Advanced Heart Failure Treatment Options Among the Elderly

Abstract

Journal of Patient-Centered Research and Reviews ( JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations.

Ventricular arrhythmias following continuous‐flow left ventricular assist device implantation: A systematic review

“…Approximately 6.5 million US citizens greater than 20 years old currently suffer from heart failure and 10% of these individuals are considered to have advanced stage heart disease . Transplant remains the gold standard for treatment of advanced heart failure; however, with the limited supply of donors, continuous‐flow left ventricle assist device (CF‐LVAD) placement has become more prominent and a well‐established treatment modality for advanced heart failure, with more than 18 000 CF‐LVADs implanted as of 2017 . The benefits of CF‐LVAD therapy are clear, with an increased survival rate and improved quality of life compared to medical therapy alone .…”

Treatment and management of advanced heart failure in elderly

“…The decision to leverage these options must be balanced with not only age, but also frailty, comorbidities, and cognition, functional, social and nutritional status to determine the right candidates for each therapy [4]. Comorbidities can complicate the evaluation of patients with HF, and sometimes influence candidacy for MCS or HT, although it should be recognized that in some cases comorbidities may improve after application of advanced therapies.…”

“…The rational allocation of heart replacement options HT or Left Ventricular Assist Device Therapy (LVAD) among elderly patients requires an understanding of risk and benefit in the context of clinical care, disease trajectory and, particularly, noncardiac comorbidities (renal insufficiency, chronic lung disease, neuromuscular or cognitive disorders, nutrition and psychosocial isolation, etc. ), including frailty [4].…”

“…In high-income countries, the mean age of patients referring to medical wards with symptoms of acute heart failure is almost 75 years, while octogenarians (≥80 years) among them range between 21% and 38% [1][2][3]. Heart failure (HF) is currently the most common cause for hospitalization in the elderly and by 2030 it is expected that almost half of the medical resources for HF will be spent for the treatment of HF patients >80 years old age [1] and it stands to reason that the most terminal stage, known as advanced heart failure, is more common among the elderly [4]. Patients with AHF comprise an estimated 1% to 10% of the overall heart failure population [5,6], and the increasing prevalence of HF in the elderly may be attributed to the outstanding improvements in the treatment of cardiovascular disease and the development of life-prolonging HF medication and device therapy.…”

“…Patients with AHF comprise an estimated 1% to 10% of the overall heart failure population [5,6], and the increasing prevalence of HF in the elderly may be attributed to the outstanding improvements in the treatment of cardiovascular disease and the development of life-prolonging HF medication and device therapy. Moreover, HF with preserved ejection fraction (HFpEF) syndrome is being increasingly acknowledged as a different entity, affecting primarily the elderly population [1][2][3][4][5][6][7].…”