Heart Failure

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Heart Failure

NIH - Heart Failure: Summary

"Heart failure is a condition where the heart cannot pump enough blood throughout the body. ... The most common symptoms of heart failure are shortness of breath, feeling tired, and swelling in the ankles, feet, legs, and sometimes the abdomen."

NIH - Medical Encyclopedia Heart failure

"The most common causes of heart failure are hypertension (high blood pressure) and coronary artery disease (for example, you have had a heart attack). Other structural or functional causes of heart failure include the following: • Valvular heart disease • Congenital heart disease • Dilated cardiomyopathy • Lung disease • Heart tumor Heart failure becomes more common with advancing age. You are also at increased risk for developing heart failure if you are overweight, have diabetes, smoke cigarettes, abuse alcohol, or use cocaine."

Highlighted Articles

Aerobic exercise reverses signs of heart failure "In an editorial, Dr. Stanley A. Rubin, at the UCLA School of Medicine, urges caution before starting heart failure patients on an exercise training program. Rubin outlines the considerations to be taken into account when starting a patient on an exercise training program -- including pre-training evaluation, as well as the type, degree, and venue of exercise training."

Superior Cardiovascular Effect of Aerobic Interval Training Versus Moderate Continuous Training in Heart Failure Patients. A Randomized Study. (Circulation. 2007) "CONCLUSIONS: Exercise intensity was an important factor for reversing LV remodeling and improving aerobic capacity, endothelial function, and quality of life in patients with postinfarction heart failure. These findings may have important implications for exercise training in rehabilitation programs and future studies."

Antithrombotic therapy for congestive heart failure. (Int J Clin Pract. 2006)

"Aspirin may be detrimental for heart failure due to a possible interaction with angiotensin-converting enzyme inhibitors, leading to increased hospitalisations from decompensated heart failure."

Visit InfoMedSearch's Home Page for all InfoMedLinks Cardiovascular Topics: Atherosclerosis, Atrial Fibrillation, Coronary Artery Disease, Cholesterol - Lipids, General Cardiovascular, Heart Failure, Hypertension, Myocardial Infarction (Heart Attack), Peripheral Artery Disease, and Stroke.

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Heart Failure

Daily Treatment Report

Cognitive Therapy-CBT-Psychotherapy

Device Therapy

Angiotensin II Receptor Blockers for the Treatment of Heart Failure: A Class Effect? (Pharmacotherapy. 2007) "Conclusions: Elderly patients with heart failure who were prescribed losartan had worse survival rates compared with those prescribed other commonly used ARBs. The absence of a class effect for ARBs is consistent with data showing pharmacologic differences among the drugs."

Therapeutic and diagnostic role of electrical devices in acute heart failure. (Heart Fail Rev. 2007)

Drug Side-Effects and Interactions

The safety of amiodarone in patients with heart failure. (J Card Fail. 2007) "CONCLUSIONS: Treatment with amiodarone was associated with an increased risk of death from circulatory failure independent of functional class."

Drugs

Beta-blocker therapy in heart failure in the elderly. (Int J Cardiol. 2007)

Diuretics Improve Sleep Apnea in Heart Failure Patients "Use of diuretics in obese patients with diastolic heart failure appears to reduce sleep-disordered breathing, Italian researchers report in the August issue of Chest."

Persistent Use of Evidence-Based Pharmacotherapy in Heart Failure Is Associated With Improved Outcomes. (Circulation. 2007) "CONCLUSIONS: Persistence of treatment was high once medication was started, but treatment dosages were below recommended dosages. Increased severity of heart failure or increased number of concomitant medications did not worsen persistence, but nonpersistence identified a high-risk population of patients who required special attention. A focused effort on early treatment initiation, appropriate dosages, and persistence with the regimen is likely to provide long-term benefit."

Effects of discontinuation of digoxin versus continuation at low serum digoxin concentrations in chronic heart failure. (Am J Cardiol. 2007)

Are statins beneficial in heart failure? (Arq Bras Cardiol. 2007)

Diuretics for the treatment of acute decompensated heart failure. (Heart Fail Rev. 2007)

Vasodilators in acute heart failure. (Heart Fail Rev. 2007)

The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) heart failure Validation Study: Diagnosis and prognosis (American Heart Journal 2007) "An independent review of source documentation showed a high degree of agreement with the HF diagnoses assigned by site physicians and confirmed the higher risk of HF associated with first-step therapy using amlodipine, lisinopril, or doxazosin compared with chlorthalidone. Thiazide-type diuretics should be the preferred first-step therapy for prevention of HF in high-risk patients with hypertension."

Exercise

Six-month aerobic exercise training ameliorates central sleep apnea in patients with chronic heart failure. (J Card Fail. 2007)

Effects of a home-based exercise program on clinical outcomes in heart failure. (Am Heart J. 2007) "CONCLUSIONS: A home-based walking program that incorporated aerobic and resistance exercise did not result in improved clinical outcomes at 1-year follow-up in this cohort of patients with systolic HF. However, the exercise program resulted in reduced rehospitalization rates."

Is strength training the more efficient training modality in chronic heart failure? (Med Sci Sports Exerc. 2007)

Principles of exercise prescription for patients with chronic heart failure. (Heart Fail Rev. 2007)

[Heart failure and physical activity] (Przegl Lek. 2007)

Exercise can help a bad heart repair itself "Having a bad heart doesn't mean you can skip exercise, doctors said Wednesday. In fact, it may even help your heart to repair itself. Research presented at the European Society of Cardiology meeting showed that exercise sparks the creation of new heart vessels. In a small study of 37 people at Leipzig University in Germany, Dr. Robert Hollriegel found that people with serious heart failure who rode a bike for up to 30 minutes a day for four months produced new stem cells in their bones. "

Enhancement of sleep stability with Tai Chi exercise in chronic heart failure: Preliminary findings using an ECG-based spectrogram method. (Sleep Med. 2007) "CONCLUSIONS: Tai Chi exercise may enhance sleep stability in patients with chronic heart failure. This sleep effect may have a beneficial impact on blood pressure, arrhythmogenesis and quality of life."

A meta-analysis of the effect of exercise training on left ventricular remodeling in heart failure patients: the benefit depends on the type of training performed. (J Am Coll Cardiol. 2007) "CONCLUSIONS: Aerobic training reverses LV remodeling in clinically stable individuals with HF. This benefit was not confirmed with combined aerobic and strength training."

Effects of exercise training on heart rate recovery in patients with chronic heart failure. (Am Heart J. 2007) "CONCLUSION: Exercise training results in a faster HRR in patients with HF. Heart rate recovery, as a simple marker of autonomic function, is an easily acquired response that may be useful for evaluating patient outcomes in cardiac rehabilitation."

Superior Cardiovascular Effect of Aerobic Interval Training Versus Moderate Continuous Training in Heart Failure Patients. A Randomized Study. (Circulation. 2007) "CONCLUSIONS: Exercise intensity was an important factor for reversing LV remodeling and improving aerobic capacity, endothelial function, and quality of life in patients with postinfarction heart failure. These findings may have important implications for exercise training in rehabilitation programs and future studies."

Aerobic exercise reverses signs of heart failure "In an editorial, Dr. Stanley A. Rubin, at the UCLA School of Medicine, urges caution before starting heart failure patients on an exercise training program. Rubin outlines the considerations to be taken into account when starting a patient on an exercise training program -- including pre-training evaluation, as well as the type, degree, and venue of exercise training."

Water activities okay for some with heart failure "Swimming and other water activities appear to be generally safe for many patients with severe but stable chronic heart failure, according to a report published in the journal Heart this month. Heart failure patients "should not be forbidden to do sports activities in water," Dr. Jean-Paul Schmid from University Hospital, Bern, Switzerland, told Reuters Health. Chronic heart failure or CHF is a condition in which the heart loses its ability to pump blood efficiently. The disease causes fatigue and shortness of breath as fluid accumulates in the lungs and tissues. It's generally recommended that heart failure patients avoid swimming as it may overtax their heart."

The effects of exercise training on the kinetics of oxygen uptake in patients with chronic heart failure. (Eur J Cardiovasc Prev Rehabil. 2007) "CONCLUSIONS: Exercise training improves O2 kinetics in chronic heart failure patients. Both continuous and interval training improve phase I O2-kinetics, but continuous training results in superior improvement of the phase II O2-kinetics, an indirect index of muscle oxidative capacity."

Improved exercise tolerance and cardiac function in severe chronic heart failure patients undergoing a supervised exercise program. (Int J Cardiol. 2007) "CONCLUSIONS: A hospital-based supervised exercise and rehabilitation program significantly improves functional and hemodynamic parameters in severe CHF patients, and may partially contribute to better physical conditioning detected in these patients after exercise training."

The effect of endurance training on exercise capacity following cardiac resynchronization therapy in chronic heart failure patients: a pilot trial. (Eur J Cardiovasc Prev Rehabil. 2007) "CONCLUSIONS: ET in resynchronized CHF patients is feasible and further enhances exercise tolerance. Patients with severe CHF should be prescribed an exercise training programme after implantation in order to maximize the expected benefit."

Physical training in patients with chronic heart failure of ischemic origin: effect on exercise capacity and left ventricular remodeling. (Eur J Cardiovasc Prev Rehabil. 2007) "CONCLUSIONS: Six-month training in ischemic CHF patients is a safe modality. Training improves exercise capacity. There was no negative impact on LV morphology, and a trend towards improvement of functional parameters on MRI may suggest an anti-remodeling effect of training in patients with ischemic CHF."

Improved exercise tolerance and cardiac function in severe chronic heart failure patients undergoing a supervised exercise program. (Int J Cardiol. 2007) "CONCLUSIONS: A hospital-based supervised exercise and rehabilitation program significantly improves functional and hemodynamic parameters in severe CHF patients, and may partially contribute to better physical conditioning detected in these patients after exercise training."

Exercise Training Improves the Net Balance of Cardiac Ca2+ Handling Protein Expression in Heart Failure. (hysiol Genomics. 2007)

General Information

Management of atrial fibrillation in patients with heart failure (European Heart Journal 2007) "While the prevalence of AF is <1% at an age below 60 years, about 8% at age 80 or older suffer from the arrhythmia. … In patients with AF and CHF, achievement and maintenance of sinus rhythm (‘rhythm control’) has been presumed to be advantageous. … The outcomes in CHF patients were similar with both treatment strategies, whereas in patients without CHF there was a trend toward lower mortality with rate control. Similarly, in a pre-defined analysis of the RACE study rate control was not inferior to rhythm control in 261 patients with mild-to-moderate CHF.32 However, there was a trend for a higher mortality and major bleeding complications under rate control. Rhythm control was associated with excellent survival if sinus rhythm could be maintained. … From a clinical point of view, resting heart rate may not be sufficient to guide rate control. Treadmill exercise tests and 24 h Holter monitoring seem more reliable. Heart rates above 110 b.p.m., as well as excessive reductions in ventricular rate that could limit exercise tolerance, should be avoided."

A propensity-matched study of the effects of chronic diuretic therapy on mortality and hospitalization in older adults with heart failure. (Int J Cardiol. 2007)

[Guideline satisfying therapy for chronic heart failure.] (Internist (Berl). 2007)

Management of patients with heart failure in clinical practice: differences between men and women. (Heart. 2007) "Conclusions Fewer women had an assessment of LV function, but, when investigated, had better ventricular function. Women were less often treated with evidence-based drugs, even after adjusting for age and important clinical characteristics. Clinicians need to be aware of deficiencies in the treatment of women with heart failure and measures should be taken to rectify them."

Untreated Obstructive Sleep Apnea May Worsen Survival in Heart Failure "The presence of obstructive sleep apnea (OSA) in patients with heart failure significantly raises their risk of death, independent of ventricular function and HF severity, suggests a prospective single-center observational study that emphasizes the importance of looking for--and maybe treating--the breathing disorder when it accompanies heart failure [1]."

Atrial fib: No reason to avoid resynchronization therapy for heart failure "Under the right circumstances, cardiac resynchronization therapy (CRT) can benefit patients with heart failure who are in atrial fibrillation (AF) as much as those in sinus rhythm, …"

Relationship of Depression to Death or Hospitalization in Patients With Heart Failure (Arch Intern Med. 2007) "Conclusions Symptoms of depression were associated with an adverse prognosis in patients with HF after controlling for HF severity. The unexpected association of antidepressant medications with worse clinical outcome suggests that patients with HF requiring an antidepressant medication may need to be monitored more closely."

Curriculum in cardiology: integrated diagnosis and management of diastolic heart failure. (m Heart J. 2007)

Relationship Between {beta}-Blocker Treatment and the Severity of Central Sleep Apnea in Chronic Heart Failure. (Chest. 2007)

Guidelines

NGC - Management of adults with chronic heart failure. (2007)

[Guideline satisfying therapy for chronic heart failure.] (Internist (Berl). 2007) "Chronic heart failure may be caused by systolic pump failure and/or impairment of diastolic filling of the ventricles. The standard pharmacotherapy for systolic heart failure includes an ACE inhibitor, betablocker, diuretics and, in patients with severe symptoms, a low dose aldosterone antagonist. An AT1 receptor blocker is indicated for those patients who do not tolerate ACE inhibitors. If patients remain in the functional class NYHA III-IV despite optimal medication and have cardiac dyssynchrony, biventricular pacing may improve the symptoms and prognosis."

SIGN - Management of chronic heart failure (2007)

NGC - Cardiac resynchronisation therapy for the treatment of heart failure. (2007)

NICE - Cardiac resynchronisation therapy for the treatment of heart failure. (2007)

Improving the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting: The IMPROVE HF performance improvement registry (American Heart Journal 2007) "Evidence-based consensus treatment guidelines are available to assist physicians with the management of chronic heart failure (HF). Although it has been generally presumed that physicians incorporate these treatment guidelines into clinical practice, the actual assimilation of evidence-based strategies and guidelines has been demonstrated to be less than ideal. Studies of HF care show that treatment guidelines are slowly adopted and inconsistently applied and, thus, often fail to lead to improvements in patient care and outcomes."

Current Guidelines for Treatment of Heart Failure: 2006 Update (Pharmacotherapy. 2007)

NGC - Management of chronic heart failure. A national clinical guideline. (2007)

Immunotherapy

Internet Sites

Treatment Information

DrugBank (drug structure)

FDA - MedWatch (Drug Alerts)

Drug-Food-Supplement Information

Drug Information Online

Drug Interaction Checker

DrugDigest (drug interactions)

FDA - Drug Interactions: What You Should Know

NIH - Botanical Dietary Supplements: Background Information

NIH - Drug, Supplements, and Herbal Information

NIH - Herbal Supplements: Consider Safety, Too

NIH - Medicines

NIH - Vitamin and Mineral Supplement Fact Sheets

Nutrition

Other

Other Treatments

Mortality in patients with heart failure treated with cardiac resynchronisation therapy. A long-term multi-centre follow-up study. (Kardiol Pol. 2007)

Experimental

Radiotherapy

Supplements-Vitamins-CAM

Omega-3 Polyunsaturated Fatty Acids Prevent Atrial Fibrillation Associated With Heart Failure but Not Atrial Tachycardia Remodeling (Circulation 2007) "Conclusions—PUFAs suppress congestive heart failure–induced atrial structural remodeling and AF promotion but do not affect atrial tachycardia–induced electrical remodeling. The beneficial effects of PUFAs on structural remodeling, possibly related to prevention of mitogen-activated protein kinase activation, may contribute to their clinical anti-AF potential."

Surgery

Revascularization in heart failure: the role of percutaneous coronary intervention. (Heart Fail Clin. 2007)

Revascularization in heart failure: coronary bypass or percutaneous coronary intervention? (Heart Fail Clin. 2007)

Coronary artery bypass for heart failure in ischemic cardiomyopathy: 17-year follow-up. (Ann Thorac Surg. 2007)

Transplantation

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