Bayes-Genis Antoni, Petrie Mark C, Moura Brenda, Chioncel Ovidiu, Volterrani Maurizio, Adamo Marianna, Rakisheva Amina, Savarese Gianluigi, Tocchetti Carlo Gabriele, Metra Marco, Rosano Giuseppe
Heart Institute, Hospital Unbiversitari Germasn Trias i Pujol, Universitat Autonoma de Barcelona, CIBERCV, Carretera del Canyet s/n 08916, Badalona, Spain.
School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
ESC Heart Fail. 2025 Feb;12(1):54-59. doi: 10.1002/ehf2.14825. Epub 2024 Sep 4.
This survey investigates natriuretic peptide (NP) testing in community and hospital settings, assessing awareness, accessibility, and utilization.
This investigator-initiated survey, conceived within the HFA of the European Society of Cardiology, comprised 14 questions. It underwent validation and pilot testing to ensure question readability and online system functionality. The survey was accessible for 87 days, from 5 April 2023 to 1 July 2023 via a web platform. There were 751 healthcare professionals across 99 countries who responded. Of them, 92.5% had access to NPs testing in hospital whereas 34.3% had no access to NTproBNP in community settings. Access to point of care NP testing was uncommon (9.6%). Public insurance fully covered NPs testing in 31.0% of cases, with private insurance providing coverage in 37.9%. The majority (84.0%) of participants believed that the medical evidence supporting NPs testing was strong, and 54.7% considered it cost-effective. Also, 35.8% found access, awareness, and adoption to be in favour of NPs testing both in hospital and community settings. Strategies to optimize NP testing involved regular guideline updates (57.9%), prioritizing NPs testing for dyspnoea assessment (36.4%), and introducing clinician feedback mechanisms (21.2%). Notably, 40% lacked a community-based HF diagnostic pathway for referring high-NP patients for echocardiography and cardiology evaluation.
This survey reveals NP awareness, access, and adoption across several countries. Highlighting the importance of community-based early heart failure diagnosis and optimizing HF diagnostic pathways remains a crucial, unmet opportunity to improve patient outcomes.
本调查旨在研究社区和医院环境中的利钠肽（NP）检测情况，评估其知晓度、可及性和使用情况。
这项由研究者发起的调查是在欧洲心脏病学会的“健康心脏倡议”（HFA）框架内构思的，包含14个问题。该调查经过了验证和预测试，以确保问题的可读性和在线系统功能。调查于2023年4月5日至7月1日通过网络平台进行，为期87天。来自99个国家的751名医疗保健专业人员进行了回应。其中，92.5%的人在医院能够进行NP检测，而34.3%的人在社区环境中无法进行NTproBNP检测。即时检测（POC）NP检测的可及性并不常见（9.6%）。31.0%的情况下公共保险完全覆盖NP检测，37.9%的情况下私人保险提供覆盖。大多数（84.0%）参与者认为支持NP检测的医学证据充分，54.7%的人认为其具有成本效益。此外，35.8%的人发现无论是在医院还是社区环境中，NP检测的可及性、知晓度和采用情况都较为有利。优化NP检测的策略包括定期更新指南（57.9%）、将NP检测优先用于呼吸困难评估（36.4%）以及引入临床医生反馈机制（21.2%）。值得注意的是，40%的人缺乏基于社区的心力衰竭诊断途径，无法将高NP患者转诊进行超声心动图和心脏病学评估。
本调查揭示了多个国家对NP的知晓度、可及性和采用情况。强调基于社区的早期心力衰竭诊断以及优化心力衰竭诊断途径的重要性，仍然是改善患者预后的关键且未得到满足的机会。
