Long-term management of end-stage heart failure

Habal, Marlena V.; Garan, A.R.

doi:10.1016/j.bpa.2017.07.003

Cited by 27 publications

(28 citation statements)

References 77 publications

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“…End-stage HF is a progressive and complex clinical syndrome that results from impaired cardiac function to sufficiently meet physiological demands, leading to vascular congestion and tissue hypoperfusion [21,22]. Heart failure can develop following various cardiovascular disturbances such as AMI, myocarditis, metabolic syndrome, drug/alcohol abuse, arrhythmia, hypertension, cardiomyopathy [21,22,23]. Cardiac dysfunction is a hallmark of HF and the heart is exposed to extensive adverse remodeling that further exacerbates the myocardial impairment.…”

Section: Critically Ill Cardiac Patientsmentioning

confidence: 99%

Hurdles to Cardioprotection in the Critically Ill

Hoe

Bartnikowski

Wells

et al. 2019

IJMS

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Cardiovascular disease is the largest contributor to worldwide mortality, and the deleterious impact of heart failure (HF) is projected to grow exponentially in the future. As heart transplantation (HTx) is the only effective treatment for end-stage HF, development of mechanical circulatory support (MCS) technology has unveiled additional therapeutic options for refractory cardiac disease. Unfortunately, despite both MCS and HTx being quintessential treatments for significant cardiac impairment, associated morbidity and mortality remain high. MCS technology continues to evolve, but is associated with numerous disturbances to cardiac function (e.g., oxidative damage, arrhythmias). Following MCS intervention, HTx is frequently the destination option for survival of critically ill cardiac patients. While effective, donor hearts are scarce, thus limiting HTx to few qualifying patients, and HTx remains correlated with substantial post-HTx complications. While MCS and HTx are vital to survival of critically ill cardiac patients, cardioprotective strategies to improve outcomes from these treatments are highly desirable. Accordingly, this review summarizes the current status of MCS and HTx in the clinic, and the associated cardiac complications inherent to these treatments. Furthermore, we detail current research being undertaken to improve cardiac outcomes following MCS/HTx, and important considerations for reducing the significant morbidity and mortality associated with these necessary treatment strategies.

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Section: Critically Ill Cardiac Patientsmentioning

confidence: 99%

Hurdles to Cardioprotection in the Critically Ill

Hoe

Bartnikowski

Wells

et al. 2019

IJMS

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“…Current therapies to manage HF include combined drug therapies, left ventricular assist devices (LVAD), cardiac resynchronization therapy (CRT), and ultimately cardiac transplantation for end-stage disease [2,3,4]. However, none of these therapies are efficacious in arresting the loss of cardiomyocyte function and development of fibrosis in a failing heart, and the therapeutic option of cardiac transplantation remains unavailable to many due to the large gap between available donors and eligible recipients, further complicated by the need of long-term immunosuppression needed after a transplant.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Stem Cell Therapies in Improving Clinical Outcomes in Patients With Heart Failure

Bhawnani¹,

Ethirajulu²,

Alkasabera³

et al. 2021

Cureus

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“…[ 3 ] For these patients with advanced HF, Left Ventricular Assist Device (LVAD) has been widely used as the bridge to heart transplant who are not immediately able to undergo heart transplantation or as the destination therapy who are not eligible to heart transplantation. [ 4 ] Morbidity, mortality, and physiologic function have been improved after LVAD procedure. [ 3 , 5 ] Nonetheless, 20% of patients with an LVAD experience continued severe HF.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of readmission to acute care hospital among individuals with heart failure and left ventricular assist device (LVAD) at inpatient rehabilitation setting (STROBE compliant article)

et al. 2020

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In post-acute care hospital setting, the heart failure (HF) individuals with left ventricular assist device (LVAD) have about 30% of transfer to acute care hospitals which requires readmission. There is relative increase in cost and mortality due to the readmission. The goal of this study is to identify possible risk factors at Inpatient Rehabilitation Unit (IRU) to decrease the rate of readmission to acute care hospitals. This study is retrospective study at the Inpatient Rehabilitation Unit (IRU) Twenty one individuals with HF and LVAD were admitted to IRU. We determined 2 subgroups. One is the readmission group (Readmission) and the other is the control group (Control). Readmission (n = 6) is the individuals who were transferred to acute care hospital, and Control (n = 15) is the individuals who were discharged. To compare Readmission group with Control group and evaluate demographic, laboratory, and functional outcome parameters. Main Outcome Measures are Body Mass Index (BMI), International Normalized Ratio (INR), and Functional independence measure (FIM). At admission, INR in Readmission group was 3.4 ± 1.2 and in Control group was 2.2 ± 0.5 with a statistically significant p value (P = .004) and FIM score in Readmission group was 81.2 ± 15.9 and in Control group was 96.3 ± 11.5 with a statistically significant p value ( P = .023). The study showed the individuals with HF and LVAD at IRU had high INR and low FIM which may be the cause for readmission and need more attentive care. This data can help identify the factors causing readmission and help reduce the rate of readmission. Further evaluation is necessary to determine the cause for readmission.

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Long-term management of end-stage heart failure

Cited by 27 publications

References 77 publications

Hurdles to Cardioprotection in the Critically Ill

Hurdles to Cardioprotection in the Critically Ill

Effectiveness of Stem Cell Therapies in Improving Clinical Outcomes in Patients With Heart Failure

Risk factors of readmission to acute care hospital among individuals with heart failure and left ventricular assist device (LVAD) at inpatient rehabilitation setting (STROBE compliant article)

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