Current Approach to Heart Failure

Description:

This book is intended to be a link between guidelines and clinical practice, a complementary tool to help physicians to be well informed regarding the important field of heart failure. It will be a useful tool for professionals from all the fields of cardiology: non-invasive cardiology, interventional cardiology, electrophysiology and cardiovascular imaging. The topic of heart failure is continuously changing, with new important information being added constantly. The pathophysiology is better understood and there is a trend for a better characterization of special groups of population, such as oncologic patients with heart failure. The new imaging techniques have become valuable tools for the diagnosis of heart failure, while pharmacological and novel cell and gene treatments have evolved enormously. The challenge for the practitioners is making the right selection of treatment strategy that best fits a patient. This book presents detailed information on the indications, selection and mechanism of action of these treatments, whether they be mechanical circulatory devices or pharmacological treatments. The contemporary pharmacological and non-pharmacological management of heart failure has the main target of early prevention of disease progression and the avoidance of heart transplant. In the era of shortage of donors, prevention is the mainstay of the therapeutic strategy, and this is the main philosophy of our book.

 

Table of Contents:

 

Part I: New Concepts on Epidemiology and Mechanisms of Heart Failure

Chapter 1: Prevalence, Incidence and Lifetime Risk of Heart Failure

Lifetime Risk

Prevalence of Heart Failure

Asymptomatic Left Ventricular Dysfunction

Heart Failure with Reduced Versus Preserved Ejection Fraction

Incidence of Heart Failure

References

Chapter 2: Evolving Concepts on the Basic Mechanisms of Heart Failure

The Current Heart Failure Mechanisms in Heart Failure with Reduced Ejection Fraction (HFrEF)

The Pump Failure

The Role of Neurohormones

The Kidney: Responsible for HF

Loss of Cardiac Myocytes

Dysfunctional Cardiac Myocytes due to Abnormal Cytoplasmic Ca2+ Homeostasis

The Myocardial Extracellular Matrix

Genes Contribution

Heart Failure with Preserved Ejection Fraction (HFpEF)

From Left to Right Heart Failure

Noncardiac Comorbidities and HF

References

Part II: The Role of Cardiac Imaging in the Evaluation of Heart Failure

Chapter 3: Assessment of Left Ventricular Systolic and Diastolic Function by Echocardiography

Introduction

Assessment of Left Ventricular Systolic Function

Left Ventricular Fractional Shortening

Left Ventricular Ejection Fraction

2D Echocardiography

3D Echocardiography

Data Acquisition

Analysis

Stroke Volume and Cardiac Output

LV Regional Function

Doppler Methods of LV Systolic Function Evaluation

Rate of LV Pressure Increase

Myocardial Deformation Imaging

Assessment of Left Ventricular Diastolic Function

Echocardiographic Diagnosis of LVDD in Patients with HFpEF

Echocardiographic Assessment of Left Ventricular Filling Pressures and Diastolic Dysfunction Grad

References

Chapter 4: The Imaging of Right Ventricular Dysfunction in Heart Failure

Introduction

Echocardiography

Standard Echocardiographic Views of the RV

Right Ventricular Global Systolic Function

Conventional 2DE Parameters

3DE Assessment of the RV Systolic Function

Right Ventricular Regional Systolic Function

RV Diastolic Function

Right Ventricular Mechanics

RV Dyssynchrony

Cardiac Magnetic Resonance

RV Global Systolic Function

RV Regional Systolic Function

RV Myocardial Mechanics

Computed Tomography

Nuclear Imaging

Conclusions

References

Chapter 5: The Role of Atrial Functional Assessment in Heart Failure

Left Atrial Function

Echocardiographic Assessment of Left Atrial Function

Left Atrial Function and Heart Failure

Conclusion

References

Chapter 6: Assessment of Secondary Mitral Regurgitation

Introduction

Definition, Mechanisms, and Physiopathology

Echocardiographic Assessment of SMR

Diagnosis and Mechanism of SMR

Valve Morphology: Overall Assessment

Valve Morphology: Quantitative Analysis of Mitral Valve Deformation

LV Remodeling Assessment

Quantification of SMR Severity

2D Echocardiography

3D Echocardiography

The Dynamic Nature of Chronic Ischaemic MR: Role of Stress Echocardiography

Role of 3D During MitraClip Therapy

References

Chapter 7: Left Ventricular Contactile Reserve

Introduction

Contractility Indices

Stroke Volume and Ejection Fraction

LV Longitudinal Function

Future Directions and Possible Developments

Bibliography

Chapter 8: Role of Cardiovascular Magnetic Resonance Imaging in Heart Failure

Cardiovascular Magnetic Resonance Techniques

Functional Imaging (cine-CMR)

Flow CMR

Myocardial Perfusion Imaging (MPI)

Myocardial Tissue Characterization

Evolving CMR Techniques

Safety and Limitations

The Role of CMR in Suspected or Confirmed Heart Failure

Ischemic Cardiomyopathy

Myocardial Infarction

Ischemia Testing

Viability Assessment

Non-ischemic Cardiomyopathies

Cardiomyopathies Presenting Mostly with a Hypertrophic Phenotype

Hypertrophic Cardiomyopathy

Amyloidosis

Cardiomyopathies Presenting Mostly with a Dilative Phenotype

Dilated Cardiomyopathy

Iron Overload Cardiomyopathy

Cancer Therapy Related Cardiomyopathies

Muscular Dystrophy

Arrhythmogenic Right Ventricular Cardiomyopathy

Inflammatory Diseases and Other Cardiomyopathies

Acute Myocarditis

Sarcoidosis

Systemic Inflammatory Diseases

Left Ventricular Non-compaction

Takotsubo Cardiomyopathy

Valvular Heart Disease

Adult Congenital Heart Disease

Pericardial Disease

The Role of CMR in Guiding Implantable Cardioverter-­Defibrillator (ICD)/Cardiac Resynchronizati

ICD

CRT

References

Chapter 9: The Evolving Role of Multimodality Imaging in Heart Failure

Imaging of Ischemia: Risk Area and Coronary Arteries

Metabolic Imaging

Molecular Imaging: The Evaluation of Cardiac Innervation

Innervation Imaging of Arrhythmias

Cardiac Resynchronization Therapy

Rheumatic Disease

Management of Aortic Stenosis in HF

Cardio-oncology and HF

Cardiac Amyloidosis

Quantitative Cardiac Imaging: The Need for an Absolute Measurement of Cardiac Parameters

Future Perspectives—Hybrid Imaging Using Molecular Targets

Conclusion

References

Part III: Treatment of Heart Failure

Chapter 10: Contemporary Pharmacological Treatment of Heart Failure

The Goals of Treatment

Pharmacological Treatment in Chronic Heart Failure

Heart Failure with Reduced Ejection Fraction

Treatments Improving the Outcomes

Treatments Recommended in All Patients with HFrEF- Neurohormonal Antagonists

Angiotensin- Converting Enzyme Inhibitors

Beta- Blockers

Mineralocorticoid Receptor Antagonists

Treatments Recommended in Selected Symptomatic Patients

Diuretics

Angiotensin Receptor Neprilysin Inhibitor

If- Channel Inhibitor

Angiotensin II Type I Receptor Blockers

Combination of Hydralazine and Isosorbide Dinitrate

Digoxin and Other Digitalis Glycosides

Heart Failure with Preserved and with Mid- Range Ejection Fraction

References

Chapter 11: Myocardial Revascularization in Heart Failure

Background

Revascularization for Treatment of Angina Pectoris

Revascularization for Prognostic Purposes

The Role of Myocardial Viability

Similar Value of Percutaneous Coronary Intervention?

What Do the Guidelines Tell Us?

Conclusion

References

Chapter 12: Approach to Arrhythmia in Heart Failure

Introduction

Brady-Arrhythmias in Heart Failure

Approach to Supraventricular Arrhythmias

Epidemiology of Atrial Fibrillation in Heart Failure

Mechanisms of Atrial Fibrillation Occurrence in Heart Failure

Treatment of Atrial Fibrillation in Heart Failure

Prevention of Thromboembolism

Acute Management of Atrial Fibrillation in Acute Heart Failure

Rate Control: Pharmacological and Interventional Treatments

Rhythm Control: Pharmacological and Interventional Treatment

Other Supraventricular Arrhythmias in Heart Failure

Ventricular Arrhythmias

Epidemiology of Ventricular Arrhythmias in Heart Failure

Mechanisms of Ventricular Arrhythmias in Heart Failure

Treatment of Ventricular Arrhythmias in Heart Failure

Prevention of Sudden Cardiac Death in Heart Failure

Pharmacological Treatment for Ventricular Arrhythmias

Interventional Treatments for Ventricular Arrhythmias

Arrhythmias in Heart Failure with Preserved Ejection Fraction

References

Chapter 13: Devices for Heart Failure: Implantable Cardioverter Defibrillator

Epidemiology of Heart Failure: Insight into the Device Therapy

Evolution of the Implantable Cardioverter Defibrillator from Thoracotomy to the Subcutaneous I

Current Tendencies in the Treatment of Heart Failure (Prevention of Sudden Cardiac Death): From

Prevention of Sudden Cardiac Death Among Heart Failure Patients

Secondary Prevention of Sudden Cardiac Death Among Heart Failure Patients

Primary Prevention of Sudden Cardiac Death Among Heart Failure Patients

Cardiac Dyssynchrony

The Concept of Biventricular Pacing: Cardiac Resynchronization Therapy

The Concept and Rational of the Subcutaneous Implantable Defibrillators

Peri- and Post-procedural Complications of Implantable Cardioverter Defibrillators Implantation

References

Chapter 14: Cardiac Resynchronization Therapy

Introduction

Pathophysiology of Cardiac Dyssynchrony. Dyssynchrony Assessment

Imaging in Cardiac Resynchronization Therapy

Clinical Evidence in Cardiac Resynchronization Therapy and Current Guidelines.

Response to CRT: Patient Selection and Improving CRT Delivery

Conclusion

References

Chapter 15: Mechanical Circulatory Support

Introduction and Epidemiology

Acute (Temporary) Mechanical Circulatory Support Devices

Durable (Permanent) Ventricular Assist Devices

Underlying Physiologic Principles of Continuous Flow Devices

Patient Selection

Current Clinical Results with Continuous Flow Pumps

In Hospital Management

Long-Term Management

Management of Ventricular Assist Device Long-Term Complications

Management of Gastrointestinal Bleeding

Management of Infections

Management of Atrial and Ventricular Arrhythmias

Management of de Novo Aortic Insufficiency

Management of Pump Thrombosis and Pump Malfunction

Management of Neurological Events

Total Artificial Heart

Conclusions

References

Chapter 16: Gene and Cell Therapy in Heart Failure

Introduction

Gene Therapy

Calcium Homeostasis-Related Therapies

Therapies for the Treatment of Tachy- and Brady-Arrhythmias

Therapies Targeting Adrenergic Signalling

Therapies Targeting Myofilaments

Cardiac Regeneration and Proliferation Therapies

Cell-Based Therapies

Non-cardiac Origin SCs

Second Generation SCs

Cardiac Origin SCs

Pluripotent SCs

SC-Derived Products

Clinical Evidences

References

Chapter 17: Valvular Surgery in Heart Failure

Introduction

Aortic Regurgitation

Natural History

Evaluation

Indications for Surgery

Surgery

Medical Therapy

Aortic Stenosis

Natural History

Evaluation

Intervention

Aortic Valve Replacement (AVR)

Balloon Valvuloplasty

Transcatheter Aortic Valve Implantation

Medical Therapy

Mitral Regurgitation

Primary (Organic) Mitral Regurgitation

Acute Mitral Regurgitation

Chronic Mitral Regurgitation

Surgery

Percutaneous Intervention

Medical Therapy

Secondary Mitral Regurgitation

Natural History

Evaluation

Indications for Intervention

Surgery

Percutaneous Intervention

Medical Treatment

Mitral Stenosis

Tricuspid Regurgitation (TR)

Natural History

Evaluation

Indications for Surgery

Surgery

Tricuspid Stenosis

Evaluation

Interventions

Combined and Multiple Valve Diseases

References

Chapter 18: Percutaneous Valvular Therapies in Heart Failure

Transcatheter Aortic Valve Intervention for Patients with HF

Pathophysiologic and Diagnostic Considerations

Transcatheter Treatment

Percutaneous Balloon Aortic Valvuloplasty (PBAV)

Transcatheter Aortic Valve Implantation (TAVI)

Transcatheter Mitral Valve Intervention (TMVI) for Patients with HF

Why Do We Need TMVI?

Which Device Should We Use for TMVI?

Patient Selection for TMVI

CRT Non-responders

End-Stage Heart Failure

Acute MR Following Acute Myocardial Infarction

Failing Annuloplasty Rings

Expected Benefits from TMVI

Persistent MR Reduction

Symptom Improvement

Survival Advantage

Effect on Heart Remodeling: Annulus and LV

When Is the Right Time for TMVI?

Transcatheter Tricuspid Valve Intervention for Patients with HF

References

Chapter 19: Pre-transplant Evaluation

Introduction

Indications for Heart Transplantation

Patients on Stable Condition

Cardiopulmonary Stress Testing

Use of Heart Failure Prognostic Scores

Role of Diagnostic Right-Heart Catheterization (RHC)

Restrictive and Infiltrative Cardiomyopathies

Patients on Unstable Conditions

Comorbidities and Their Implications as Contraindications for Heart Transplantation

Age

Obesity

Diabetes Mellitus

Renal Function

Cancer

Cerebral and Peripheral Vascular Disease

Assessment of Frailty

Mechanical Circulatory Support (MCS) for Bridge to Candidacy

Tobacco Use, Substance Abuse

Psychosocial Evaluation

Retransplantation

Human Immunodeficiency Virus (HIV)

Chagas Disease

Hepatitis C and Hepatitis B

Vaccinations

Recommended Tests for Heart Transplant Evaluation

References

Chapter 20: Heart Transplantation

Introduction and Epidemiology

Donor-Recipient Matching and Organ Allocation Procedures

Immunosuppression Therapy

Induction Therapy

Maintenance Immunosuppression

Mechanisms and Diagnosis of Cardiac Allograft Rejection

Treatment of Cardiac Allograft Rejection

Management of Acute Cellular Rejection

Management of Antibody-Mediated Rejection

Long-Term Complications of Immunosuppression Therapy

Infections

Malignancy

Cardiac Allograft Vasculopathy

Hypertension

Diabetes Mellitus

Dyslipidemia

Chronic Renal Insufficiency

Conclusions

References

Part IV: Particular Forms of Heart Failure

Chapter 21: Heart Failure and Hypertension

Epidemiology

Role of Echocardiography in HF Staging in Patients with Hypertension

LV Remodeling in Hypertensive Heart Disease

LV Diastolic Dysfunction

Prevalence and Determinants of Diastolic Dysfunction in the Community

Prognostic Significance of LV Diastolic Dysfunction

LV Systolic Dysfunction

Biomarkers

Prevention of HF in Patients with Hypertension

Conclusion

References

Chapter 22: Right Heart Failure

Introduction

Anatomy and Mechanics of the Right Ventricle

Etiology and Pathogenesis of Right Ventricular Failure

Hemodynamic Consequences of the Right Heart Failure

Stages of RV Failure

Clinical Presentation and Assessment of the Right Heart Failure

Clinical Symptoms and Signs

Electrocardiography

Laboratory Markers

Echocardiography

RV Shape

RV Size

RV Function and Mechanics

Pulmonary Artery Pressure

Other Imaging Modalities

Invasive Hemodynamic Assessment

Prognostic Impact of the Right Heart failure

Management of RV Failure

Conclusions

References

Chapter 23: Acute Heart Failure

Definition

Classification

Diagnostic Evaluation

Biomarkers for the Diagnosis and Management of AHF

Main Causes of Elevated Natriuretic Peptide Concentrations

Cardiac

Noncardiac

Risk Stratification

Management

General Management

Immediate Ventilatory and Hemodynamic Stabilization

Respiratory Distress with Hypoxaemia and Peripheral Desaturation; acute Respiratory Failure

Cardiogenic Shock

Further Management – Initial In-hospital Phase

Acute Co-morbidities

Acute Coronary Syndrome

Arrhythmias

Hypertensive Heart Failure

Acute Mechanical Cause Underlying AHF

Acute Pulmonary Embolism

Cardiovascular Medication

Diuretics

Vasodilators

Digoxin

Inotropes and Inodilators

Vasopressors

Other Pharmacological Therapy

Drugs Under Research

Devices

Ultrafiltration

Mechanical Circulatory Support

Criteria for Discharge from the Hospital and Follow up in High Risk Period

Table 4. Instructions for the Optimization of Management of AHF Patients at Hospital Discharge

References

Part V: Heart Failure in Special Populations

Chapter 24: Heart Failure in Oncologic Patients

Introduction

Clinical Presentation

Definition

Classification

Anticancer Agents: Pathophysiology

Anthracyclines

HER2-Targeted Cancer Therapies

Microtubular Polymerization Inhibitors, Vascular Endothelial Growth Factor (VEGF) Inhibitors and T

Risk Factors

Diagnosis

Monitoring

Treatment

Prevention

Primary Prevention

Prevention in High-Risk Patients

Conclusion

References

Chapter 25: Iron Deficiency in Heart Failure

Background

Importance of Iron in Physiology

Pathogenesis of Iron Deficiency in Heart Failure

Definition of Iron Deficiency in Heart Failure

Prevalence and Clinical Consequences of Iron Deficiency in Heart Failure

Iron Supplementation in Heart Failure

References

Chapter 26: The Kidney and Electrolytes Imbalances in Heart Failure

Introduction

Epidemiology

Pathophysiology

Normal Physiology of the Kidney

The Kidney in Heart Failure

Classification of Heart Failure and Renal Failure

Worsening Renal Function

Markers of Renal Function

Glomerular Filtration Rate and Creatinine

Cystatin C

Blood Urea Nitrogen

Albuminuria and Proteinuria

Tubular Markers

Neutrophil Gelatinase-Associated Lipocalin (NGAL)

N-Acetyl-β-D-Glucosaminidase (NAG)

Kidney Injury Molecule 1 (KIM-1)

Treatment in Heart Failure Patients with Concomitant Renal Dysfunction

Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers

Beta-Blockers

Mineralocorticoid Receptor Antagonists

Angiotensin Receptor Neprilysin Inhibitor

Diuretics

Electrolytes in Heart Failure

Sodium

Hyponatremia

Hypernatremia

Potassium

Hypokalemia

Hyperkalemia

Chloride

Hypochloremia

Hyperchloremia

References

Part VI: Prognostic Factors and Rehabilitation in Heart Failure

Chapter 27: Prognostic Factors and Risk Scores in Heart Failure

Prognostic Factors and Risk Scores in Heart Failure

Risk Scores in Chronic Heart Failure

Cardiopulmonay Exercise Test and Prognosis in Heart Failure

Risk Prediction in Acute Heart Failure

Use of Risk Scores in Clinical Practice

Obesity and the Obesity Paradox

Depression and Prognosis in Heart Failure

References

Chapter 28: Rehabilitation Therapy in Patients with Heart Failure

Pathophysiological Basis of Physical Training

Targets of Physical Training in Heart Failure

Hemodynamics

Functional Capacity

Ventilatory Response

Cardiac Rehabilitation Phases

Physical Training Indications

Contraindications to Physical Training [7]

Increased Risk for Training [7]

Evaluation of Exercise Capacity Before Starting Physical Training

Training Modalities

Aerobic, Endurance Physical Training

Resistance/Strength Training

Inspiratory Muscles Training

Additional Measures: Cardiovascular Risk Factors Modification

Social and Professional Reinsertion in Patients with Heart Failure

References

Index

 

Springer

An aparitie	20 Jan 2017
Autor	Maria Dorobanţu,‎ Frank Ruschitzka ,‎ Marco Metra
Dimensiuni	16 x 3.8 x 24.2 cm
Editura	Springer
Format	Hardcover
ISBN	9783319452364
Limba	Engleza
Nr pag	642