New England Journal of Medicine
01/05/2023
Vol 388; Pages 22-32
Heart failure is a persistent and progressive disorder in which the heart is unable to pump sufficient blood to satisfy the body’s needs. Individuals suffering from heart failure who take multiple prescribed drugs may find it difficult to stick to their treatment plans. There are a few therapies that have been tested to improve patient compliance.
Interventions:
Lifestyle modifications are an essential part of heart failure management.
Medication management is a critical component of heart failure treatment. Angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) are commonly used to reduce blood pressure and improve heart function (2).
Compared to standard care, a hospital-based strategy to aid clinical decision-making for patients with acute heart failure presenting to the emergency room was linked to a reduced risk of a composite of death rate from any cause or hospitalization for cardiovascular causes. (3).
Advanced interventions to improve cardiac disease may include transcatheter aortic valve replacement (TAVR), which is a minimally invasive procedure for patients with aortic stenosis who are not candidates for traditional open-heart surgery (4). Another advanced intervention is left ventricular assist devices (LVADs), mechanical devices that can support the heart’s function in patients with progressive heart failure who are awaiting transplantation (5).
Electrophysiology procedures, such as ablation and implantation of cardiac resynchronization therapy (CRT) devices, are other advanced interventions that can improve end results in patients with arrhythmias and heart failure (6). Genetic testing and personalized medicine are also emerging as advanced interventions in cardiac disease management.
Conclusion
Surgical interventions are sometimes necessary for patients with advanced heart failure. In addition to these interventions, patient education and self-management strategies can improve heart failure outcomes in addition to these interventions. Patients are often provided with educational materials and support to help them understand their condition, manage their symptoms, and adhere to their treatment plan.
References:
- A Multifaceted Intervention for Acute Heart Failure [Internet]. [cited 2023 Feb 14]. Available from: https://www.jwatch.org/na55507/2022/11/08/multifaceted-intervention-acute-heart-failure
- Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A, et al. Prediction of Heart Failure Mortality in Emergent Care: A Cohort Study. Ann Intern Med. 2012 Jun 5;156(11):767.
- Hospital-Based Strategy Lowers Risk of Death in Patients with Acute Heart Failure [Internet]. Practical Cardiology. 2022 [cited 2023 Feb 14]. Available from: https://www.practicalcardiology.com/view/hospital-based-strategy-lowers-risk-death-acute-heart-failure
- Transcatheter Aortic Valve Replacement (TAVR) – Transcatheter Aortic Valve Replacement (TAVR) | NHLBI, NIH [Internet]. 2022 [cited 2023 Feb 14]. Available from: https://www.nhlbi.nih.gov/health/tavr
- Left Ventricular Assist Device [Internet]. [cited 2023 Feb 14]. Available from: https://stanfordhealthcare.org/medical-treatments/l/lvad.html
- Electrophysiology Procedure [Internet]. ucsfhealth.org. [cited 2023 Feb 14]. Available from: https://www.ucsfhealth.org/Education/Electrophysiology Procedure