Assessment of regional variation in the management of heart failure with a preserved ejection fraction between the Russian Federation and the European Union: the results of the international survey

Objectives Regional differences in heart failure with preserved ejection fraction (HFpEF) care have been reported. We aimed to assess a physician-reported HFpEF management in the Russian Federation (RF) and a variation in the diagnosis and treatment of HFpEF between the RF and the European Union (EU...

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Main Authors: Nathan Mewton, Clara Saldarriaga, Irina Dyachuk, Han Naung Tun, Ilya Giverts, Anastasia Shchendrygina, Natalia Cherkasova, Aleksandr Suvorov, Irina Komarova, Nadezhda Mukhina, Violetta Sitnikova, Elena Kuzheleva, Soloveva Anzhela, Nikolay Novitsky, Andrey Baglikov, Alina Bibarsova, Anastasia Rogova, Viktoria Lezhneva, Ekaterina Stepanenko, Sydney Goldfeder de Gracia, Vergun Marija, Yu V Mareev, Galib Imanov
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/8/e103134.full
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author Nathan Mewton
Clara Saldarriaga
Irina Dyachuk
Han Naung Tun
Ilya Giverts
Anastasia Shchendrygina
Natalia Cherkasova
Aleksandr Suvorov
Irina Komarova
Nadezhda Mukhina
Violetta Sitnikova
Elena Kuzheleva
Soloveva Anzhela
Nikolay Novitsky
Andrey Baglikov
Alina Bibarsova
Anastasia Rogova
Viktoria Lezhneva
Ekaterina Stepanenko
Sydney Goldfeder de Gracia
Vergun Marija
Yu V Mareev
Galib Imanov
author_facet Nathan Mewton
Clara Saldarriaga
Irina Dyachuk
Han Naung Tun
Ilya Giverts
Anastasia Shchendrygina
Natalia Cherkasova
Aleksandr Suvorov
Irina Komarova
Nadezhda Mukhina
Violetta Sitnikova
Elena Kuzheleva
Soloveva Anzhela
Nikolay Novitsky
Andrey Baglikov
Alina Bibarsova
Anastasia Rogova
Viktoria Lezhneva
Ekaterina Stepanenko
Sydney Goldfeder de Gracia
Vergun Marija
Yu V Mareev
Galib Imanov
author_sort Nathan Mewton
collection DOAJ
description Objectives Regional differences in heart failure with preserved ejection fraction (HFpEF) care have been reported. We aimed to assess a physician-reported HFpEF management in the Russian Federation (RF) and a variation in the diagnosis and treatment of HFpEF between the RF and the European Union (EU).Design/settings It is a post hoc analysis of an academic web-based international HFpEF designed as a cross-sectional survey and conducted between May 2023 and July 2023.Participants Medical doctors who work in the fields of cardiology and general medicine.Results Among 1460 medical doctors who completed the study were 166 Russian and 646 European specialists. The responders were comparable across the groups in most of the baseline characteristics, except that RF specialists were less likely to be heart failure specialists (RF: 2% vs EU: 26%) and less often worked in academic environments (RF: 17% vs EU: 61%). The utilisation of specific echocardiography parameters (RF: 66% vs EU: 80%) and natriuretic peptides (RF: 83% vs EU: 91%) to establish a diagnosis of HFpEF was less frequent in RF compared with EU, while HFpEF scores were more likely to be used by Russian physicians (RF: 58% vs EU: 40%). In the settings when all HF medications are available, responders of both regions prioritised sodium-glucose co-transporter type 2 inhibitors (SGLT2is) (mean rank: RF: 2.6 (IQR: 2.3–3) vs EU: 2.3 (IQR: 2.2–2.5)), followed by diuretics in the EU and ACE inhibitors in the RF. Every second responder in both regions preferred SGLT-2is if only one drug was available (RF: 57% vs EU 51%).Conclusions The results reveal discrepancies in physician-reported HFpEF management between RF and EU responders, particularly in the diagnostic workup. Although the utilisation of relevant diagnostic tests was lower in the RF compared with the EU, these were used by two-thirds of Russian respondents. Nevertheless, further measures are required to improve the care of HFpEF patients in the RF.
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spelling doaj-art-08c8ce2d5be84004af856d5eb81c965c2025-08-20T03:36:45ZengBMJ Publishing GroupBMJ Open2044-60552025-08-0115810.1136/bmjopen-2025-103134Assessment of regional variation in the management of heart failure with a preserved ejection fraction between the Russian Federation and the European Union: the results of the international surveyNathan Mewton0Clara Saldarriaga1Irina Dyachuk2Han Naung Tun3Ilya Giverts4Anastasia Shchendrygina5Natalia Cherkasova6Aleksandr Suvorov7Irina Komarova8Nadezhda Mukhina9Violetta Sitnikova10Elena Kuzheleva11Soloveva Anzhela12Nikolay Novitsky13Andrey Baglikov14Alina Bibarsova15Anastasia Rogova16Viktoria Lezhneva17Ekaterina Stepanenko18Sydney Goldfeder de Gracia19Vergun Marija20Yu V Mareev21Galib Imanov22Clinical Investigation Center, Hôpital Cardiovasculaire Louis Pradel, Bron, FranceDepartment of Cardiovascular Medicine, Universidad Pontificia Bolivariana, Medellin, ColombiaCity Clinical Hospital Named After S. S. Yudin, Moscow, Russian FederationRobert Larner MD College of Medicine, Burlington, Vermont, USAMassachusetts General Hospital, Boston, Massachusetts, USADepartment of Cardiology, Sechenov University, Moscow, Russian FederationI M Sechenov First Moscow State Medical University, Moscow, Russian FederationWorld-Class Research Center Digital biodesign and personalized healthcare”, I M Sechenov First Moscow State Medical University, Moscow, Russian FederationI M Sechenov First Moscow State Medical University, Moscow, Russian FederationI M Sechenov First Moscow State Medical University, Moscow, Russian FederationI M Sechenov First Moscow State Medical University, Moscow, Russian FederationTomsk National Research Medical Center Cardiology Research Institute, Tomsk, Russian FederationAlmazov National Medical Research Centre, Saint Petersburg, Russian FederationK E Tsiolkovsky Kaluga State University, Kaluga, Russian FederationK E Tsiolkovsky Kaluga State University, Kaluga, Russian FederationI M Sechenov First Moscow State Medical University, Moscow, Russian FederationI M Sechenov First Moscow State Medical University, Moscow, Russian FederationI M Sechenov First Moscow State Medical University, Moscow, Russian FederationI M Sechenov First Moscow State Medical University, Moscow, Russian FederationUniversidad Pontificia Bolivariana, Medellín, Antioquia, ColombiaI M Sechenov First Moscow State Medical University, Moscow, Russian FederationUniversity of Glasgow, Glasgow, UKAzerbaijan Medical University, Baku, AzerbaijanObjectives Regional differences in heart failure with preserved ejection fraction (HFpEF) care have been reported. We aimed to assess a physician-reported HFpEF management in the Russian Federation (RF) and a variation in the diagnosis and treatment of HFpEF between the RF and the European Union (EU).Design/settings It is a post hoc analysis of an academic web-based international HFpEF designed as a cross-sectional survey and conducted between May 2023 and July 2023.Participants Medical doctors who work in the fields of cardiology and general medicine.Results Among 1460 medical doctors who completed the study were 166 Russian and 646 European specialists. The responders were comparable across the groups in most of the baseline characteristics, except that RF specialists were less likely to be heart failure specialists (RF: 2% vs EU: 26%) and less often worked in academic environments (RF: 17% vs EU: 61%). The utilisation of specific echocardiography parameters (RF: 66% vs EU: 80%) and natriuretic peptides (RF: 83% vs EU: 91%) to establish a diagnosis of HFpEF was less frequent in RF compared with EU, while HFpEF scores were more likely to be used by Russian physicians (RF: 58% vs EU: 40%). In the settings when all HF medications are available, responders of both regions prioritised sodium-glucose co-transporter type 2 inhibitors (SGLT2is) (mean rank: RF: 2.6 (IQR: 2.3–3) vs EU: 2.3 (IQR: 2.2–2.5)), followed by diuretics in the EU and ACE inhibitors in the RF. Every second responder in both regions preferred SGLT-2is if only one drug was available (RF: 57% vs EU 51%).Conclusions The results reveal discrepancies in physician-reported HFpEF management between RF and EU responders, particularly in the diagnostic workup. Although the utilisation of relevant diagnostic tests was lower in the RF compared with the EU, these were used by two-thirds of Russian respondents. Nevertheless, further measures are required to improve the care of HFpEF patients in the RF.https://bmjopen.bmj.com/content/15/8/e103134.full
spellingShingle Nathan Mewton
Clara Saldarriaga
Irina Dyachuk
Han Naung Tun
Ilya Giverts
Anastasia Shchendrygina
Natalia Cherkasova
Aleksandr Suvorov
Irina Komarova
Nadezhda Mukhina
Violetta Sitnikova
Elena Kuzheleva
Soloveva Anzhela
Nikolay Novitsky
Andrey Baglikov
Alina Bibarsova
Anastasia Rogova
Viktoria Lezhneva
Ekaterina Stepanenko
Sydney Goldfeder de Gracia
Vergun Marija
Yu V Mareev
Galib Imanov
Assessment of regional variation in the management of heart failure with a preserved ejection fraction between the Russian Federation and the European Union: the results of the international survey
BMJ Open
title Assessment of regional variation in the management of heart failure with a preserved ejection fraction between the Russian Federation and the European Union: the results of the international survey
title_full Assessment of regional variation in the management of heart failure with a preserved ejection fraction between the Russian Federation and the European Union: the results of the international survey
title_fullStr Assessment of regional variation in the management of heart failure with a preserved ejection fraction between the Russian Federation and the European Union: the results of the international survey
title_full_unstemmed Assessment of regional variation in the management of heart failure with a preserved ejection fraction between the Russian Federation and the European Union: the results of the international survey
title_short Assessment of regional variation in the management of heart failure with a preserved ejection fraction between the Russian Federation and the European Union: the results of the international survey
title_sort assessment of regional variation in the management of heart failure with a preserved ejection fraction between the russian federation and the european union the results of the international survey
url https://bmjopen.bmj.com/content/15/8/e103134.full
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