Heart failure

Overview

Heart failure occurs when abnormal cardiac function causes failure of the heart to pump blood at a rate sufficient for metabolic requirements under normal filling pressure. It is characterised clinically by breathlessness, effort intolerance, fluid retention, and poor survival. Fluid retention and the congestion related to this can often be relieved with diuretic therapy. However, diuretic therapy should generally not be used alone and, if required, should be combined with the pharmacological treatments outlined in this review. Heart failure can be caused by systolic or diastolic dysfunction, and is associated with neurohormonal changes.[1] Left ventricular systolic dysfunction (LVSD) is defined as a left ventricular ejection fraction (LVEF) <0.40. It may be symptomatic or asymptomatic. Defining and diagnosing diastolic heart failure can be difficult. Proposed criteria include: (1) clinical evidence of heart failure; (2) normal or mildly abnormal left ventricular systolic function; (3) evidence of abnormal left ventricular relaxation, filling, diastolic distensibility, or diastolic stiffness; and (4) evidence of elevated N-terminal-probrain natriuretic peptide.[2] However, assessment of some of these criteria is not standardised.

Latest citations

Effect of high-dose atorvastatin on hospitalizations for heart failure: subgroup analysis of the Treating to New Targets (TNT) study. ( 18 September 2014 )

Development and validation of an integrated diagnostic algorithm derived from parameters monitored in implantable devices for identifying patients at risk for heart failure hospitalization in an ambulatory setting. ( 18 September 2014 )

Latest citations

Effect of high-dose atorvastatin on hospitalizations for heart failure: subgroup analysis of the Treating to New Targets (TNT) study. ( 18 September 2014 )

Development and validation of an integrated diagnostic algorithm derived from parameters monitored in implantable devices for identifying patients at risk for heart failure hospitalization in an ambulatory setting. ( 18 September 2014 )