Palazzuoli Alberto, Agostoni Piergiuseppe, Nodari Savina, Paolillo Stefania, Filardi Pasquale Perrone
Cardiovascular Diseases Unit, Cardio Thoracic and Vascular Department, Le Scotte Hospital, University of Siena, Viale Bracci 53100, Siena, Italy.
Centro Cardiologico Monzino, IRCCS, Milan, Italy.
Heart Fail Rev. 2025 May;30(3):505-513. doi: 10.1007/s10741-024-10480-0. Epub 2025 Jan 8.
The current paper reports the model organization, level of health care, and type of medical and research activities related to the existing heart failure centers of the Italian Society of Cardiology. Of note, we conduced an internal survey among the members of heart failure working group and related hospital and territorial sites about the quality of care and assistance levels according to the local hospital resources and type of diagnostic therapeutic and management resources. Thirty-two hospital ambulatorial structures have been identified, the centers were equally distributed within the national ground, with similar concentration between north and south regions of the Italian country. We distinguished three different levels of organization: (1) basal territorial clinics in which patients with suspected or already diagnosed heart failure (HF) are initially identified and screened; (2) intermediate clinics in which HF patients can be routinary followed by HF specialists supported by a dedicated staff including imaging and arrythmologist experts, and interventional cardiologist; (3) advanced clinics composed by all the technical and staff resources capable of guarantying repetitive invasive assessment, continuous invasive monitoring, dedicated telemedicine structures focused on more advanced HF management integrated by heart transplantation or mechanical assistance programs. Different type of assistance is supported by a relevant number of research activity primarily conducted by the Italian Society of Cardiology or spontaneous studies arranged by HF specialist members. The number of HF centers has increased over the past few decades in proportion to the progressive rise in HF diagnoses and associated hospitalization. The expansion of ambulatory structures has been facilitated by an increasing socioeconomic and research influence. The quality of HF services in Italy could be raised by improving the network and connections between HF specialists, general practitioners (GPs), caregivers, and other specialists frequently working in this field.
本文报道了与意大利心脏病学会现有心力衰竭中心相关的模式组织、医疗保健水平以及医疗和研究活动类型。值得注意的是，我们针对心力衰竭工作组的成员以及相关医院和地区站点，就根据当地医院资源以及诊断、治疗和管理资源类型所提供的护理质量和援助水平进行了一项内部调查。已确定了32个医院门诊机构，这些中心在全国范围内分布均匀，在意大利的北部和南部地区之间的集中度相似。我们区分了三种不同的组织级别：（1）基层地区诊所，在此对疑似或已确诊心力衰竭（HF）的患者进行初步识别和筛查；（2）中级诊所，在此心力衰竭患者可由包括影像专家、心律失常专家和介入心脏病专家在内的专业人员协助下，由心力衰竭专科医生进行常规随访；（3）高级诊所，由所有能够保证进行重复性侵入性评估、持续侵入性监测、专注于更高级心力衰竭管理的专用远程医疗结构组成，并结合心脏移植或机械辅助项目。不同类型的援助得到了大量研究活动的支持，这些研究活动主要由意大利心脏病学会开展，或者由心力衰竭专科成员安排的自发研究。在过去几十年中，随着心力衰竭诊断和相关住院人数的逐步增加，心力衰竭中心的数量也有所增加。社会经济和研究影响力的不断增强促进了门诊机构的扩张。通过改善心力衰竭专科医生、全科医生（GPs）、护理人员以及经常在该领域工作的其他专科医生之间的网络和联系，可以提高意大利心力衰竭服务的质量。
