Contents
Saurabh Rajpal, Ragavendra R. Baliga, and Eduardo Bossone (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - March 9, 2024 Category: Cardiology Source Type: research
Forthcoming Issues
Amyloid Cardiomyopathies: Clinical, Diagnostic and Therapeutic Aspects (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - March 9, 2024 Category: Cardiology Source Type: research
Heart Failure in Adults with Congenital Heart Disease: The Time to Act is Now
The aim of this work is to provide a comprehensive review of all aspects of heart failure in adults with congenital heart disease (ACHD) (Fig. 1). While the surge in heart failure due to acquired heart disease is well-known, the parallel increase in heart failure cases within the congenital heart disease (CHD) population remains underappreciated. Notably, ACHD heart failure is characterized by prolonged hospitalization periods and elevat ed health care costs compared with acquired heart disease–related heart failure. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - January 29, 2024 Category: Cardiology Authors: Saurabh Rajpal, Ragavendra Baliga, Eduardo Bossone Tags: Preface Source Type: research
Adults with Congenital Heart Disease and Transplant
The rate of heart transplantation in adults with congenital heart disease (ACHD) is rising, but the 1-year mortality posttransplantation remains higher than non-ACHD patients. A robust pretransplant assessment and operative and postoperative planning can mitigate much of the perioperative risk. Importantly, ACHD patients who survive the first year have significantly better 10-year survival compared with non-ACHD patients. The current allocation system gives ACHD patients a relatively high priority, but providers must use the prespecified exception requests for higher status, especially for patients with the Fontan circulat...
Source: Heart Failure Clinics - January 24, 2024 Category: Cardiology Authors: Nicole Herrick, Marcus Urey, Laith Alshawabkeh Source Type: research
Failing with Cyanosis-Heart Failure in End-Stage Unrepaired or Partially Palliated Congenital Heart Disease
Heart failure in cyanotic congenital heart disease (CHD) is diagnosed clinically rather than relying solely on ventricular function assessments. Patients with cyanosis often present with clinical features indicative of heart failure. Although myocardial injury and dysfunction likely contribute to cyanotic CHD, the primary concern is the reduced delivery of oxygen to tissues. Symptoms such as fatigue, lassitude, dyspnea, headaches, myalgias, and a cold sensation underscore inadequate tissue oxygen delivery, forming the basis for defining heart failure in cyanotic CHD. Thus, it is pertinent to delve into the components of ox...
Source: Heart Failure Clinics - January 19, 2024 Category: Cardiology Authors: Nael Aldweib, Craig Broberg Source Type: research
Vision Statement and Call to Action for Adult Congenital Heart Disease Heart Failure
For the last several decades, the majority of those born with congenital heart disease (CHD) have survived to adulthood, and not just those with simple or moderate forms of CHD but also those with complex and severe forms of CHD. The overall prevalence of CHD has shifted to adulthood, driven by the improved survival of those with complex CHD. As such, the median age for patients with complex CHD now sits squarely in adulthood, to be cared for by adult congenital heart disease (ACHD) specialists. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - January 19, 2024 Category: Cardiology Authors: Curt J. Daniels Tags: Special Article Source Type: research
Heart Failure Staging and Indications for Advanced Therapies in Adults with Congenital Heart Disease
Heart failure (HF) is common in adults with congenital heart disease (CHD), and it is the leading cause of death in this population. Adults with CHD presenting with stage D HF have a poor prognosis, and early recognition of signs of advanced HF and referral for advanced therapies for HF offer the best survival as compared with other therapies. The indications for advanced therapies for HF outlined in this article should serve as a guide for clinicians to determine the optimal time for referral. Palliative care should be part of the multidisciplinary care model for HF in patients with CHD. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - January 17, 2024 Category: Cardiology Authors: Alexander C. Egbe, Heidi M. Connolly Source Type: research
Surgical Considerations in Adult Congenital Heart Disease Heart Failure
Surgical intervention is often used in the management of heart failure in patients with adult congenital heart disease. This review addresses anatomic variations and complications due to prior surgical interventions, including sternal reentry, collateral vessels, and the neo-aortic root after the Damus –Kaye–Stansel procedure. Surgical considerations for systemic atrioventricular valvular surgery, Fontan revision, and advanced heart failure therapies including ventricular assist devices, heart transplant, and combined heart–liver transplant are discussed, with a focus on unique patient popul ations including those wi...
Source: Heart Failure Clinics - January 17, 2024 Category: Cardiology Authors: William H. Marshall V, Patrick McConnell Source Type: research
Special Considerations for Mechanical Circulatory Support or Device Therapy in Adult Congenital Heart Disease Heart Failure
Heart failure has become the leading cause of mortality in adult congenital heart disease (ACHD) patients after the fifth decade of life. There is scanty evidence supporting the use of guideline-directed medical therapy in ACHD, especially in systemic right ventricle or single ventricle physiology. In complex patients, diagnosing heart failure and timely referral for advanced therapies are challenging. Mechanical circulatory support has been significantly developed over the past decade and has recently emerged as a feasible therapeutic option for these patients. This review summarizes current evidence of mechanical circula...
Source: Heart Failure Clinics - January 5, 2024 Category: Cardiology Authors: Rafael Alonso-Gonzalez, Guillermo Agorrody Source Type: research
Arrhythmias in Adult Congenital Heart Disease Heart Failure
Heart failure and arrhythmias represent 2 major causes of mortality and morbidity in adults with congenital heart disease. Arrhythmias and heart failure are interdependent, and one may exacerbate the other. Treatment of one also has a positive impact on the other. Management approaches need to be multifaceted, including pharmacotherapy, optimization of hemodynamic status with catheter-based or surgical interventions, and specific management of arrhythmia with device or catheter ablation therapy. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - January 5, 2024 Category: Cardiology Authors: Anudeep K. Dodeja, Shailendra Upadhyay Source Type: research
Epidemiology and Definition of Heart Failure in Adult Congenital Heart Disease
Adults with congenital heart disease (ACHD) are facing lifelong complications, notably heart failure (HF). This review focuses on classifications, incidence, prevalence, and mortality of HF related to ACHD. Diagnosing HF in ACHD is intricate due to anatomic variations, necessitating comprehensive clinical evaluations. Hospitalizations and resource consumption for ACHD HF have significantly risen compared with non-ACHD HF patients. With more than 30% prevalence in complex cases, HF has become the leading cause of death in ACHD. These alarming trends underscore the insufficient understanding of ACHD-related HF manifestations...
Source: Heart Failure Clinics - January 2, 2024 Category: Cardiology Authors: Magalie Ladouceur, Judith Bouchardy Source Type: research
Palliative Care in Adult Congenital Heart Disease –Associated Advanced Heart Disease
The practice of palliative care (PC) strives to mitigate patient suffering through aligning patient priorities and values with care planning and via improved understanding of complex physical, psychosocial, and spiritual stressors and dynamics that contribute to patient-centered outcomes. Through representative ‘case examples’ and supportive data, the role and value of a PC consultant, within the framework of a comprehensive adult congenital heart disease (ACHD) team caring for ACHD with advanced heart disease, are reviewed. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - January 2, 2024 Category: Cardiology Authors: Michael J. Landzberg Source Type: research
Medical Therapy and Monitoring in Adult Congenital Heart Disease Heart Failure
Heart failure (HF) in adult congenital heart disease (ACHD) is an increasingly common problem facing ACHD and advanced heart disease and transplant providers. Patients are highly nuanced, and therapies are poorly studied. Standard HF medications are often used in patients who are not targets of large clinical trials. HF management in this data-free zone requires focused, comprehensive team-based care and close follow-up and communication with patients. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - December 29, 2023 Category: Cardiology Authors: Jeremy Nicolarsen, James Mudd, Andrew Coletti Source Type: research
Targeted Therapies for Microvascular Disease
Coronary microvascular dysfunction (CMD) is a common cause of ischemia but no obstructive coronary artery disease that results in an inability of the coronary microvasculature to meet myocardial oxygen demand. CMD is challenging to diagnose and manage due to a lack of mechanistic research and targeted therapy. Recent evidence suggests we can improved patient outcomes by stratifying antianginal therapies according to the diagnosis revealed by invasive assessment of the coronary microcirculation. This review article appraises the evidence for management of CMD, which includes treatment of cardiovascular risk, antianginal the...
Source: Heart Failure Clinics - November 11, 2023 Category: Cardiology Authors: Adam Bland, Eunice Chuah, William Meere, Thomas J. Ford Source Type: research
The Ability of Near-Infrared Spectroscopy to Identify Vulnerable Patients and Plaques: A Systematic Review and Meta-Analysis
Previous studies have analyzed the efficacy of near-infrared spectroscopy-derived lipid core burden index (LCBI) in quantifying and identifying high-risk plaques and patients at increased risk of future major adverse cardiac outcomes/major adverse cardiovascular and cerebrovascular events. A maxLCBI4mm of 400 or greater seems to be an effective threshold for classifying at-risk plaques. This meta-analysis provides a more precise odds ratio with a narrow standard deviation that can be used to guide future studies. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 11, 2023 Category: Cardiology Authors: Ronald D. Bass, Joseph Phillips, Jorge Sanz S ánchez, Priti Shah, Stephen Sum, Ron Waksman, Hector M. Garcia-Garcia Source Type: research
