Therapies for Advanced Heart Failure Patients Ineligible for Heart Transplantation: Beyond Pharmacotherapy

Publication date: February 2020Source: Canadian Journal of Cardiology, Volume 36, Issue 2Author(s): Ashlay A. Huitema, Karen Harkness, Shiraz Malik, Neville Suskin, Robert S. McKelvieAbstractGlobally, there are ∼ 26 million people living with heart failure (HF), 50% of them with reduced ejection fraction, costing countries billions of dollars each year. Improvements in treatment of cardiovascular diseases, including advanced HF, have allowed an unprecedented number of patients to survive into old age. Despite these advances, patients with HF deteriorate and often require advanced therapies. As the proportion of elderly patients in the population increases, there will be an increasing number of patients to be evaluated for advanced therapies and an increasing number that do not qualify for, won’t be considered for, or decline orthotopic heart transplantation. The purpose of this article is to review the benefits of palliative care (PC), exercise-based cardiac rehabilitation (ExCR), device therapy (cardiac resynchronization therapy and mitral clip), and mechanical circulatory support (MCS) in advanced HF patients who are transplant ineligible. PC interventions should be introduced early in the course of a patient’s diagnosis to manage symptoms, address goals of care, and improve patient-centered outcomes. Further improvement in health-related quality of life as well as functional capacity can be achieved safely in patients with advanced HF through patient partic...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research

Related Links:

Publication date: Available online 5 April 2020Source: Urology Case ReportsAuthor(s): Arvind Krishnan, Jeffy Jacob, Trushar Patel
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Authors: Lin X, Fang L Abstract Heart failure (HF) is defined as a clinical syndrome resulting from structural or functional impairment of ventricular fillings or ejections of blood. Currently, HF is divided into three groups which include HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF) and HF with midrange EF (HFmrEF). Even though major advances have been made in treating HFrEF during the past decades, heart failure is a fatal disease. In this review, we briefly summarize the current advances in pharmaceutical managements for heart failure, which includes drugs used in acute ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Authors: Gu D, Qu J, Zhang H, Zheng Z Abstract Coronary revascularization is the most important strategy for coronary artery disease. This review summarizes the current most prevalent approaches for coronary revascularization and discusses the evidence on the mechanisms, indications, techniques, and outcomes of these approaches. Targeting coronary thrombus, fibrinolysis is indicated for patients with diagnosed myocardial infarction and without high risk of severe hemorrhage. The development of fibrinolytic agents has improved the outcomes of ST-elevation myocardial infarction. Percutaneous coronary intervention has...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
This report reviews our basic studies and clinical trials using curcumin therapeutically to prevent heart failure, as well as the possibility of clinical applications of curcumin. PMID: 32238626 [PubMed - in process]
Source: Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan - Category: Drugs & Pharmacology Authors: Tags: Yakugaku Zasshi Source Type: research
Publication date: Available online 2 April 2020Source: Revista Clínica Española (English Edition)Author(s): J.P. Miramontes González, L. Pérez de Isla
Source: Revista Clinica Espanola - Category: Internal Medicine Source Type: research
PMID: 32238128 [PubMed - as supplied by publisher]
Source: Current Topics in Medicinal Chemistry - Category: Chemistry Authors: Tags: Curr Top Med Chem Source Type: research
Resumo A s índrome da fístula artério-portal (FAP) é uma rara e reversível causa de hipertensão portal pré-sinusoidal, ocasionada pela comunicação de uma artéria visceral com o sistema venoso portal. A maioria dos pacientes é assintomática, mas quando desenvolvem sintomas, estes são mais relaciona dos com sangramento gastrointestinal, ascite, insuficiência cardíaca congestiva e diarreia. Este desafio terapêutico apresenta um caso de FAP decorrente de ferimento antigo por arma branca e subsequente evoluç&atil...
Source: Jornal Vascular Brasileiro - Category: Surgery Source Type: research
Reduced expression of the key regulator of cardiac metabolism, transcription factor PPAR α, in surgical samples of the auricles from patients with coronary heart disease and heart failure was detected by real-time quantitative PCR. These changes indicate reduced activity of this factor and a shift of energy metabolism from oxidative phosphorylation to glycolysis typical of dedifferenti ated cells. Electron microscopy revealed dedifferentiated cardiomyocytes with disassembled contractile apparatus and disorganized sarcomeres. In the examined specimens from patients with heart failure, severe myocardial fibrosis was revealed.
Source: Bulletin of Experimental Biology and Medicine - Category: Biology Source Type: research
AbstractBackgroundVarious postoperative predictive markers following cardiovascular surgery have been examined for use in the current aging population. The controlling nutritional status (CONUT) score, which is advocated not only as a screening tool for poor nutritional status, but also as an immunonutritional assessment, has started to attract attention in several clinical settings, such as in cancer and heart failure patients. The aim of this study was to evaluate the value of the CONUT score as a postoperative prognostic marker in patients who underwent cardiovascular surgery.MethodsA total of 75 patients who underwent ...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
END-STAGE heart failure remains one of the leading causes of hospitalization in patients older than 65 years and carries a 50% mortality within 5 years of initial diagnosis.1 Heart transplantation once was believed to be associated with increased morbidity; however, dramatic advancements in immunosuppression and preservation techniques have contributed to a significant improvement in survival. One-year survival after heart transplantation in the 1980s was as low as 76%, whereas now it has improved to 85%, with many experienced centers reporting even higher rates.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research
More News: Canada Health | Cardiac Resynchronization Therapy | Cardiology | Cardiovascular | Heart | Heart Failure | Heart Transplant | Palliative | Palliative Care | Rehabilitation | Sexual Abuse | Sports Medicine | Transplant Surgery | Transplants