Abstract 12847: The Heart Bus: A Mobile Patient-Centered Approach to Improve Early Diagnosis of Heart Failure in the Community

Abstract

Introduction: Heart failure with preserved ejection fraction (HFpEF) is associated with poor quality of life and considerable morbidity and mortality risk. Early diagnosis is expected to improve clinical outcomes, but requires imaging and laboratory analyses with frequent hospital visits. We developed a mobile care unit, the Heart Bus, to improve early diagnosis of HF. Methods: The Heart Bus was a 70 m 2 trailer with examination rooms, cardiac ultrasound, exercise testing equipment, a clinical laboratory, and 4 staff. During 2020-2022, the Heart Bus team reached out to the population in local newspapers, via HF patient digital platforms, and visited locations in the West Coast of Sweden. Eligible participants had suspected signs or symptoms of HF. Participants underwent echocardiography and tests for cardiopulmonary exercise, vascular function, adenosine-stress coronary flow reserve, and routine biochemistry and haematology. Molecular and physiological deep phenotyping were also performed in the Heart Bus to facilitate future patient stratification and precision medicine (data to be presented Nov 2023). Results: Of 218 participants screened over 18 months (12/month), 200 were included. Most participants actively reached out to take part. Twenty three participants (11.5%) had HFrEF, 54 (27.0%) had HFmrEF, and 62 (31.0%) had HFpEF; 70 (35.0%) had a previous HF diagnosis. Of the remaining patients, 60 (30.0%) had intermediate risk of HFpEF. The phenotypes of the EF-stratified HF subgroups were similar. However, participants in the HFpEF cohort had more women ( p < 0.001), lower lung volume ( p < 0.01), higher pulse wave velocity ( p < 0.01) and poorer kidney function ( p < 0.05) than those with HFrEF. Conclusions: The Heart Bus mobile clinic identified large numbers of patients with HF and may represent a cost-effective way to early HF diagnosis also for underserved communities, those located remotely, or have other thresholds for admittance to HF clinics.