The Usefulness of Chronic Heart Failure Treatments in Chronic Cardiac Graft Failure

Abstract

Following cardiac transplantation, registry data has demonstrated a gradual improvement in survival over the last several decades, which is testament to continual improvement in aftercare strategy. However, a significant number of patients will eventually develop a new syndrome of chronic heart failure, owing to the multitude of physiological processes that occur after transplantation. This condition, referred to as chronic graft failure (CGF) should be regarded as a unique illness rather than one that is simply analogous with chronic heart failure. In particular, the unique pathophysiological (and pharmacological) environment in the setting of CGF presents a challenging situation to the transplant physician. There is uncertainty over which treatments to offer given a paucity of clinical trial data to support the use of standard heart failure treatments in CGF. In this review, we discuss which chronic heart failure treatments could be considered in the setting of CGF based on their mechanisms of action, benefits within the native heart failure setting, and the relevant issues within the posttransplant environment.

Design, fabrication, and testing of a microfluidic system for cardiac cell culture.

“…A healthier heart from a donor is replaced for the failing diseased heart. [13] However, people undergoing heart transplant face high risk of the rejection of the donor heart, infection, artery problems, medication side effect and potential high risk of cancer due to the immunosuppresant medications. [13] In addition, due to the shortage of donors, people who need heart transplants experience long wait times.…”

“…[13][14][15] Cardiomyocytes are the cells that make up the heart muscle and have the ability to contract spontaneously. To perform their function in synchrony, cardiomyocytes need to align in parallel and establish end to end cell-cell contacts (Fig.I.3.).…”