Author + information
- Received October 7, 2019
- Revision received January 17, 2020
- Accepted January 28, 2020
- Published online June 29, 2020.
- Lauren K. Truby, MD and
- Joseph G. Rogers, MD∗ ()
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
- ↵∗Address for correspondence:
Dr. Joseph G. Rogers, 10 Duke Medicine Cir, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710.
• The prevalence of heart failure is increasing as the population ages. As a result of advances in medical therapy for heart failure, more patients are living longer and with more end-stage disease.
• The current review focuses on the diagnosis and management of advanced heart failure, including cardiogenic shock, temporary mechanical circulatory support, durable heart failure therapies including left ventricular assist devices and heart transplantation, and palliative care.
• Future directions discussed include translational research efforts in myocardial recovery, emerging left ventricular assist device technology, and innovative approaches to post-heart transplant care.
In broad terms, “advanced” heart failure describes a clinical syndrome characterized by persistent or progressive symptoms and ventricular dysfunction despite guideline-directed medical therapy. Clinically the definition is often dependent upon iterative and integrated clinical assessments to identify patients with worsening status and reliance on specific therapies. This review examines current consensus definitions, highlights strategies for risk stratification and prognostication, and examines short- and long-term treatment strategies. Lastly, this paper explores future directions of research and development for the field.
- advanced heart failure
- cardiogenic shock
- heart transplantation
- left ventricular assist device
- mechanical circulatory support
- palliative care
Both authors have reported that they have no relationships relevant to the contents of this paper to disclose. John Teerlink, MD, was Guest Editor on this paper.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Heart Failure author instructions page.
- Received October 7, 2019.
- Revision received January 17, 2020.
- Accepted January 28, 2020.
- 2020 American College of Cardiology Foundation
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