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Improving health-related quality of life (HRQL) is an important goal for heart failure (HF) patients, and understanding the factors that influence HRQL is essential to this process. We investigated the influence of social support and cognitive impairment on HRQL in community dwelling HF patients (n = 104) without diagnosed dementia. Patients were aged mean 80.93 years (SD 11.01) and were classified as New York Heart Association Class 1/II (45%) or III/IV (53%). Age, social support and cognition had important independent effects. Younger people had the most negative effects of HF in all areas of HRQL: emotional (B = -0.32), physical (B = -0.44) and overall (B = -1). Well-supported patients (general social support) had the least negative effect from HF on HRQL: emotional domain (B = -4.62) and overall (B = -11.72). Patients with normal cognition had more negative impact of HF on HRQL: physical domain (B = 5.51) and overall HRQL (B = 10.42). A clearer understanding of the relationships between age, social support and cognition and the effect on the impact of HF on HRQL is needed before interventions can be appropriately developed.

This study investigated the symptom patterns and duration and associated predictors occurring prior to first heart failure (HF) admission. Data from the Managing Cardiac Function (MACARF) program from January to December 2007 were reviewed in relation to preadmission symptoms and contacts with health professionals. Patients (n = 242) were aged 78.7 years (SD 12 years), male (54%) and married (45%). Patients experienced up to seven symptoms (Mean 2.7, SD 1.4) for a median of 4.47 days (range 1-7) before admission, most commonly increased dyspnoea on exertion (88%), and for the shortest duration chest discomfort. Less than half (48%) contacted a health professional before hospitalization, most often a general practitioner (37%). The duration patients experienced before presenting to hospital was increased if they presented during business hours (beta = 2.68) or the evening (beta = 1.88) (and therefore less from midnight to 8:30 am), or with a change in symptom (beta = 1.4), whereas duration was reduced by chest discomfort (beta = -2.01) and older age (beta = -0.07). There is a significant time window during which patients and health professionals may detect and act on worsening HF symptoms. Newly diagnosed patients with HF need support to recognize and respond to these symptoms to avoid hospital admission.

S76Heart, Lung and Circulation CSANZ 2012 Abstracts 2012;21:S1-S142 was inversely related to alveolar fluid clearance (p ≤ 0.001). Plasma volume expansion was reduced at 24 h in chronic heart failure patients (p = 0.02). Conclusion: Chronic elevation of pulmonary microvascular pressure leads to decreased intrinsic bi-directional fluid flux at the alveolar-capillary barrier which may contribute to delayed resolution of acute pulmonary oedema once this barrier is breached. http://dx.

Background: Heart Failure with Preserved Ejection Fraction (HFPEF) (EF ≥ 50%) is a challenge in clinical management due to the limited randomised trials showing improved outcomes and lack of evidence based guidelines to manage this increasingly common condition.Aims: To identify the proportion of HFPEF patients in the Management of Cardiac Function (MACARF) program and evaluate the impact of beta blockers (BB) on HF readmission rate (≥1) within one year of initial HF hospitalisation.Methods: We retrospectively analysed data from the MACARF database between the years 2007-2009 inclusive. A total of 1054 patients were initially hospitalised with HF in the seven Northern Sydney Area Health hospitals, of whom 400 (38%) had HFPEF (male -163 (41%), female -237 (59%)). Of these, 55% had prior ischemia.Results: The HFPEF patients were further classified into those discharged with beta-blockers (BB n = 199 patients, 49.75%) (female 60%) and those without beta-blockers (NB n = 201 patients, 50.25%) (female 58%). A major reason for not receiving BB was asthma (39%). Twelve month HF readmission rate for those on BB was 22.6% (n = 45), and not on BB was 22.9% (n = 46), p value = NS.Conclusions: In this observational study of HFPEF, betablocker therapy was not associated with a lower rate of heart failure readmission. Heart Failure with Preserved Ejection Fraction is common in the overall HF population (38%) particularly among women. Beta blockers was prescribed in half of the HFPEF population and its utility should be further defined in randomised prospective trials.