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AP Therapy Outcome and Prevention in case of LV-EF <40%


Heart failure is the only cardiovascular disease whose incidence and prevalence are increasing in Germany as well as worldwide. Its course is progressive and medicated inadequately its prognosis resembles malignant diseases. Numerous controlled studies on selected patients have proven that due to a stage-adapted therapy both morbidity and mortality can be reduced considerably and the quality of life can be improved. However, the penetration of these results in the daily clinical routine is insufficient. On the one hand, the currently increasing hospitalization- and mortality rates account primarily to older patients who are underrepresented in the randomized studies. On the other hand, the implementation of evidence based therapy measures on suitable patients is insufficient, at least because of economic constraints. In contrast to other heart diseases as Myocardial Infarction or Atrial Fibrillation, whose epidemiology and supply situation are well examined within the scope of national and regional registers (Berlin Myocardial Infarction Registry), no systematical examinations with representative data exist when it comes to heart failure.


“TOP 40” is the first step in the creation of the Berlin Heart Failure Registry, whose goal it is to determine the level of care that patients hospitalized for systolic heart failure receive. Special attention will be given to evidence-based heart failure medication and device therapy (ICD, CRT). Results of the pilot project are to serve as basis for concepts for quality assurance and for an optimization of regional supply structures.

Key Results

Registry data were analysed according to current standards of heart failure care. Patients treated for heart failure at teaching hospitals received significantly more betablocker therapy, coronary catheterization and device therapy compared with patients treated at community hospitals.


  • Tscholl V et al. Differences in the management of patients with heart failure in university and non-university hospitals in Berlin: the TOP 40 (therapy outcome and prevention) pilot-registry. Poster presented at the ESC HFA Congress, Göteborg, 2011.


Initial data collection as well as the 1-year follow-up has been completed.  A long-term follow-up for “TOP 40” is planned.


PD Dr. Hans-Dirk Düngen
Charité – Universitätsmedizin Berlin
Medizinische Klinik mit Schwerpunkt Kardiologie
Tel.: +49 (0)30 450676818
E-Mail: ed.etirahcnull@negneud.krid-snah

Dr. Richard Stern
Jüdisches Krankenhaus Berlin, Zentrum für Herzinsuffizienz
Tel.: +49 (0)30 49942277
E-Mail: ed.enilno-bkjnull@nretS.drahcir