International Circulation:  Heart failure clinic seems a promising approach to meet the challenge of reducing mortality and re-hospitalization rates of heart failure. What is the reality of HF clinics in US?
《国际循环》：心衰诊所似乎是降低心衰死亡率和再住院率的有前景的方法，美国心衰诊所的现实情况如何？

Mariell Jessup:   There is a growing recognition that specialized clinics probably have the best outcomes for patients with advanced heart failure.  In our country the vast majority or heart failure patients are taken care of by general practioners or internists， but the advanced patient probably require advanced， specialized clinics.  In the United States there is now an advanced secondary subspecialty of cardiology， just like there is interventional cardiology and electrophysiology， there is now a new subspecialty called advanced heart failure and transplant recognizing that this is a very special field which will grow in the future.
Mariell Jessup: 越来越多的人认识到专科诊所可能是改善严重心力衰竭预后最好的手段。在美国绝大多数心衰患者是由全科医生或内科医生护理，但严重心力衰竭患者可能需要先进的专科诊所。在美国，与介入性心脏病学和电生理学一样，“严重心力衰竭和移植”已成为一门新的心脏病学二级学科，人们意识到这是一个在将来会有所发展的特殊领域。因为这是一个全新的二级学科，所以我们还不清楚目前有多少医生加入。2008年九月，美国内科学委员会批准了成立该学科的提案，目前正在编写考试题目，2010年将举行第一次考试，届时我们会对愿意参加认证的人数有准确的认识。

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