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The pathogenesis and prognosis of end-stage heart disease

N E Strickman1

  • 1Clayton Foundation for Research Cardiovascular Laboratories, Texas Heart Institute, Houston, Texas 77030, USA.

Texas Heart Institute Journal
|December 1, 1987
PubMed

Insights

Congestive heart failure (CHF) occurs when the heart cannot pump enough blood. This condition has a poor prognosis, with many patients becoming candidates for cardiac transplantation due to high mortality.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Congestive heart failure (CHF) is a common endpoint for various heart diseases.
  • It is characterized by the heart's inability to meet metabolic demands due to impaired pumping or filling.
  • CHF encompasses systolic dysfunction (impaired contractility) and diastolic dysfunction (impaired ventricular relaxation).

Purpose of the Study:

  • To provide an overview of congestive heart failure (CHF).
  • To discuss the general features, prognosis, and treatment challenges of CHF.
  • To highlight indicators of a poor prognosis in CHF patients.

Main Methods:

  • This abstract synthesizes information on congestive heart failure (CHF).
  • It reviews the pathophysiology, clinical features, and prognostic factors associated with CHF.
  • Information is presented based on established medical knowledge and clinical observations.

Main Results:

  • CHF presents with features like pressure/volume overload, muscle loss, or restrictive filling.
  • The prognosis for CHF is generally poor, with a 5-year mortality rate of 50%, higher in specific patient groups.
  • Poor prognostic indicators include advanced age, cardiomegaly, low cardiac index, elevated left-ventricular end-diastolic pressure, reduced ejection fraction, and arrhythmias.

Conclusions:

  • Congestive heart failure (CHF) is a serious condition with limited treatment options, primarily palliative.
  • A significant proportion of CHF patients face high mortality, necessitating consideration for advanced therapies like cardiac transplantation.
  • Identifying poor prognostic markers is crucial for patient management and treatment planning in CHF.

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