/- 8.2% to 39.9 +/- 14.6% (p < 0.01). Hospitalization rate was reduced from 62.7% within the year prior to initial evaluation to 7.2% at the end of the 12-month period (p < 0.01).


CONCLUSIONS
In our patient population, we found significant improvement in several parameters, including NYHA functional class, LVEF, and hospitalization rate after intervention at the HFTC-CCPRC. These findings are most likely related to improved guideline adherence, and are consistent with published data regarding the value of DMP's.
Banchs-Pieretti
Héctor L
HL
University of Puerto Rico, School of Medicine, Department of Medicine, Cardiology Section.
Franqui-Rivera
Hilton
H
Segarra-Alonso
Omar
O
González-Mercado
Velda J
VJ
Altieri-Nieto
Pablo I
PI
Calderón-Rodríguez
Rafael
R
Vélez-Crespo
Michael
M
D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies