Heart failure and importance of collaboration of professional organizations: the role of the heart failure association of the European Society of Cardiology and its committee on national heart failure societies.

Heart failure (HF) is a major public health problem and affects millions of people from all around the world and expected to increase overtime due to growing ageing population. Although prevalence of HF is almost 1-3% in general population, it rises dramatically to 10% to 15% after 65 years of age and the incidence approaches 20 per 1000 population per year in >75 year-old people (1). Data from European countries demonstrated that HF prevalence ranged between 1% and 3% in Europe (2) and it is estimated that almost 15 million people have HF in European countries. HAPPY study showed that the prevalence of HF is 2.9% in Turkey and almost 1.5 million people suffer from HF in this country (3). Moreover, despite the advances in therapy, mortality and morbidity remains to be unacceptably high in HF. The rate of 1-year mortality or hospitalization is reported as 36% in acute HF and 18% in chronic HF (4). Also, this disorder causes substantial economic burden on the healthcare systems. Therefore, HF deserves meticulous care to overcome its worse consequences in the community and requires special collaborations with national and international societies in the field of HF.

Heart Failure Association (HFA) is one of the very active, attractive and highly influential association in the European Society of Cardiology (ESC). The mission of the HFA is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research. ESC guidelines for the diagnosis and treatment of acute and chronic HF which is essentially created by the HFA is widely implemented not only in European countries but also at the rest of the world. For educational purpose, HFA regularly organize the HFA Annual Congress, the Translational Winter Research Meeting, Education and Training programmers and Workshops. The HFA Annual Congress is the world's biggest congress in the field of HF and every year, almost 4.500 participants interested in HF come together from all over the world. HFA also promotes the researches to improve understanding of the mechanisms of disease progression and to improve treatment and its delivery to the HF patients. In this context, a scientific journal, European Journal of Heart Failure, is published by the HFA. Promotion of surveys regarding the epidemiology, procedures and treatments in acute and chronic HF is one of the important objectives of the HFA.

Recently, new Heart Failure Specialists of Tomorrow (HoT) initiative has been launched by the HFA, aiming to spread the HFA's mission to the young generation and promoting excellence among young people in the field of HF at national level. Also, based on the fact that organized care of HF patients improves patient outcomes, HFA has developed and published a heart failure subspecialty curriculum for using in training across Europe (5). The purpose of this HF subspecialty curriculum is to describe the expert knowledge of HF, document the necessary skills required of a HF specialist and define the training required for cardiologists with an interest in HF.

Heart Failure Association includes several scientific committees and study groups. Among these, the Committee on National Heart Failure Societies (NHFS) was founded in 2007 and aims to create a European network of National Heart Failure Societies or

Just in the center, three colleagues from left to right are Lale Tokgözoğlu-President of TSC, Petar M Seferovic- Co-coordinator of HFA NHFS Committee, Yüksel Çavuşoğlu-Member of HFA NHFS Committee. A Photograph from the joint meeting of HFWG of TSC and HFA of the ESC in 2013.

Working Groups, facilitate the implementation of clinical trials, registries and surveys, and promote the implementation of HF guidelines with an ultimate goal of the improvement of the management of HF patients, which is one of the greatest challenges for this growing epidemic. In the scope of the organization of HF management in ESC member countries, a survey has been conducted by NHFS Committee to obtain real-life contemporary demographics of HF, as well as the organization and major activities of the national HF organizations in ESC member countries (2). This survey demonstrated that although almost all countries have organizations dealing specifically with HF, there was a significant heterogeneity in the organization of HF management and activities of the national HF organizations, which shows paramount importance for developing better cooperation among national HF organizations and HFA.

Currently, NHFS committee has a very close collaboration with more than 50 national HF organizations, including HF Working Group of the Turkish Society of Cardiology (TSC). These member countries bring together at annual NHFS Summit Meeting under the umbrella of the HFA to address the needs of the national HF societies and also create new plans and activities. Over the last few years, European Heart Failure Awareness Day activity initiated by the HFA has been conducted successfully by national HF groups in their own countries in order to raise public awareness. Moreover, HFA has very recently launched the Global Heart Failure Awareness Programme and the white paper entitled “Heart Failure: preventing disease and death worldwide” has been prepared as a core component of the inaugural phase of this Global Awareness Programme which defines policy recommendations on HF prevention, awareness among healthcare professionals, supporting patients and their caregivers and promoting HF research.

NHFS Committee also supports local educational meetings in collaboration with national HF groups and in this context; several local HF meetings have been organized in Turkey by HF working group of the TSC in association with HFA in order to increase guidelines implementation. One of the main projects run by NHFS Committee is the European-wide Heart Failure Registry aimed to register patients with all different types of HF and integrate existing European HF registries into this Europeanwide cumulative registry and this project is currently under design process.