Epidemiology and Cost of Advanced Heart Failure

Norton, Catherine; Georgiopoulou, Vasiliki V.; Καλογερόπουλος, Ανδρέας; Butler, Javed

doi:10.1016/j.pcad.2011.04.002

Cited by 101 publications

(66 citation statements)

References 54 publications

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“…1 The number of patients with advanced HF who have refractory symptoms, despite medical therapy is also expected to increase. 2 Options for the majority of these patients with end-stage heart disease are limited. Both heart transplantation and mechanical circulatory support improve survival and quality of life, but because of limited donor supply and medical comorbidities, most patients are not candidates for these lifesaving therapies.…”

mentioning

confidence: 99%

Clinical Characteristics and Outcomes of Intravenous Inotropic Therapy in Advanced Heart Failure

Hashim

Sanam

Revilla-Martinez

et al. 2015

Circ: Heart Failure

115

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Background-Inotrope use in heart failure treatment was associated with improved symptoms, but worse survival in clinical trials. However, these studies predated use of modern heart failure therapies. This study evaluates contemporary outcomes on long-term inotropes. Methods and Results-We collected baseline and postinotrope data on 197 patients discharged on inotropes between January 2007 and March 2013. Baseline characteristics, hemodynamic and clinical changes on inotropes, and survival were evaluated. Patients initiated on inotropes had refractory heart failure, with median baseline New York Heart Association class IV, cardiac index of 1.7 L/min per m 2 , pulmonary capillary wedge pressure of 25.6 mm Hg, and left ventricular ejection fraction of 18.7%. Inotropes were used in patients listed for transplant or scheduled for left ventricular assist device (LVAD; 60 patients), in patients being evaluated for LVAD/transplant (20 patients), for stabilization pending cardiac resynchronization therapy/percutaneous coronary intervention (4 patients), in patients who were offered LVAD but chose inotropes (15 patients), and for palliation (98 patients). Milrinone was used in 84.8% and dobutamine in 15.2%. At the end of the study, 68 patients had died, 24 were weaned off inotropes, 23 were transplanted, 32 received LVADs, and 50 remained on inotropes. Patients who received inotropes for palliation or those who preferred inotropes over LVAD had median survival of 9.0 months (interquartile range, 3.1-37.1 months), actuarial 1-year survival of 47.6%, and 2-year survival of 38.4%. Of 60 patients who were placed on inotropes as a bridge to transplant/LVAD, 55 were successfully maintained on inotropes until transplant/LVAD. Conclusions-Survival on inotropes for patients who are not candidates for transplant/LVAD is modestly better than previously reported, but remains poor. Inotropes are effective as a bridge to transplant/LVAD. (Circ Heart Fail.

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mentioning

confidence: 99%

Clinical Characteristics and Outcomes of Intravenous Inotropic Therapy in Advanced Heart Failure

Hashim

Sanam

Revilla-Martinez

et al. 2015

Circ: Heart Failure

115

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“…H eart failure (HF) affects more than 5.8 million patients in the United States, with 550 000 new cases being diagnosed each year (1). Despite significant progress in management strategies, morbidity and mortality remain high in these patients.…”

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confidence: 99%

Peritoneal Dialysis Reduces the Number of Hospitalization Days in Heart Failure Patients Refractory to Diuretics

et al. 2014

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♦ Background: Previous small studies have reported favorable results of peritoneal dialysis (PD) in the setting of chronic refractory heart failure (CRHF). We evaluated the impact of PD in a larger cohort of patients with CHRF where end-stage renal disease was excluded. ♦ Methods: All patients who received PD therapy for CRHF between January 1995 and December 2010 in two medical centers in France were included in this retrospective study. Baseline characteristics were compared with clinical parameters during the first year after initiation of PD. Mortality, safety, and sustainability of PD were also analyzed. ♦ Results: The 126 patients included had a mean age of 72 ± 11 years and an estimated glomerular filtration rate of 33.5 ± 15.1 mL/min/1.73 m2. Mean time on PD was 16 ± 16.6 months. During the first year, patients with a left ventricular ejection fraction (LVEF) of 30% or less experienced improvement in cardiac function (30% ± 10% vs 20% ± 6%, p < 0.0001). We observed a significant reduction in the number of days of hospitalization for acute decompensated heart failure after PD initiation (3.3 ± 2.6 days/patient-month vs 0.3 ± 0.5 days/patient-month, p < 0.0001). One-year mortality was 42%. ♦ Conclusions: In CRHF, PD significantly reduces the number of days of hospitalization for acute heart failure. Improved LVEF may have led to the comparatively good 1-year survival in this cohort.

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“…ICDs were shown to reduce mortality in HF patients with a high risk of sudden cardiac death in a systemic review of randomized controlled trials [24]. Moreover, as many as one third of patients with severe HF develop intra-ventricular conduction delays, which are associated with dyssynchronized contraction of the left ventricle, resulting in inefficient pumping work [16][17][18]. Based on clinical randomized trials, CRT was shown to reduce symptoms, improve heart function and increase survival rate in selected patients, when added to optimal medical therapy [25][26][27][28].…”

Section: Interventional Therapymentioning

confidence: 99%

“…Thus, HF has become a major public health issue in terms of high mortality rate and enormous healthcare expenditure [17].…”

Section: Introductionmentioning

confidence: 99%

Endogenous Cardiac Stem Cell Therapy for Ischemic Heart Failure

Hsiao

Carr²

2013

J Clin Exp Cardiolog

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Cardiovascular disease remains the number one cause of morbidity and mortality in the world. With great advances in medical and interventional therapies, patients who suffer from acute myocardial infarction have a longer life expectancy than before, but gradually develop chronic heart failure in their later life due to irreversible loss of cardiomyocytes. So far, heart transplantation is the only therapeutic option for advanced heart failure. However, the shortage of donor organs largely limits its role as the gold standard therapy. In the past decades, stem cell-based regenerative medicine has been proposed as a promising approach for the treatment of heart failure based on numerous animal studies. A variety of potential stem cell types, including skeletal myoblasts and bone marrowderived stem cells, have been investigated in clinical trials for cardiac repair and regeneration, but have shown mixed results in heart functional improvement or life-threatening disadvantages such as ventricular arrhythmia. On the other hand, due to the advantages of autologous origin and cardiac-committed lineage, cardiac stem cell therapy has emerged as a promising cell-based strategy for treatment of HF. Thus, this review discusses the current therapies for heart failure and further focuses on stem cell therapy using different endogenous cardiac stem cells, purified by stem cell surface markers (e.g., c-kit or Sca-1) or derived from explants via the formation of cardiospheres. In addition, the potential effect of patient age on cell-based therapy for heart disease is discussed.

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Epidemiology and Cost of Advanced Heart Failure

Cited by 101 publications

References 54 publications

Clinical Characteristics and Outcomes of Intravenous Inotropic Therapy in Advanced Heart Failure

Clinical Characteristics and Outcomes of Intravenous Inotropic Therapy in Advanced Heart Failure

Peritoneal Dialysis Reduces the Number of Hospitalization Days in Heart Failure Patients Refractory to Diuretics

Endogenous Cardiac Stem Cell Therapy for Ischemic Heart Failure

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