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Advanced Heart Failure Management and Transplantation

Avi Levine1, Chhaya Aggarwal Gupta1, Alan Gass2

  • 1Advanced Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Westchester Medical Center, New York Medical College, Macy Pavilion, Suite 100, 100 Woods Road, Valhalla, NY 10595, USA.

Cardiology Clinics
|November 19, 2018
PubMed

Insights

Hypertrophic cardiomyopathy is a genetic heart condition that can lead to advanced heart failure. Cardiac transplantation is an effective treatment option for patients with end-stage disease, offering encouraging long-term outcomes.

Area of Science:

  • Cardiology
  • Genetics
  • Heart Failure Research

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart disease characterized by diverse clinical presentations.
  • Progression to advanced heart failure in HCM can stem from outflow obstruction or intrinsic myocardial fibrosis and dysfunction.
  • Conventional heart failure treatments are often ineffective for end-stage HCM patients.

Purpose of the Study:

  • To review the management strategies for advanced heart failure in patients with hypertrophic cardiomyopathy.
  • To evaluate the efficacy of advanced therapies, specifically left ventricular assist devices (LVADs) and cardiac transplantation, in this patient population.

Main Methods:

  • Literature review of studies focusing on hypertrophic cardiomyopathy and end-stage heart failure.
  • Analysis of treatment outcomes for LVADs and cardiac transplantation in HCM patients.

Main Results:

  • Left ventricular assist device (LVAD) support is infrequently utilized in HCM due to the condition's restrictive physiology.
  • Cardiac transplantation demonstrates effectiveness as a treatment for end-stage hypertrophic cardiomyopathy.
  • Encouraging long-term outcome data support cardiac transplantation as a viable option for select HCM patients.

Conclusions:

  • For patients with end-stage hypertrophic cardiomyopathy, advanced therapies are necessary.
  • Cardiac transplantation is a recommended and effective treatment for advanced hypertrophic cardiomyopathy, with positive long-term results.

Keywords:
Cardiac transplantHeart failureHypertrophic cardiomyopathyLVAD

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