Structural Cardiac Interventions in Patients With Heart Failure: JACC Scientific Statement
Rebecca T Hahn1, JoAnn Lindenfeld2, Scott D Lim3
1Division of Cardiology, Columbia University Medical Center, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA.
Journal of the American College of Cardiology
|August 21, 2024
Summary
Transcatheter interventions offer new hope for heart failure patients with structural issues like ventricular remodeling and valve disease, especially when surgery is not an option. These percutaneous strategies provide alternatives for persistent symptoms despite medical therapy.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Pathologic left ventricular remodeling and valvular heart disease are key factors in heart failure presentation and outcomes.
- These conditions can limit the efficacy of standard guideline-directed medical therapy for heart failure.
- Surgical interventions are established treatments but may not be suitable for all patients.
Purpose of the Study:
- To review current and investigational percutaneous strategies for managing structural heart disease contributing to heart failure.
- To focus on dilated left ventricular cardiomyopathies and valvular heart disease as specific structural contributors.
- To provide a scientific statement on the role of transcatheter interventions.
Main Methods:
- Review of current available percutaneous strategies.
- Review of investigational percutaneous strategies.
- Focus on transcatheter interventions for specific structural heart conditions.
Main Results:
- Growing evidence supports transcatheter interventions as viable options for heart failure.
- These options are particularly relevant for patients with persistent symptoms despite optimal medical therapy.
- Transcatheter approaches address limitations of surgical options in select patient groups.
Conclusions:
- Transcatheter interventions represent a significant advancement in managing structural heart disease contributing to heart failure.
- Percutaneous strategies offer alternative therapeutic avenues for patients with dilated left ventricular cardiomyopathies and valvular heart disease.
- The review highlights the evolving landscape of heart failure treatment beyond traditional surgical methods.
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