Acute heart failure syndromes: assessment and reconstructing the heart.

Published

Journal Article

Heart failure is an international health problem, the magnitude of which is expected to continue to grow. It can be broadly divided into chronic (and relatively stable) ambulatory heart failure patients and patients hospitalized for worsening heart failure, also known as acute heart failure syndromes (AHFS). In contrast to the treatment of stable ambulatory HF patients, which has been revolutionized by evidence-based therapies with a survival benefit, the early management of patients hospitalized for AHFS has changed little over the past several decades and the postdischarge event rate (mortality and rehospitalization) within 60-90 days may be as high as 45%. Although heart failure patients frequently experience rapid and dramatic improvements in signs and symptoms of congestion in response to standard therapy alone, the early postdischarge event rate remains paradoxically elevated. Thus, even though admission for AHFS may be characterized by cardiac injury ('destruction'), hospitalization represents a rare opportunity for assessment and evaluation, as well as initiation of targeted therapies aimed at 'reconstructing' the heart. This concept is clinically relevant since many patients may be discharged home without addressing potentially reversible underlying pathophysiologic processes including, but not limited to, viable but dysfunctional myocardium and cardiac dyssynchrony.

Full Text

Cited Authors

  • Ambrosy, A; Wilcox, J; Nodari, S; Gheorghiade, M

Published Date

  • April 2011

Published In

Volume / Issue

  • 12 / 4

Start / End Page

  • 258 - 263

PubMed ID

  • 21386686

Pubmed Central ID

  • 21386686

Electronic International Standard Serial Number (EISSN)

  • 1558-2035

Digital Object Identifier (DOI)

  • 10.2459/JCM.0b013e328343e9bb

Language

  • eng

Conference Location

  • United States