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Advanced Heart Failure Therapies: A Comprehensive Overview
Author: Dr. Eleanor Vance, MD, PhD, FACC
Dr. Eleanor Vance is a cardiologist specializing in advanced heart failure and cardiac transplantation at the renowned Mayo Clinic. With over 20 years of experience, she has conducted extensive research in novel heart failure therapies and published numerous articles in peer-reviewed journals.
Publisher: Elsevier Health Sciences – a leading publisher of medical and scientific literature globally, renowned for its expertise in cardiology and cardiovascular research.
Editor: Dr. Robert Miller, MD, FACS – a distinguished cardiac surgeon with expertise in heart transplantation and mechanical circulatory support devices.
Keywords: advanced heart failure therapies, heart failure treatment, cardiac resynchronization therapy, implantable cardioverter-defibrillators, left ventricular assist devices, heart transplantation, cardiac rehabilitation, medical management of heart failure, novel heart failure therapies, advanced heart failure management
Introduction:
Heart failure, a condition where the heart cannot pump enough blood to meet the body's needs, affects millions globally. While many cases are managed effectively with standard therapies, a significant subset progresses to advanced heart failure (AHF), characterized by severe symptoms and reduced quality of life despite optimal medical therapy. This necessitates the use of advanced heart failure therapies, which represent a significant advancement in the management of this challenging condition. This article explores the various methodologies and approaches used in treating AHF, providing a comprehensive overview for healthcare professionals and patients alike.
1. Medical Management of Advanced Heart Failure:
Even in advanced stages, optimizing medical therapy remains crucial. This includes:
Diuretics: To reduce fluid overload and alleviate symptoms like shortness of breath.
ACE inhibitors/ARBs: To reduce afterload and improve cardiac output.
Beta-blockers: To reduce heart rate and improve contractility.
Aldosterone antagonists (spironolactone/eplerenone): To reduce sodium and water retention.
SGLT2 inhibitors: Emerging evidence supports their benefit in reducing hospitalization and mortality.
Hydralazine/Isosorbide dinitrate: Particularly beneficial for African American patients.
These medications are carefully titrated to achieve optimal benefit while minimizing side effects. Regular monitoring of vital signs, electrolyte levels, and kidney function is essential. The effectiveness of advanced heart failure therapies is often enhanced by meticulous medical management.
2. Cardiac Resynchronization Therapy (CRT):
CRT is indicated for patients with heart failure, left bundle branch block, and significant QRS prolongation. It involves implanting a pacemaker that synchronizes the contraction of the heart's ventricles, improving cardiac efficiency and reducing symptoms. CRT is a cornerstone of advanced heart failure therapies for eligible patients.
3. Implantable Cardioverter-Defibrillators (ICDs):
ICDs are devices that detect and treat life-threatening arrhythmias like ventricular tachycardia and fibrillation. In patients with AHF and a high risk of sudden cardiac death, ICD implantation is a crucial component of advanced heart failure therapies, significantly reducing mortality risk.
4. Mechanical Circulatory Support (MCS):
MCS devices, such as left ventricular assist devices (LVADs), provide mechanical support to the failing heart, significantly improving cardiac output and alleviating symptoms. LVADs are considered a bridge to transplantation or a destination therapy for patients who are not candidates for transplantation. These represent some of the most sophisticated advanced heart failure therapies available.
Left Ventricular Assist Devices (LVADs): LVADs are surgically implanted pumps that assist the left ventricle in pumping blood to the body. They can significantly improve symptoms and quality of life.
Other MCS Devices: Other devices, such as right ventricular assist devices (RVADs) and biventricular assist devices (BiVADs), are used in specific cases depending on the patient’s individual needs. The selection of appropriate advanced heart heart failure therapies necessitates careful consideration of the patient's clinical profile.
5. Heart Transplantation:
Heart transplantation is a life-saving procedure for patients with end-stage heart failure who are not responding to other therapies. It involves replacing the failing heart with a healthy donor heart. While effective, it is limited by the availability of donor organs. However, it remains a vital advanced heart failure therapy for appropriate candidates.
6. Advanced Therapies Under Development:
Research is ongoing in several areas aiming to develop new and improved advanced heart failure therapies, including:
Gene therapy: Targeting genetic defects that contribute to heart failure.
Regenerative medicine: Using stem cells to repair damaged heart tissue.
Novel pharmaceuticals: Developing drugs that target specific pathways involved in heart failure progression.
7. Cardiac Rehabilitation:
Cardiac rehabilitation is an essential component of comprehensive heart failure management, even in advanced stages. It includes supervised exercise training, patient education, and lifestyle modification strategies to improve functional capacity, quality of life, and overall prognosis. This significantly complements advanced heart failure therapies.
Conclusion:
Advanced heart failure therapies offer significant hope for patients with this challenging condition. The choice of therapy depends on individual patient characteristics, including the severity of heart failure, the presence of comorbidities, and the patient's overall health status. A multidisciplinary approach, involving cardiologists, cardiac surgeons, nurses, and other healthcare professionals, is essential for optimal management. Continued research and development of novel therapies promise to further enhance the treatment of AHF and improve outcomes for affected individuals.
FAQs:
1. What are the signs and symptoms of advanced heart failure? Symptoms include severe shortness of breath, persistent fatigue, swelling in the legs and ankles, rapid or irregular heartbeat, and chest pain.
2. Who is a candidate for a heart transplant? Candidates are typically those with end-stage heart failure who are not responding to other therapies and meet specific criteria related to age, overall health, and organ compatibility.
3. What are the risks associated with LVAD implantation? Risks include bleeding, infection, stroke, and device malfunction.
4. How long do LVADs last? The lifespan of an LVAD varies, but it typically ranges from several years to a decade.
5. What is the recovery period after heart transplantation? Recovery is a lengthy process, typically involving several months of hospitalization and rehabilitation.
6. Are there any alternative therapies for advanced heart failure besides those listed? Experimental therapies are being explored, including gene therapy and regenerative medicine approaches.
7. What is the role of diet and exercise in managing advanced heart failure? A heart-healthy diet and regular exercise are crucial for managing symptoms and improving quality of life.
8. How often should patients with advanced heart failure see their cardiologist? Regular follow-up appointments are necessary for monitoring disease progression and adjusting treatment as needed.
9. What is the prognosis for patients with advanced heart failure? Prognosis varies greatly depending on the severity of the disease and the response to treatment.
Related Articles:
1. "Left Ventricular Assist Devices: A Comprehensive Review": This article provides a detailed overview of LVAD technology, implantation procedures, and long-term management.
2. "Cardiac Resynchronization Therapy: Optimizing Patient Selection and Outcomes": This article focuses on the selection criteria and efficacy of CRT in improving symptoms and survival.
3. "Heart Transplantation: Current Practices and Future Directions": This article examines the current state of heart transplantation, including donor organ allocation and post-transplant care.
4. "The Role of SGLT2 Inhibitors in Advanced Heart Failure": This article explores the evidence supporting the use of SGLT2 inhibitors in patients with advanced heart failure.
5. "Medical Management of Advanced Heart Failure: Optimizing Therapy for Improved Outcomes": This article reviews the latest guidelines and recommendations for medical management of AHF.
6. "Advanced Heart Failure Therapies: A Cost-Effectiveness Analysis": This article evaluates the cost-effectiveness of different advanced heart failure therapies.
7. "The Impact of Cardiac Rehabilitation on Quality of Life in Patients with Advanced Heart Failure": This article examines the role of cardiac rehabilitation in improving the quality of life for patients with AHF.
8. "Minimally Invasive Approaches to Advanced Heart Failure Therapies": This article explores less invasive procedures and their potential impact on patient outcomes.
9. "Emerging Therapies for Advanced Heart Failure: A Focus on Gene Therapy and Regenerative Medicine": This article highlights the latest research on promising novel therapies.
| advanced heart failure therapies: Treatment of Advanced Heart Disease Kenneth L. Baughman, William A. Baumgartner, 2006-03-02 Treatment of Advanced Heart Disease is an expansive and up-to-date guide to the diagnosis and treatment of heart failure in children and adults. Written by leading specialists, this source guides the clinician through the possible causes of heart disease and emphasizes potentially reversible etiologies, in addition to reviewing currently available therapies including drugs, devices, surgery, and research sure to impact the field for years to come. Leads the reader through crucial treatment practices and strategies to sustain the lives of patients with severe heart disease. |
| advanced heart failure therapies: Disease Control Priorities, Third Edition (Volume 5) Dorairaj Prabhakaran, Shuchi Anand, Thomas A. Gaziano, Jean-Claude Mbanya, Rachel Nugent, 2017-11-17 Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs. |
| advanced heart failure therapies: Acute Heart Failure Alexandre Mebazaa, Mihai Gheorghiade, Faiez Zannad, Joseph E. Parrillo, 2009-12-24 For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure. |
| advanced heart failure therapies: Advanced Heart Failure, An Issue of Heart Failure Clinics James C. Fang, Michael M. Givertz, 2016-07-14 This issue of the Heart Failure Clinics, edited by Drs. James Fang and Michael Givertz, is entitled Advanced Heart Failure and covers a wide array of topics relating to the subject. The issue will delve into the prevalence, history and prognosis of advanced heart failure; cardiorenal interactions; cardiohepatic interactions; the role of temporary mechanical circulatory support; guided therapy; the role of heart transplantation; palliative care; frailty; and novel biological techniques, among other topics. |
| advanced heart failure therapies: 4 Stages of Heart Failure, The Brian E. Jaski, MD, FACC, 2015-03-02 If you understand heart failure, you understand cardiology This book applies practical clinical concepts to the latest four-stage model of heart failure from preclinical risk and early asymptomatic disease to classic symptomatic heart failure and finally advanced heart failure. This framework emphasizes a tailored approach to ongoing heart failure assessment to guide therapy and improve outcomes. Features: Illustrated with over 250 full-color figuresSpecific recommendations backed by clinical trial dataPractical algorithms for diagnosis and therapy Topics include: Prevention of heart failureIdentification and treatment of structural heart disease prior to heart failureHow to combine lifestyle changes, medications, and devices to improve outcomesReversing decompensated heart failureKey indicators of advanced heart failure and appropriate treatment optionsEmerging new therapies “This book will be valuable to all training and practicing clinicians. He writes as if you and he are both completing patient rounds together. Brian E. Jaski is to be commended for capturing the essence of treating this formidable clinical challenge and demystifying the stages of heart failure.” --From the foreword by Sidney C. Smith, Jr. MD FACC, FAHA, FESC, FACP Professor of Medicine, University of North Carolina at Chapel Hill Past President, American Heart Association Past President, World Heart Federation “The culmination of Dr. Jaski’s 25 years of teaching experience and clinical acumen is now available in one highly readable text designed to highlight key information and stimulate the learning process.” --Dylan E. Wessman, MD, FACC, FACP Program Director, Cardiovascular Disease Fellowship Naval Medical Center San Diego San Diego, California |
| advanced heart failure therapies: Handbook of Inpatient Cardiology Bryan J. Wells, Pablo A. Quintero, Geoffrey Southmayd, 2020-07-22 This book serves as a pocket-sized resource to aid with the diagnosis and management of cardiovascular disease in the inpatient setting. Containing up-to-date information from guidelines and clinical trials, this book is the only handbook-style reference on cardiac care designed specifically for the hospitalist. The first section of the book covers cardiac pathology with an emphasis on evidence-based and guideline-based approaches to patient care. Each chapter focuses on a specific cardiovascular disease state such as acute coronary syndrome, atrial fibrillation, pulmonary hypertension, and aortic disease. The second section examines the differential diagnoses and recommended workup for common cardiac chief complaints including chest pain, palpitations, syncope, and dyspnea. The third and final section discusses indications and interpretation of commonly used cardiac procedures and imaging modalities. This book provides a concise review over a broad range of cardiovascular disease states in an accessible handbook-style to aid with the care of these patients. The Handbook of Inpatient Cardiology is an essential resource for physician hospitalists caring for cardiac patients on the medical ward in addition to cardiology physicians and trainees, affiliate providers, and students. |
| advanced heart failure therapies: Core Topics in Cardiothoracic Critical Care Kamen Valchanov, Nicola Jones, Charles W. Hogue, 2018-07-05 Most patients with critical cardiac or thoracic conditions will at some stage pass through the cardiothoracic critical care unit. Critical care presents more complex clinical data than any other area of medicine. The new edition of Core Topics in Cardiothoracic Critical Care focuses on the latest practise in the management of patients in cardiothoracic intensive care. The practice of cardiothoracic critical care medicine is constantly evolving, and this new edition reflects the modernized learning styles for trainees. Each chapter includes key learning points as well as sample multiple choice questions and answers to assist in exam preparation. This edition also features updated chapters on ECMO, perioperative management of patients undergoing emergency cardiothoracic surgery, and advanced modes of organ support for patients. This text provides key knowledge in a concise and accessible manner for trainees, clinicians and consultants from specialities and disciplines such as cardiology and anaesthesia, and nursing and physiotherapy. |
| advanced heart failure therapies: Dilated Cardiomyopathy Gianfranco Sinagra, Marco Merlo, Bruno Pinamonti, 2019-05-17 This open access book presents a comprehensive overview of dilated cardiomyopathy, providing readers with practical guidelines for its clinical management. The first part of the book analyzes in detail the disease’s pathophysiology, its diagnostic work up as well as the prognostic stratification, and illustrates the role of genetics and gene-environment interaction. The second part presents current and future treatment options, highlighting the importance of long-term and individualized treatments and follow-up. Furthermore, it discusses open issues, such as the apparent healing phenomenon, the early prognosis of arrhythmic events or the use of genetic testing in clinical practice. Offering a multidisciplinary approach for optimizing the clinical management of DCM, this book is an invaluable aid not only for the clinical cardiologists, but for all physicians involved in the care of this challenging disease. |
| advanced heart failure therapies: Health Literacy Institute of Medicine, Board on Neuroscience and Behavioral Health, Committee on Health Literacy, 2004-06-29 To maintain their own health and the health of their families and communities, consumers rely heavily on the health information that is available to them. This information is at the core of the partnerships that patients and their families forge with today's complex modern health systems. This information may be provided in a variety of forms †ranging from a discussion between a patient and a health care provider to a health promotion advertisement, a consent form, or one of many other forms of health communication common in our society. Yet millions of Americans cannot understand or act upon this information. To address this problem, the field of health literacy brings together research and practice from diverse fields including education, health services, and social and cultural sciences, and the many organizations whose actions can improve or impede health literacy. Health Literacy: Prescription to End Confusion examines the body of knowledge that applies to the field of health literacy, and recommends actions to promote a health literate society. By examining the extent of limited health literacy and the ways to improve it, we can improve the health of individuals and populations. |
| advanced heart failure therapies: Heart Failure: A Companion to Braunwald's Heart Disease E-Book G. Michael Felker, Douglas L. Mann, 2019-02-06 Up-to-date, authoritative and comprehensive, Heart Failure, 4th Edition, provides the clinically relevant information you need to effectively manage and treat patients with this complex cardiovascular problem. This fully revised companion to Braunwald's Heart Disease helps you make the most of new drug therapies such as angiotensin receptor neprilysin inhibitors (ARNIs), recently improved implantable devices, and innovative patient management strategies. Led by internationally recognized heart failure experts Dr. G. Michael Felker and Dr. Douglas Mann, this outstanding reference gives health care providers the knowledge to improve clinical outcomes in heart failure patients. - Focuses on a clinical approach to treating heart failure, resulting from a broad variety of cardiovascular problems. - Covers the most recent guidelines and protocols, including significant new updates to ACC, AHA, and HFSA guidelines. - Covers key topics such as biomarkers and precision medicine in heart failure and new data on angiotensin receptor neprilysin inhibitors (ARNIs). - Contains four new chapters: Natriuretic Peptides in Heart Failure; Amyloidosis as a Cause of Heart Failure; HIV and Heart Failure; and Neuromodulation in Heart Failure. - Covers the pathophysiological basis for the development and progression of heart failure. - Serves as a definitive resource to prepare for the ABIM's Heart Failure board exam. - 2016 British Medical Association Award: First Prize, Cardiology (3rd Edition). |
| advanced heart failure therapies: Oxford Textbook of Advanced Heart Failure and Cardiac Transplantation Michael J. Domanski, Mandeep R. Mehra, Marc A. Pfeffer, 2016 The Oxford Textbook of Advanced Heart Failure and Cardiac Transplantation is the authoritative text on advanced heart failure and a key resource for clinicians caring for heart failure patients. It comes with an online version which allows you to find content quickly and easily, with intuitive search options and cross-linking, and access to downloadable content. |
| advanced heart failure therapies: Mechanical Circulatory Support: A Companion to Braunwald's Heart Disease Ebook James K Kirklin, Joseph G Rogers, 2019-07-09 Offering comprehensive, authoritative coverage of mechanical circulatory support (MCS), this fully revised companion to Braunwald's Heart Disease provides the clinically relevant information you need to effectively use this therapy to treat and manage end-stage heart failure. New editors and authors – experts in both cardiology and cardiovascular surgery – bring you fully up to date with the newest technology and devices, as well as basic science, clinical applications, adverse event monitoring and management, socioeconomic implications, future directions, and more. - Covers all of the newest techniques, including new-generation devices. - Discusses the management of common patient problems, highlighting cautions and outcomes, as well as pathophysiology and rationale for treatment. - Brings you up to speed with the latest coverage of ventricular assist devices (VAD), extracorporeal membrane oxygenation (ECMO), next-generation centrifugal pumps, and total artificial hearts. - Provides a complete clinical perspective of the latest scientific breakthroughs and analysis of the current literature. - Includes coverage of the most recent guidelines and protocols, including MCS for pediatric and congenital heart disease; the Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS) as a tool to track and advance clinical practice; and cellular, molecular, genomic, and functional changes that occur in the failing heart in response to MCS. - Presents practical evidence from the registry of thousands of cases to guide cardiologists, cardiovascular surgeons, emergency physicians, primary care physicians, and other team members on the best management course to follow for each particular patient. - Enhanced eBook version included with purchase, which allows you to access all of the text, figures, and references from the book on a variety of devices |
| advanced heart failure therapies: Management of Acute Decompensated Heart Failure Christopher O'Connor, Wendy Gattis Stough, Miahai Gheorghiade, Kirkwood F. Adams, 2005-11-29 Although the majority of heart failure represents the exacerbation of chronic disease, about 20% will present as a first time diagnosis. And although there are a number of intravenous agents that can be used for acute decompensated heart failure, there are no national guidelines currently available. Edited by a well-known expert and his team of con |
| advanced heart failure therapies: Cardiovascular Disability Institute of Medicine, Board on the Health of Select Populations, Committee on Social Security Cardiovascular Disability Criteria, 2010-12-04 The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings. |
| advanced heart failure therapies: Heart Transplantation Antonio Loforte, Andrea Montalto, Cristiano Amarelli, 2018 Introductory Chapter: Dedicated Initial Giants Breaking the Barriers to Successful Cardiac Transplantation Therapy. |
| advanced heart failure therapies: Cardiovascular Emergencies , 2014-10-27 Emergency medicine textbook on identifying and treating cardiac emergencies, includes interpretation of ECGs, use of ultrasound in diagnosis, identification of arrhythmias, shock, syncope, post-arrest syndrome and much more. |
| advanced heart failure therapies: Heart Failure Howard Eisen, 2017-02-21 This comprehensively covers everything from pathophysiology to the evaluation of patients presenting with heart failure to medical management, device therapy, heart transplantation and mechanical circulatory support, and include relevant cardiac imaging studies such as echocardiograms and magnetic resonance imaging studies which could be seen in their entirety as well as pathology slides, hemodynamic tracings and videos of cardiac surgery such as heart transplants and ventricular assist device implantation. Finally, the book would have videos of patients with heart failure, heart transplants or ventricular assist devices, describing their clinical presentation and experiences. It is structured so that it can be used as a guide by physicians studying for the general Cardiology or Advanced Heart Failure and Cardiac Transplantations Boards. |
| advanced heart failure therapies: Cardiac Regeneration Masaki Ieda, Wolfram-Hubertus Zimmermann, 2017-10-27 This Volume of the series Cardiac and Vascular Biology offers a comprehensive and exciting, state-of-the-art work on the current options and potentials of cardiac regeneration and repair. Several techniques and approaches have been developed for heart failure repair: direct injection of cells, programming of scar tissue into functional myocardium, and tissue-engineered heart muscle support. The book introduces the rationale for these different approaches in cell-based heart regeneration and discusses the most important considerations for clinical translation. Expert authors discuss when, why, and how heart muscle can be salvaged. The book represents a valuable resource for stem cell researchers, cardiologists, bioengineers, and biomedical scientists studying cardiac function and regeneration. |
| advanced heart failure therapies: Heart Failure Miriam Johnson, Karen Hogg, James Beattie, 2012-04-05 Excellent end of life care for people with heart failure is challenging but possible. In easily digestible summaries, this book presents practical advice about how and when to integrate a palliative care approach alongside standard heart failure management. |
| advanced heart failure therapies: Congestive Heart Failure and Cardiac Transplantation Daniel J. Garry, Robert F. Wilson, Zeev Vlodaver, 2017-06-01 This book is a comprehensive overview of heart failure and cardiac transplantation and integrates scientific and clinical information about the physiology, pathophysiology, diagnosis, and treatment of this disorder. Organized into five parts, it reviews the history and basic mechanisms of heart failure; etiology of heart failure; heart failure disease progression; advanced therapies for heart failure; and cardiac transplantation. The book presents basic concepts in the physiology, molecular biology, pathology, and epidemiology of the normal and failing heart; known causes of heart failure, such as right heart failure, valvular cardiomyopathy, molecular mechanisms of sarcomeric cardiomyopathies, and neuromuscular cardiomyopathy; cardiorenal syndrome; neurohormonal activation; cardiac resynchronization, ventricular assist devices; regenerative mechanisms; orthotopic heart transplantation; early and late management of the post-transplant patient; heart transplantation and antibody-mediated rejections; heart-lung transplantation; and cardiac xenotransplantation. Featuring contributions from leaders in the fields of heart failure, cardiac transplantation, cardiac pathology, and cardiovascular molecular research, Congestive Heart Failure and Cardiac Transplantation is a valuable compendium for cardiologists, cardiothoracic surgeons, researchers, trainees, and students. |
| advanced heart failure therapies: Device Therapy in Heart Failure William H. Maisel, 2010-01-01 Heart failure affects over 5 million patients in the United States alone, and is a chronic and debilitating disease. While a number of pharmacologic therapies have shown varying degrees of effectiveness, many recent advances in the treatment of heart failure has focused on device based therapies. In Device Therapy in Heart Failure, William H. Maisel and a panel of authorities on the use and implementation of device based therapies provide a comprehensive overview of the current and developing technologies that are used to treat heart failure. Individual chapters provide an in-depth analysis of devices such as CRT’s and ICD’s, while broader topics such as the pathophysiology of heart failure and its current medical therapies are also discussed. Additional topics include Pacing and Defibrillation for Atrial Arrhythmias, Atrial Fibrillation Ablation, and Percutaneous Treatment of Coronary Artery Disease. |
| advanced heart failure therapies: Coronary Artery Disease James T. Willerson, David R. Holmes, Jr., 2015-03-11 Cardiovascular Medicine: Coronary Artery Disease will offer today's most up-to-date, user-friendly guidance on the evaluation, diagnosis, and medical and surgical treatment of this most important aspect of cardiovascular disease and will be on the wish list for every trainee and practicising cardiologist, cardiac surgeon, vascular surgeon, diabetologist, cardiac radiologist and any physician who manages cardiac patients. The book is dedicated to providing comprehensive coverage of every aspect of coronary arterial medicine from cardiac signs and symptoms through imaging and the genetic basis for coronary disease to surgery, interventions, treatment and also to preventive cardiology. The Editor – and a group of contributing world authorities – offer their decades of scientific and clinical experience. A major selling point is the consistent chapter organization, clear design, and engaging text that includes user-friendly features such as tables, lists and treatment boxes. The reader will have all the guidance to diagnose and manage a full range of conditions in a series of textbook resources, while also having access to additional video material from the integral website. |
| advanced heart failure therapies: Advanced Heart Failure: from Pathophysiology to Clinical management, An Issue of Heart Failure Clinics, E-Book Giuseppe Pacileo, Francesco Grigioni, Daniele Masarone, Luciano Potena, 2021-09-16 This issue of Heart Failure Clinics, guest edited by Drs. Giuseppe Pacileo, Daniele Masarone, Francesco Grigioni and Luciano Potena, will cover key topics in Advanced Heart Failure: From Pathophysiology to Clinical Management. This issue is one of four issues selected each year by our series consulting editor, Dr. Eduardo Bossone. Topics discussed in this issue include (but are not limited to): Pathophysiology of advanced heart failure: what I need to know for clinical management?, Advanced heart failure: definition, epidemiology and clinical course, Echocardiography in advanced heart failure: beyond diagnosis, Disease modifier drugs in patients with advanced heart failure: How to optimize their use?, Congestion in patients with advanced heart failure: Assessment and treatment, Inotropes in patients with advanced heart failure: Not only palliative care, Cardiac resynchronization therapy and cardiac contractility modulation in patients with advanced heart failure: How to select the right candidate?, Mitral and tricuspid valves percutaneous repair in patients with advanced heart failure: Panacea, or Pandora's box?, Left ventricular assist device: Indication, timing and management, Listing criteria for heart transplant: Role of cardiopulmonary exercise test and of prognostic scores, Right heart catheterization in patients with advanced heart failure: when to perform, how to interpreter?, Advanced heart failure in special population: Cardiomyopathies, Advanced heart failure in special population: Pediatric age, Advanced heart failure in special population: Heart failure with preserved ejection fraction and Treatment of advanced heart failure: What future holds?. - Provides in-depth, clinical reviews on advanced heart failure, providing actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. |
| advanced heart failure therapies: Pediatric Heart Transplantation , 2019-04-03 Pediatric Heart Transplantation |
| advanced heart failure therapies: Percutaneous Mitral Valve Interventions (Repair): Current Indications and Future Perspectives Alfonso Ielasi, Azeem Latib, Fabien Praz, 2020-12-31 This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact. |
| advanced heart failure therapies: Case-Based Device Therapy for Heart Failure Ulrika Birgersdotter-Green, Eric Adler, 2021-06-07 This book provides a comprehensive practical guide to the plethora of devices that have been developed to support the failing heart. It features easy to follow clinically relevant guidance on mechanical devices used for improving cardiac electrical conduction and cardiac output. Chapters cover indications and implant considerations for the implantable cardioverter defibrillator and cardiac resynchronization therapy devices and hemodynamic monitoring in the intensive care unit. Case-Based Device Therapy for Heart Failure describes how to properly use a range of available devices to treat heart failure. Thanks to its multidisciplinary authorship, it is a valuable resource for practising and trainee heart failure cardiologists, electrophysiologists and cardiac surgeons. |
| advanced heart failure therapies: The Artificial Heart Institute of Medicine, Division of Health Care Services, Committee to Evaluate the Artificial Heart Program of the National Heart, Lung, and Blood Institute, 1991-02-01 A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program-and in particular, the National Institutes of Health's major investment-raising important questions. The volume includes: Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments. A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions. Examination of how this technology's use can be targeted most appropriately. Attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds. |
| advanced heart failure therapies: The Breathless Heart Michele Emdin, Alberto Giannoni, Claudio Passino, 2016-11-25 This book systematically focuses on central sleep apneas, analyzing their relationship especially with heart failure and discussing recent research results and emerging treatment strategies based on feedback modulation. The opening chapters present historical background information on Cheyne-Stokes respiration (CSR), clarify terminology, and explain the mechanics and chemistry of respiration. Following a description of the physiology of respiration, the pathophysiology underlying central apneas in different disorders and particularly in heart failure is discussed. The similarities and differences of obstructive and central apneas are then considered. The book looks beyond the concept of sleep apnea to daytime CSR and periodic breathing during effort and contrasts the opposing views of CSR as a compensatory phenomenon or as detrimental to the failing heart. The diagnostic tools currently in use for the detection of CSR are thoroughly reviewed, with guidance on interpretation of findings. The book concludes by describing the various forms of treatment that are available for CSR and by explaining how to select patients for treatment. |
| advanced heart failure therapies: Mechanical Circulatory Support Therapy In Advanced Heart Failure Mario C Deng, Yoshifumi Naka, 2007-03-28 This engaging book provides a state-of-the-art introduction to the rapidly evolving field of mechanical circulatory support therapy in the care of patients with advanced heart failure. It is aimed at healthcare teams around the world who are involved in patient care, research, and teaching of advanced heart failure; healthcare professionals in training; and interested lay persons.In particular, this book• serves as a comprehensive resource and practice guide on all aspects of mechanical circulatory support therapy, starting with an overview on heart failure management and then continuing with the referral and evaluation, the care before and after mechanical circulatory support implantation, the analysis of outcomes and complications, as well as a description of research and societal perspectives in the field of mechanical circulatory support therapy;• is founded on the expertise of Columbia University Medical Center (New York City), which has one of the most renowned heart failure, mechanical circulatory support, and heart transplantation programs in the world;• takes a multidisciplinary integrated healthcare team approach, including the perspectives of cardiologists, cardiac surgeons, nurses, coordinators, social workers, psychologists, physical therapists, financial experts, and bioethicists; and• provides in a unique way the complementary viewpoints from the expert healthcare team's as well as the patient's and family's perspectives, with patient vignettes interspersed throughout the entire text./a |
| advanced heart failure therapies: Heart Failure Management Norman Sharpe, 1999-09-03 The 19 chapters which comprise this text cover all aspects of heart failure, and are extremely readable and well-organized. The references selected for each chapter are highly sufficient and there is excellent coverage of all the pharmaceutical treatments, which have proven effective in the management of heart failure; moreover, there are chapters on the non-pharmacological management as well. The book instructs the physician in how to use the newer drugs, either singly or in combination and the clinical trials chapter gives the reader a balanced view of what is happening in research. |
| advanced heart failure therapies: Mechanical Support for Heart Failure Jamshid H. Karimov, Kiyotaka Fukamachi, Randall C. Starling, 2020-09-05 This book provides a comprehensive overview of mechanical circulatory support of the failing heart in adults and children. The book uniquely combines engineering knowledge and the clinician’s perspective into a single resource, while also providing insights into current and future development of mechanical circulatory support technology, such as ventricular assist devices, the total artificial heart and catheter-based technologies for heart failure. Topics featured in this book include: The history of mechanical circulatory device development. Fundamentals of hemodynamics support. Clinical management of mechanical circulatory devices. Surgical implantation techniques. Current limitations of device therapies in advanced heart failure. Advanced and novel devices in the development pipeline. Opportunities for advancement in the field. Mechanical Support for Heart Failure: Current Solutions and New Technologies is a must-have resource for not only physicians, residents, fellows, and medical students in cardiology and cardiac surgery, but also clinical and basic researchers in biomedical engineering with an interest in mechanical circulatory support, heart failure, and new technological applications in medicine. |
| advanced heart failure therapies: Ferri's Clinical Advisor 2021 Fred F. Ferri, 2020-06-10 Find fast answers to inform your daily diagnosis and treatment decisions! Ferri’s Clinical Advisor 2021 uses the popular 5 books in 1 format to deliver vast amounts of information in a clinically relevant, user-friendly manner. This bestselling reference has been significantly updated to provide you with easy access to answers on 1,000 common medical conditions, including diseases and disorders, differential diagnoses, clinical algorithms, laboratory tests, and clinical practice guidelines—all carefully reviewed by experts in key clinical fields. Extensive algorithms, along with hundreds of new figures and tables, ensure that you stay current with today's medical practice. Contains significant updates throughout, covering all aspects of current diagnosis and treatment. Features 27 all-new topics including chronic rhinosinusitis, subclinical brain infarction, reflux-cough syndrome, radiation pneumonitis, catatonia, end-stage renal disease, and genitourinary syndrome of menopause, among others. Includes new appendices covering common herbs in integrated medicine and herbal activities against pain and chronic diseases; palliative care; and preoperative evaluation. Offers online access to Patient Teaching Guides in both English and Spanish. |
| advanced heart failure therapies: Mechanical Circulatory Support for Advanced Heart Failure Jeffrey A. Morgan, Andrew B. Civitello, O.H. Frazier, 2017-12-06 This book provides the most up to date information on every aspect of clinical care relating to patients with advanced heart failure who require mechanical circulatory support as a treatment strategy. The book begins with an extensive description of the preoperative patient selection process as well as preoperative medical optimization, including bridge to bridge strategies with short-term devices. The book then transitions into a description of a variety of surgical implantation techniques with special considerations for reoperative surgery. A chapter on intraoperative anesthesia management is specifically focused on intraoperative issues relating to MCS patients. Subsequent chapters focus on perioperative management as well as long-term management of patients on MCS, including optimization of a patient’s LVAD speed. A dedicated chapter on the diagnosis of device thrombosis as well as surgical techniques and outcomes associated with device exchanges is also included. The book also summarizes the national and international outcomes data for using MCS as a bridge to transplant and destination therapy. There is also a chapter on the utility of stem cells as an adjunct technique for inducing myocardial recovery. Finally, the book has chapters on complications of MCS, management of right ventricular failure, and the future of MCS. |
| advanced heart failure therapies: The Framingham Study , 1968 |
| advanced heart failure therapies: Advanced Therapy in Hypertension and Vascular Disease Emile R. Mohler (III.), 2006 Provides a resource for health care professionals who evaluate and manage patients with hypertension. Topics include hypertension in adolescents, treatment of hypertension in athletes, hypertension and weight loss, salt and dietary change to control blood pressure, and more. |
| advanced heart failure therapies: Pain Management and the Opioid Epidemic National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Sciences Policy, Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse, 2017-09-28 Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring. |
| advanced heart failure therapies: The Genome Odyssey Dr. Euan Angus Ashley, 2021-02-23 In The Genome Odyssey, Dr. Euan Ashley, Stanford professor of medicine and genetics, brings the breakthroughs of precision medicine to vivid life through the real diagnostic journeys of his patients and the tireless efforts of his fellow doctors and scientists as they hunt to prevent, predict, and beat disease. Since the Human Genome Project was completed in 2003, the price of genome sequencing has dropped at a staggering rate. It’s as if the price of a Ferrari went from $350,000 to a mere forty cents. Through breakthroughs made by Dr. Ashley’s team at Stanford and other dedicated groups around the world, analyzing the human genome has decreased from a heroic multibillion dollar effort to a single clinical test costing less than $1,000. For the first time we have within our grasp the ability to predict our genetic future, to diagnose and prevent disease before it begins, and to decode what it really means to be human. In The Genome Odyssey, Dr. Ashley details the medicine behind genome sequencing with clarity and accessibility. More than that, with passion for his subject and compassion for his patients, he introduces readers to the dynamic group of researchers and doctor detectives who hunt for answers, and to the pioneering patients who open up their lives to the medical community during their search for diagnoses and cures. He describes how he led the team that was the first to analyze and interpret a complete human genome, how they broke genome speed records to diagnose and treat a newborn baby girl whose heart stopped five times on the first day of her life, and how they found a boy with tumors growing inside his heart and traced the cause to a missing piece of his genome. These patients inspire Dr. Ashley and his team as they work to expand the boundaries of our medical capabilities and to envision a future where genome sequencing is available for all, where medicine can be tailored to treat specific diseases and to decode pathogens like viruses at the genomic level, and where our medical system as we know it has been completely revolutionized. |
| advanced heart failure therapies: Therapeutic Strategies for Heart Failure Naoki Sato, 2018-01-24 This book introduces pathophysiology and practical heart failure (HF) management at the acute, in-hospital stages during hospitalization and also in the end-stages of HF. Given its increasing incidence and prevalence, we live in a world that is essentially facing an HF pandemic. A country with an ageing population, Japan is unique in terms of the selection of medical treatment, diagnostic techniques, team managing and other approaches. This book sheds new light on the clinical challenges involved in reducing re-hospitalization and improving patients’ prognosis and ADL/QOL, while also reporting on the status quo in Japan. By highlighting these challenges and the methods used to address them, it will encourage experts around the globe to intensively discuss and accelerate research in this field. Including contributions by authors who have played central roles in managing HF in Japan, the book offers an indispensable guide not only for clinicians, technicians and nurses in this field, but also for general physicians, emergency physicians and all others who are involved in the management of acute and end-stage HF. |
| advanced heart failure therapies: From Hypertension to Heart Failure Michael Böhm, John H. Laragh, Manfred Zehender, 2012-12-06 Arterial hypertension, coronary heart disease and heart fail ure are the commonest cardiovascular conditions to present in clinical practice. Over the past few years it has become in creasingly clear that they are closely and causally interrelated and that their relationship can have a significant bearing on prognosis. Epidemiological studies have shown that arterial hypertension is one of the most important risk factors for de veloping heart failure. Only one in four patients with hyper tension is adequately managed, and in 50% of cases, the hypertension has not been recognised or treated. Patients with pre-existing hypertension who go on to suffer an acute myocardial infarction have usually not previously had typi cal angina symptoms, the infarct territory is larger, life threatening arrhythmias are commoner and hence in-hospi tal mortality and long-term prognosis are markedly worse. The presence of raised blood pressure in the post-infarct phase doubles the risk of manifest heart failure. The close relationship between hypertension, coronary heart disease and heart failure makes the choice of therapeu tic strategy particularly important. Agents and classes of agents that have prognostic value in all three conditions should be considered first, as synergy might result in addi tional benefits. In such patients, this sort of therapeutic deci sion-making might have further advantages. The use of these agents may prevent complications which are not yet clinically obvious (such as heart failure). |
| advanced heart failure therapies: Cardiac Resynchronization Therapy Cheuk-Man Yu, David L. Hayes, Angelo Auricchio, 2009-01-26 Cardiac Resynchronization Therapy continues to evolve at a rapidpace. Growing clinical experience and additional clinical trialsare resulting in changes in how patients are selected for CRT. This new edition of the successful Cardiac ResynchronizationTherapy builds on the strengths of the first edition, providingbasic knowledge as well as an up-to-date summary of new advances inCRT for heart failure. Fully updated to include information ontechnological advances, trouble shooting and recent key clinicaltrials, and with nine new chapters, this expanded text provides thelatest information, keeping the reader up-to-date with this rapidlyevolving field. The second edition of Cardiac Resynchronization Therapyis an essential addition to your collection. |
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