SCReening Evaluation of the Evolution of New Heart Failure

The increasing prevalence of chronic heart failure (CHF) is a major public health concern as approximately half a million Australians have CHF and additionally it is the leading cause of hospitalization for those aged >65 years. However general practitioners often find it quite difficult, particularly in the early stages, to diagnose heart failure due to the lack of specificity of symptoms, and because it is frequently masked by other conditions.

To better target currently available preventive therapies, we need improved identification of individuals at increased risk of developing HF. Since effective therapies for the treatment and prevention of HF are readily available, it is vitally important to identify two key patient groups: those with unrecognised HF, and those at greatly increased risk of HF due to left ventricular dysfunction (LVD).

The SCREEN-HF study was Australia's largest longitudinal community-based study of the evolution of heart failure (HF) and other cardiovascular events. The aim of this study was to evaluate the use of serum amino-terminal pro-B-type natriuretic peptide (NT-proBNP) for stratification of risk for HF and other cardiovascular events. With state-of-the art echocardiographic analysis, it also examined the evolution of (LVD) in this study population.

All 3990 individuals enrolled between 2007-2009 and had plasma NT-proBNP measured at a baseline visit. Baseline echo visit (within 1- 3 years of their screening visit) were conducted for a further 3346 individuals. Repeat echocardiograms were conducted approximately 5 years after enrolment with 2596 study participants attending visits at the Clinical Trials Centre Caulfield; The Heart Centre, St Vincent's Hospital, Fitzroy; Monash University, Frankston; Goulburn Valley Base Hospital, Shepparton. Blood samples were collected at the time of the initial and subsequent echocardiogram visit and are stored in a -80 freezer. Ethics approval was gained from the AIHW to undertake data linkage with the National Death Index, with 526 deceased subjects identified. Analysis of all echo data has been finalised and end of study reports and papers are in the draft process.

The study funded by BUPA and two grants from NHMRC.