Summary, Gaps, and Future Direction
Key Points
- Although HF is associated with a significant health burden and is associated with adverse outcomes; large-scale population-based registries and outcome studies specifically targeting detection of populations at-risk for HF, pre-HF, HF, or advanced HF; specific etiologies of HF and cardiomyopathies; EF subgroups; according to race/ethnicity, sex, gender, geography, SDoH, and structural inequity are lacking.
- Existing data and population cohorts do not provide continuous information over time; as such, the authors have examined trends across multiple descriptive studies to be able to provide their high-level interpretation of changes over time. The authors recognize that the existing cohorts represent specific patient populations, and trends may be specific to particular geographic and age groups and may not be generalizable to other populations.
- The role of biomarkers, molecular markers, imaging, and genetic profiling is rapidly evolving, and will likely be incorporated at a greater scale in HF care for risk detection, diagnosis, determination of specific etiology, prognosis, and outcomes in HF.
- It is important to also recognize that existing coding guidelines fail to recognize HF as an underlying cause of death, but rather as a mediator between death and disease, requiring death attributable to other conditions (e.g., CHD, hyper-tension, cardiomyopathy). HF mortality is often redistributed to these causes and is therefore under-detected.
- These considerations underline the necessity of large-scale registries and research studies specifically addressing HF epidemiology, risk factors, and outcomes, and the importance of capturing HF as a primary underlying cause of death.
