scholarly journals The New Heart Failure Association Definition of Advanced Heart Failure

2019 ◽  
Vol 5 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Marco Metra ◽  
Elisabetta Dinatolo ◽  
Nicolò Dasseni
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Clinical Course ◽  
Circulatory Support ◽  
Preserved Ejection Fraction ◽  
Traditional Treatment ◽  
Advanced Therapies ◽  
Disease Management Programmes ◽  
Definition Of

The clinical course of heart failure is characterised by progressive worsening of cardiac function and symptoms. Patients progress to a condition where traditional treatment is no longer effective and advanced therapies, such as mechanical circulatory support, heart transplantation and/or palliative care, are needed. This condition is called advanced chronic heart failure. The Heart Failure Association first defined it in 2007 and this definition was updated in 2018. The updated version emphasises the role of comorbidities, including tachyarrhythmias, and the role of heart failure with preserved ejection fraction. Improvements in mechanical circulatory support technology and better disease management programmes are major advances and are radically changing the management of these patients.

scholarly journals The role of long-term mechanical circulatory support in patients with advanced heart failure

2020 ◽  
Vol 28 (S1) ◽  
pp. 115-121
Author(s):  
S. E. A. Felix ◽  
N. de Jonge ◽  
K. Caliskan ◽  
O. Birim ◽  
K. Damman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Advanced Heart Failure ◽  
Circulatory Support

scholarly journals Mechanical Circulatory Support in Advanced Heart Failure

2021 ◽  
pp. 263246362110327
Author(s):  
Sonali Arora ◽  
Auras R. Atreya
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Heart Transplantation ◽  
Medical Therapy ◽  
Mechanical Circulatory Support ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Ventricular Assist ◽  
Advanced Therapies

Advanced heart failure (HF) with persistent and progressive clinical decline despite maximal medical therapy portends a high mortality in the absence of advanced therapies, such as ventricular assist devices or heart transplantation. A subset of these advanced HF patients deteriorates into refractory cardiogenic shock, that is challenging to manage with vasoactive agents alone. Temporary mechanical circulatory support (MCS) device options have evolved over the years and provide a viable option to rescue and rest the myocardium of patients in cardiogenic shock. The goal of such therapy is to serve as bridge to recovery, or more often, a bridge to durable advanced therapies. For those patients with progressive advanced HF despite extensive medical therapy, durable MCS devices (ventricular assist devices) are available when heart transplantation is not feasible. In this article, we review currently available temporary and durable MCS devices, with a focus on their hemodynamic profiles, to inform optimal device selection for patients with advanced HF.

Indications for Mechanical Circulatory Support

2019 ◽  
pp. 9-15
Author(s):  
Michael Dickinson ◽  
Stephen Wilkinson ◽  
Milena Jani
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Organ Damage ◽  
Advanced Heart Failure ◽  
Circulatory Support ◽  
Accurate Assessment ◽  
Advanced Therapies ◽  
Poor Outcomes ◽  
Intended Use

Optimal patient selection for mechanical circulatory support depends on a while accurate assessment of a given patient’s anticipated trajectory from advanced heart failure and early intervention before end organ damage occurs. Life-limiting non-cardiac diagnoses must be ruled out and goals of therapy should be defined according to the patient’s long-term wishes. This chapter reviews many of the commonly used tools that can aid the heart failure provider in planning for advanced therapies. Options and goals will vary according to what the duration of intended use may be. While guidelines are available, it is often the bedside clinical judgement that determines what device and when to implement. Most often the error is in waiting too long to initiate therapy which runs the risk of poor outcomes.

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