Diagnostic approach to heart failure in Türkiye

Tiivistelmä

Background/aim:Final diagnosis of heart failure (HF) relies on a combination clinical findings, laboratory and imaging tests.The aim of this study was to review the diagnostic approach to HF in Turkiye.Materials and methods:This study is a subanalysis of the nationwide TRends-HF study based on anonymized data of National Electronic Database between January 1, 2016, and December 31, 2022.Variables including date of birth, sex, socioeconomic development index, place of initial HF diagnosis, comorbidities, investigations, and diagnostic procedures were reported.Laboratory variables, including complete blood count, natriuretic peptides (NP), estimated glomerular filtration rate, uric acid, electrolytes, albumin, lipid profile, ferritin and hemoglobin A1c levels and other imaging techniques (coronary angiogram [CAG], transthoracic echocardiography [TTE], chest X-ray [CXR] etc.) during initial diagnosis and/or follow-up of HF patients were obtained from the National Electronic Database.The diagnostic test usage rates were analyzed according to years, geographical regions, socioeconomic regions of Turkiye.Results:The study population consisted of 2.722.151 HF patients (51.7% female, mean age 68.33±14.01 years).All HF patients had at least one electrocardiogram and one TTE examination and all had routine biochemical tests at any time during the follow-up period.CXR utilization rate was 93.7%, while CAG utilization rate was 17.9%.Coronary computed tomographic angiography and cardiac magnetic resonance imaging were performed in only 1.8% and 0.3%.Among all Turkish HF patients, 16.3% had at least one NP measurement.The highest rate of NP use was observed in Central Anatolia (21.0%) and the lowest rate in the Aegean Region (11.7%).NP measurement during HF diagnosis revealed a rising trend over time (12.3% in 2016 vs. 26.3% in 2021).Conclusion:The widespread use of TTE at the beginning of the diagnosis and during follow-up is important for providing quality care to HF patients in Turkiye.However, detailed laboratory tests and advanced imaging methods are not used enough,which could lead to problems in patient management.