Publication: Heart Failure: Past, Present, Future
Date
2021
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
There are 23 million people with heart failure in the world. Heart failure with
reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction
(HFpEF) need to be identified before advising treatment of heart failure. Coronary
artery disease, dilated cardiomyopathy, valvular heart disease, and hypertension
are the common causes of heart failure. Diuretics, angiotensin converting enzyme
inhibitors, angiotensin receptor blockers, and neprilysin receptor blockers have been
found to reduce mortality in heart failure. Natural compensatory mechanisms such
as release of various vasoconstrictors and vasodilators in heart failure come into
action to improve symptoms for some time. Ultimately compensatory mechanisms
fail to work and patients reach end-stage heart failure. Mechanical circulatory
support devices are recommended as a bridge treatment before heart transplant.
The only option at this stage is heart transplant which is not feasible easily in the
low and middle-income countries. Though end-stage heart failure treatment with
inotropic drugs improves symptoms for a short period, various trials have shown
increased mortality with their uses. On-going research on heart failure is expected
to come out with more effective treatment of heart failure in future.
KEY WORDS
Cardiac output, Cardiac transplant, Heart failure
Description
Karki DB,1 Bhattarai TR,2 Rayamajhi A3
1Department of Cardiology
2Department of Internal Medicine
Kathmandu Medical College
Sinamangal, Kathmandu
3Department of Radiation Oncology
Nepal Cancer Hospital
Harisiddhi, Lalitpur
Keywords
Cardiac output, Cardiac transplant, Heart failure