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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Medical management of advanced heart failure

Anju Nohria1, Eldrin Lewis, Lynne Warner Stevenson

  • 1Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Tower 3-A, Boston, MA 02115, USA.

JAMA
|February 7, 2002
PubMed

Insights

Current advanced heart failure management relies on consensus, not trials. Optimizing existing therapies and exploring new ones are crucial for better patient outcomes and reduced rehospitalization.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pharmacology

Background:

  • Advanced heart failure significantly contributes to morbidity and mortality.
  • It is characterized by persistent limiting symptoms despite effective therapies.

Purpose of the Study:

  • To review current medical therapy for advanced heart failure.
  • To identify areas for systematic investigation in advanced heart failure management.

Main Methods:

  • Comprehensive literature search of MEDLINE, EMBASE, Best Evidence, Evidence-Based Medicine, and Cochrane Library (1980-2001).
  • Inclusion of randomized controlled trials (≥150 patients) and other relevant clinical data.
  • Data quality assessed by peer-reviewed publication or professional society guidelines.

Main Results:

  • Management focuses on identifying and treating elevated filling pressures.
  • Angiotensin-converting enzyme inhibitors and beta-adrenergic agents can slow progression but face titration challenges.
  • Tailored medical regimens and heart failure management programs reduce rehospitalization; survival varies significantly with symptom severity.

Conclusions:

  • Current advanced heart failure management is largely consensus-driven.
  • There is a need for systematic investigation into novel therapies and optimization of existing ones.
Abstract

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