[The best of cardiac failure in 2006]

Area of Science:

• Cardiology
• Heart Failure Research

Background:

• Increasing clinical significance of diastolic dysfunction, previously underestimated.
• Systolic dysfunction research remains stable, but diastolic dysfunction prognosis is now recognized as serious.
• Challenges in diastolic dysfunction research necessitate innovative approaches.

Purpose of the Study:

• To review recent advancements in understanding and treating diastolic dysfunction.
• To highlight progress in cardiac resynchronization therapy criteria and outcomes.
• To discuss novel interventions for severe systolic dysfunction.

Main Methods:

• Analysis of recent studies focusing on diastolic dysfunction.
• Review of echocardiographic criteria for asynchrony in resynchronization therapy.
• Evaluation of left ventricular assist device efficacy in severe systolic dysfunction.

Main Results:

• ACE-inhibitors showed a trend towards benefit in diastolic dysfunction (PEP CHF study).
• Resynchronization therapy benefits are optimized with less fibrosis, non-ischemic heart disease, and specific pacing zones.
• Left ventricular assist devices show promise for severe systolic dysfunction.

Conclusions:

• Diastolic dysfunction requires greater clinical attention due to its serious prognosis.
• Optimized patient selection and technique are crucial for successful cardiac resynchronization therapy.
• Advanced circulatory assistance offers a promising therapeutic option for end-stage systolic heart failure.