Physicians’ knowledge of therapy that affecting the prognosis of patients with chronic heart failure

Aim. To find out physicians’ knowledge and perceptions about the possibilities of using therapy affecting the prognosis in patients with chronic heart failure with reduced ejection fraction (CHFrEF). Material and methods. Data of an anonymous survey of 207 physicians (155 cardiologists, 44 internists, 8 other specialists) who past advanced course of professional training in the spring of 2023. Questionnaire contained questions reflecting physicians’ awareness about treatment for improving the prognosis of patients with CHFrEF. Results. The quadruple therapy: sacubitril- valsartan (ARNI)/angiotensin- converting enzyme inhibitor /angiotensin II receptor blocker + beta-blocker (BB) + mineralocorticoid receptor antagonist (MRA) + sodium- glucose cotransporter type 2 inhibitor (SGLT2i) was named as an optimal treatment for CHFrEF by 63.3 % of doctors (71.6 % of cardiologists and 36.4 % of internists). 80 % of respondents (89 % of cardiologists and 50 % of internists) correctly pointed out the indications for ARNI, 75.4 % (83.9 % of cardiologists and 45.4 % of internists) — for therapy with BB, 71.0 % (80 % of cardiologists and 36.3 % of internists) — for prescribing AMR, and 76.8 % (86.4 % of cardiologists and 43.1 % of internists) — for using SGLT2i. 81.7 % of respondents (89.7 % of cardiologists and 52.3 % of internists) correctly named the target dose of BB, 45.9 % (51 % of cardiologists and 31.8 % of internists) indicated the neuromodulatory dose of AMR, and 74.3 % (83.9 % of cardiologists and 52.3 % of internists) correctly noted the recommended dapagliflozin dose (p < 0,01 for all comparisons between groups of cardiologists and internists). Among the drugs that are most often used in everyday practice to improve the prognosis of symptomatic patients with CHFrEF, respondents named BB (66.2 %), MRA (58.5 %), angiotensin- converting enzyme inhibitor/angiotensin II receptor blocker (57 %), ARNI (37.7 %), and SGLT2i (45.4 %). Cardiologists use ARNI (p < 0,01), SGLT2i (p < 0,01), and MRA (p < 0,05) more often than internists. Conclusion. Insufficient knowledge of physicians, especially internists, of the key provisions of clinical guidelines for CHFrEF pharmacotherapy can be considered as one of the reasons for suboptimal treatment.