The Future of Heart Failure Diagnosis, Therapy, and Management

摘要: Over the past 4 decades, patients with heart failure (HF) have derived substantial benefit from major advances in our understanding of pathophysiology HF syndrome, which led to evolving treatment paradigms. Morbidity and mortality for as documented clinical trials reduced ejection fraction (HFrEF) steadily decreased, many this syndrome also enjoyed improved functional capacity quality life. However, there are unmet needs. Hospital discharges a primary diagnosis, an index population disease burden economic impact, remain >1 million annually little change between 2000 2010.1 According American Heart Association’s Stroke Facts,2 prevalence will increase ≈50% 2012 2030, resulting >8 people ≥18 years age HF.3 This daunting future reflects increased ages, acute myocardial infarction survival improves, itself increases at rates that exceed impact prevent development HF. The national and, indeed, international growing component preserved (HFpEF), been neutral, contrast progress HFrEF. These frustrating trial results reflect incomplete more heterogeneous complex HFpEF was only defined entity recently. Knowledge area has evolved over few years, however, suggesting positive may be enabled by targeted treatments rather than broad-brush interventions shift focus symptoms daily life outcomes. In review, we use lessons recent illuminate pathways forward how is conceptualized, might better …