We encourage you to refer your patients early to the Advanced Heart Failure and Recovery Program. When referred early enough, patients potentially can recover from heart failure with medical therapy.

Consider referring your patients to the program if they:

• Experience persistent heart failure symptoms
• Have a new diagnosis of heart failure
• Have been hospitalized multiple times for decompensated heart failure

Signs of symptoms of heart failure include:

• • Left ventricular ejection fraction under 40%
  • One heart failure-related hospitalization within the previous six months

• Inability to walk one block without shortness of breath
• Intolerance of beta blockers or ACEi/ARBs
• Progressive renal insufficiency
• Inotrope dependence
• Cardiac index < 2.2 L/min
• BNP or NT-proBNP > 5x normal (BNP > 1000)
• High diuretic requirements (>1.5 mg/kg furosemide or equivalent)
• Class IIIB/IV heart failure symptoms despite medical therapy
• Nonresponsive to cardiac resynchronization therapy

Inpatient referrals to the Advanced Heart Failure and Recovery Program do not always require a general cardiology consult first.