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Heart failure.

John J V McMurray1, Marc A Pfeffer

  • 1Department of Cardiology, Western Infirmary, Glasgow, UK. j.mcmurray@bio.gla.ac.uk <j.mcmurray@bio.gla.ac.uk>

Lancet (London, England)
|June 1, 2005
PubMed
Summary
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Effective heart failure treatments, including ACE inhibitors and beta blockers, improve survival and reduce hospitalizations. While options exist for reduced ejection fraction, heart failure with preserved ejection fraction lacks evidence-based therapies.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pharmacology

Background:

  • Heart failure is a prevalent, debilitating, and often fatal condition.
  • Significant advancements have yielded effective treatments, particularly for patients with reduced left-ventricular ejection fraction.

Purpose of the Study:

  • To review current evidence-based treatment strategies for heart failure.
  • To highlight emerging therapies and areas lacking definitive treatment, such as heart failure with preserved ejection fraction.

Main Methods:

  • Review of established and emerging pharmacological and device-based therapies.
  • Analysis of clinical trial data and evidence for treatment efficacy.
  • Discussion of care delivery models and future research directions.

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Main Results:

  • Angiotensin-converting-enzyme inhibitors and beta blockers are foundational treatments improving symptoms, hospitalizations, and survival.
  • Implantable cardioverter defibrillators and additional therapies like angiotensin-receptor blockers and aldosterone antagonists offer survival benefits.
  • Cardiac resynchronisation therapy and left-ventricular assist devices show promise for select patient groups.

Conclusions:

  • Current treatments significantly improve outcomes for heart failure with reduced ejection fraction.
  • Heart failure with preserved ejection fraction remains a therapeutic challenge with no established evidence-based treatments.
  • Ongoing clinical trials are exploring novel pharmacological, device, and regenerative approaches for heart failure.