SURVEY ON HEART-FAILURE IN ITALIAN HOSPITAL CARDIOLOGY UNITS - RESULTS OF THE SEOSI STUDY

Three hundred and fifty nine cardiology units participated in a study (SEOSI) coordinated by the Association of Italian Hospital Cardiologis ts (ANMCO). The aim of the study was to: (1) evaluate how many patient s with suspected or known heart failure consecutively approach a hospi tal cardiology unit; (2) assess their clinical characteristics; (3) de fine the diagnostic-therapeutic processes set in motion by cardiologis ts; (4) evaluate the social and emotional impact of the disease on the patient. In 12 days, 3921 patients were enrolled. Mean age was 67 +/- 12 years (median 69); 49% of the patients were in NYHA class III-IV; atrial fibrillation was present in 27%; 35% of the cases were schedule d for hospital admission. Ischaemic heart disease was the primary caus e of heart failure (42%): arterial hypertension accounted for 20%, idi opathic dilated cardiomyopathy for 15% and cardiac valve disease for 1 5%. A chest X-ray, ECG and echocardiogram were performed in 70-80% of cases; ambulatory ECG in 36% and exercise testing in 11%. ACE inhibito rs were administered to 63.5%, calcium antagonists to 19% and beta-blo ckers to 5.5%. No significant differences in drug prescription were no ted in relation to NYHA classification. Multidrug use was common (3.6 +/- 1.6). Main advice was: salt restriction (47%) and rest (44%); phys ical activity and a formal exercise programme were prescribed to 10% a nd 5% of patients, respectively. Most patients were addressed to hospi tal follow-up. Thus, heart failure represents a heavy burden for hospi tal cardiology units. It can be estimated that about 190 000 patients with heart failure seek care at hospital cardiology units each year an d about 65 000 are admitted as inpatients. Cardiologists are reasonabl y well oriented regarding both examinations required and the prescribi ng of drugs. Beta-blockers and physical exercise are prescribed very c autiously. The format of the present trial, characterized by brevity, simplicity and low cost, could be used as a tool to gain periodical in formation on several aspects of national health systems and physician behaviour.