Treatment of Advanced Heart Disease

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ISBN: 9780849338267 | 0849338263
Cover: Hardcover
Copyright: 3/2/2006

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Treatment of Advanced Heart Disease is an expansive and up-to-date guide to the diagnosis and treatment of heart failure in children and adults. Written by leading specialists, this source guides the clinician through the possible causes of heart disease and emphasizes potentially reversible etiologies, in addition to reviewing currently available therapies including drugs, devices, surgery, and research sure to impact the field for years to come.

Series Introduction

iii

Samuel Z. Goldhaber

Foreword

Peter Libby

Preface

vii

Contributors

xxi

PART I: ETIOLOGY AND EPIDEMIOLOGY

Epidemiology and Prognosis in Chronic Heart Failure

(22)

G. William Dec

Introduction

(1)

Asymptomatic Left Ventricular Dysfunction

(2)

Risk Factors for Heart Failure Development

(5)

Multivariate Risk Prediction of Heart Failure

(1)

Special Populations

(1)

Establishing the Diagnosis of Heart Failure

(1)

Prognostic Features

(4)

Prognosis in Chronic Heart Failure

(1)

References

(7)

Causes and Evaluation for Reversible Etiologies

(14)

Edward K. Kasper

Introduction

(1)

Evaluation of Patients with Advanced Heart Failure

(4)

Causes of Cardiomyopathy

(1)

Reversible Causes of Cardiomyopathy

(5)

References

(4)

PART II: MEDICAL MANAGEMENT

Diet, Metabolic Syndrome, and Obesity

(22)

Michael M. Givertz

Introduction

(1)

Weight Gain and Loss

(3)

Diet

(1)

Metabolic Syndrome

(2)

Obesity

(8)

Transplant Considerations

(1)

References

(7)

Exercise and Heart Failure

(12)

Daniel E. Forman

Introduction

(1)

Heart Function and Functional Capacity

(2)

Exercise Training in HF

(2)

Safety of Exercise Training in HF

(1)

Exercise Training Modalities

(3)

Heart Failure with Normal Ejection Fraction

(1)

Exercise Adherence

(1)

References

(4)

Diuretics

(28)

Ilan S. Wittstein

Introduction

(1)

Effect of Diuretics on Heart Failure Symptoms

(1)

Hemodynamic Effects of Diuretics

(1)

Neurohormonal Effects of Loop Diuretics

(3)

Effect of Diuretics on Cardiac Remodeling

(1)

Effect of Diuretics on Mortality

(1)

Diuretic Pharmacology

(5)

Diuretic Use for the Treatment of Congestive Heart Failure

(4)

Diuretic-Related Side Effects

(2)

Other ``Diuretic'' Agents

(2)

Conclusion

(1)

References

(8)

Vasodilators in the Management of Heart Failure

(14)

David W. Markham

G. Michael Felker

Vasoconstriction in Heart Failure: Rationale for Vasodilator Therapy

(2)

Vasodilator Therapy in Acute Decompensated Heart Failure

101

(4)

Vasodilator Therapy in Chronic Heart Failure

105

(4)

Conclusions

109

(1)

References

109

(4)

Beta-Blockers in Heart Failure

113

(24)

Emily J. Tsai

Thomas P. Cappola

Introduction

113

(1)

β-Adrenergic Signaling in the Cardiovascular System

114

(4)

Evidence for the Role of Beta-Blockade

118

(7)

Clinical Guidelines

125

(4)

Future Directions

129

(1)

References

129

(8)

Inotropic Therapy in Heart Failure Management

137

(18)

Lisa M. Mielniczuk

Anju Nohria

Introduction

137

(1)

The Cardiac Contractile Apparatus

137

(2)

Mechanism of Action of Inotropic Therapy

139

(4)

Mechanisms of Harm

143

(1)

Inotrope Therapy in Acute Decompensated HF

143

(2)

Inotrope Use in Chronic HF

145

(4)

Future Directions of Inotropic Therapy

149

(1)

Conclusions and Recommendations

150

(1)

References

151

(4)

Statins, Inflammation, and Cardiomyopathy: Old Pathways, New Targets

155

(12)

Charles J. Lowenstein

Munekazu Yamakuchi

Introduction

155

(1)

The Discovery of Statins: From Microbes to Lipids

155

(1)

Anti-cholesterol Effects of Statins: The Most Decorated Molecule in Biology

156

(1)

Clinical Trials of Statins and LDL Cholesterol: The Lower the Better

157

(1)

Clinical Studies of Statins and Inflammation: Lowering LDL, Inflammation, or Both?

157

(1)

Statins Block Integrins and Leukocyte Trafficking

158

(1)

Statins Decrease Isoprenylation of Signaling Proteins: Rho

159

(1)

Statins Improve Endothelial Function: Nitric Oxide

159

(1)

Statins Decrease Vascular Inflammation: Blockade of Exocytosis

160

(1)

Statins and Cardiomyopathy

161

(1)

Conclusions: The True Significance of Statin Anti-inflammatory Effects

162

(1)

References

162

(5)

Atrial Arrhythmia

167

(16)

Aamir Cheema

Hugh Calkins

Introduction

167

(1)

Atrial Fibrillation

167

(2)

Rhythm Control

169

(3)

Rate Control

172

(2)

Atrial Flutter

174

(2)

Other Supraventricular Tachycardias

176

(1)

Conclusion

176

(1)

References

177

(6)

Management of Ventricular Arrhythmias in Heart Failure

183

(20)

Usha B. Tedrow

William G. Stevenson

Introduction

183

(1)

Ventricular Arrhythmias and Sudden Cardiac Death

183

(9)

Antiarrhythmic Drugs

192

(3)

Summary and Conclusions

195

(1)

References

196

(7)

Acute Heart Failure

203

(24)

Stuart D. Russell

Introduction

203

(1)

Clinical Context

203

(2)

Assessment

205

(5)

Studies

210

(2)

Therapy

212

(8)

Pre-discharge Goals

220

(2)

Summary

222

(1)

References

222

(5)

Diastolic Heart Failure

227

(20)

Michael M. Givertz

James C. Fang

Definitions and Classification

227

(2)

Epidemiology

229

(2)

Pathophysiology

231

(3)

Clinical Assessment

234

(4)

Treatment

238

(4)

New Directions

242

(1)

References

243

(4)

Diagnosis and Management of Secondary Pulmonary Hypertension

247

(12)

Anna R. Hemnes

Hunter C. Champion

Introduction

247

(1)

Pathophysiology

247

(1)

Pathology and Basic Science

248

(1)

Epidemiology and Clinical Evaluation

249

(2)

Management

251

(5)

References

256

(3)

PART III: DEVICE THERAPY

Cardiac Resynchronization Therapy

259

(42)

Michael O. Sweeney

A Heart Failure Epidemic

259

(1)

Abnormal Electrical Timing in Heart Failure Associated with DCM

259

(4)

Cardiac Resynchronization Therapy (CRT)

263

(3)

Implementation of CRT

266

(9)

CRT Pacing Systems

275

(4)

Programming Considerations in CRT

279

(5)

CRT Pacemaker Electrocardiography/Determining LV and RV Capture

284

(3)

Patient Selection for CRT

287

(5)

Clinical Trials of CRT

292

(1)

Clinical Trials of CRT/Defibrillation (CRTD)

292

(3)

Contak CD, Miracle ICD, and Companion

295

(1)

References

296

(5)

Device Therapy for Advanced Heart Disease: The Role of Implantable Defibrillators

301

(24)

Akshay S. Desai

Bruce A. Koplan

Background: Sudden Cardiac Death

301

(1)

Predicting Sudden Death in Patients with Heart Failure

302

(2)

Selection of Heart Failure Patients for Defibrillator Therapy

304

(14)

Conclusions

318

(3)

References

321

(4)

Device Therapy for Heart Failure

325

(20)

James C. Fang

Intra-aortic Balloon Counterpulsation (IABP)

325

(4)

Enhanced External Counterpulsation (EECP)

329

(5)

Continuous Positive Airway Pressure (CPAP)

334

(5)

References

339

(6)

PART IV: SURGICAL THERAPY

Revascularization

345

(12)

Prem S. Shekar

Gregory S. Couper

Introduction and Epidemiology of Advanced Ischemic Heart Disease

345

(1)

The Concepts of Normal Myocardium, Stunned Hibernating Myocardium, and Scar

345

(1)

Coronary Disease, Left Ventricular Dysfunction, and Survival

346

(1)

Investigational Modalities

346

(1)

Tests to Determine Myocardial Viability

347

(2)

Selection of Patients for Surgical Revascularization

349

(1)

Principles of Surgical Revascularization

349

(1)

Technical Considerations

350

(3)

CABG, PCI, or Medical Management in Ischemic Cardiomyopathy

353

(1)

The Benefits of CABG in LV Dysfunction---Who and When

354

(1)

References

354

(3)

Valvular Surgery in Cardiomyopathy

357

(10)

Frederick Y. Chen

Lawrence H. Cohn

Introduction

357

(1)

Valvular Repair or Replacement in Cardiomyopathy

358

(1)

Mitral Valve Surgery in Cardiomyopathy: A Problem of Regurgitation

359

(2)

Aortic Valve Surgery in Cardiomyopathy: Aortic Stenosis and Aortic Regurgitation

361

(2)

Conclusions

363

(1)

References

363

(4)

Surgical Ventricular Remodeling

367

(16)

John V. Conte

Introduction

367

(1)

History

368

(1)

Indications for Surgery

369

(1)

Surgical Approaches

369

(2)

Dor Procedure (Endoventricular Circular Patch Plasty)

371

(3)

Linear Closure with Septoplasty

374

(1)

Multiple Purse String or Cerclage Technique

375

(1)

Septoplasty Technique

375

(1)

Outcomes

375

(4)

References

379

(4)

Transmyocardial Laser Revascularization

383

(18)

Keith A. Horvath

Introduction

383

(1)

TMR as Sole Therapy

384

(3)

Results

387

(4)

TMR as an Adjunct to CABG

391

(1)

Results

391

(1)

Mechanisms

392

(2)

Percutaneous Myocardial Laser Revascularization

394

(1)

Future Uses of TMR

395

(1)

Summary

395

(1)

References

395

(6)

Percutaneous Left Ventricular Assist Devices

401

(18)

Piotr Sobieszczyk

Andrew C. Eisenhauer

Introduction

401

(1)

Left Ventricular Assist Devices: Pulsatile and Non-pulsatile Flow

402

(1)

Historical Perspective

403

(4)

Contemporary Percutaneous Left Ventricular Assist Devices

407

(7)

Conclusion

414

(1)

References

414

(5)

Selecting Patients for Durable Support with Ventricular Assist Devices

419

(14)

Lynne Warner Stevenson

The Current Picture

419

(1)

Beyond ``Optimal'' Medical Therapy

419

(3)

Benefit of VAD for Durable Support

422

(4)

Contraindications for Current VADs

426

(4)

References

430

(3)

Ventricular Assist Devices

433

(26)

Jason A. Williams

John V. Conte

History of Mechanical Ventricular Assistance

433

(1)

Overview of Ventricular Assist Devices

434

(1)

Patient Selection

435

(2)

Patient Management

437

(3)

Device Selection

440

(1)

Bridge to Recovery Devices

440

(5)

Bridge to Bridge Devices

445

(1)

Bridge to Transplant and Destination Therapy

445

(7)

Devices in Development (Third Generation Devices)

452

(1)

Outcomes

453

(2)

The Future of Ventricular Assist Devices

455

(1)

References

455

(4)

Total Artificial Heart (AbioCor™)

459

(14)

Laman A. Gray Jr.

Background

459

(1)

Device Description

459

(2)

Preoperative Considerations

461

(1)

Operative Technique

462

(2)

Clinical Trial

464

(6)

New Devices

470

(1)

References

470

(3)

The SynCardia CardioWest™ Total Artificial Heart

473

(18)

Marvin J. Slepian

Richard G. Smith

Jack G. Copeland

Introduction

473

(1)

Rationale for the Total Artificial Heart

474

(1)

Historical Overview of Artificial Heart Technology

475

(3)

Technical and Operational Details of the CardioWest™ TAH

478

(5)

Indications for Use of the CardioWest™ TAH

483

(1)

Clinical Experience with the CardioWest™ TAH

483

(4)

Future Applications of the CardioWest™ TAH

487

(1)

Conclusion

487

(2)

References

489

(2)

Selection and Management of Cardiac Transplantation Candidates

491

(20)

Christopher Newton-Cheh

Marc J. Semigran

Introduction

491

(1)

General Indications for Cardiac Transplantation

491

(2)

Evaluation of Severity and Prognosis of Chronic HF: Is This Patient's Prognosis Poor Enough to Require Transplantation?

493

(4)

Timing of Referral to Transplant Center

497

(1)

Contraindications to Cardiac Transplantation

497

(6)

Implications of the System for Organ Allocation

503

(1)

Outcomes on Waitlist for Transplant

504

(1)

Management Prior to Transplant

505

(1)

Conclusion

505

(1)

Appendix A: Donor Identification and Management

505

(1)

References

506

(5)

PART V: PSYCHOSOCIAL ISSUES

Education, Psychosocial Issues, and Sociodemographic Barriers in Heart Failure Disease Management

511

(20)

Aileen Aponte

Norma Osborn

Joanne R. Weintraub

Michelle A. Young

Introduction

511

(1)

Patient Education

511

(1)

Challenges in Health Education

512

(3)

Outpatient Heart Failure Disease Management

515

(3)

Depression in Heart Failure Patients

518

(1)

Anxiety in Heart Failure Patients

519

(1)

Sociodemographic Barriers to Care

520

(5)

References

525

(6)

Prognosis Assessment and End of Life Issues

531

(16)

Eldrin F. Lewis

Carol M. Flavell

Introduction

531

(1)

Clinical Use of Prognostic Factors

532

(4)

Targets of Therapy

536

(2)

Clinical Issues in End of Life Care of Heart Failure

538

(5)

References

543

(4)

PART VI: RESEARCH

Regenerative Medicine: The Promise of Cellular Cardiomyoplasty

547

(26)

Anastasios P. Saliaris

Luciano C. Amado

Karl H. Schuleri

Joshua M. Hare

Introduction

547

(1)

Repair Mechanisms

548

(2)

Cell Types Involved in Cardiac Regeneration and Repair

550

(5)

Delivery Routes

555

(1)

Homing and Migration of Stem Cells

556

(1)

Human Trials

557

(4)

Potential Complications

561

(1)

Conclusion

562

(1)

References

562

(11)

Gene Therapy for Heart Failure

573

(16)

Shi Yin Foo

Anthony Rosenzweig

Introduction

573

(1)

Vectors for Cardiac Gene Transfer

574

(3)

Delivery Systems

577

(1)

Biological Targets in Heart Failure

578

(5)

Summary and Conclusions

583

(1)

References

583

(6)

Genetics and Heart Failure: Hypertrophic Cardiomyopathy

589

(18)

Carolyn Y. Ho

Christine E. Seidman

Introduction

589

(1)

Hypertrophic Cardiomyopathy

589

(2)

Phenotype and Natural History

591

(3)

Genetic Aspects

594

(4)

New Paradigms of Inherited Cardiac Hypertrophy

598

(2)

Contemporary Diagnosis of HCM

600

(3)

References

603

(4)

Genetics and Heart Failure: Dilated, Restrictive, and Right Ventricular Cardiomyopathies

607

(16)

Nicole M. Johnson

Daniel P. Judge

Introduction

607

(1)

Familial Dilated Cardiomyopathy

607

(6)

Familial Restrictive Cardiomyopathy

613

(1)

Right Ventricular Cardiomyopathy

614

(2)

Clinical Implications

616

(1)

References

617

(6)

New Drugs for Heart Failure: Emerging Role of Oxidative Stress as a Target

623

(10)

Tania Chao

Wilson S. Colucci

New Therapeutic Targets in Heart Failure

623

(1)

Myocyte Death and Dysfunction in Heart Failure

623

(1)

Oxidative Stress in Heart Failure

624

(1)

Regulation of Reactive Species in the Myocardium

624

(1)

Oxidative Stress in Myocardial Failure

625

(1)

Myocyte Loss and Dysfunction in Heart Failure

625

(1)

Oxypurinol: An Antioxidant for the Therapy for Chronic Heart Failure

626

(1)

New Therapeutic Targets in Acute Decompensated Heart Failure

627

(1)

Cardioprotection via Activation of ATP-Dependent Potassium Channels

627

(1)

Levosimendan: A New Agent for the Treatment of Decompensated Heart Failure

628

(1)

Clinical Effects of Levosimendan

629

(1)

References

629

(4)

New Surgery for Congestive Heart Failure

633

(20)

David D. Yuh

Introduction

633

(1)

Robot-Assisted, Minimally Invasive Coronary Revascularization

634

(3)

Geometric Mitral Reconstruction

637

(1)

Minimally Invasive Mitral Valve Repair

637

(3)

Minimally Invasive, Robot-Assisted Biventricular Pacemaker Lead Placement

640

(2)

Minimally Invasive, Robot-Assisted Transmyocardial Revascularization

642

(1)

Surgical Treatment of Atrial Fibrillation

643

(5)

Cardiac Restraint Devices: The Acorn CorCap® Device

648

(2)

References

650

(3)

PART VII: PEDIATRIC THERAPY

Device and Alternative Therapies in Pediatric Heart Failure

653

(10)

Leslie B. Smoot

Jane E. Crosson

Ravi Thiagarajan

Introduction

653

(1)

Unique Aspects of Pediatric Heart Failure and Device Use

653

(1)

Electrophysiology: Catheter Ablation and Device Therapy

654

(3)

Therapeutic Circulatory Support Modalities

657

(3)

Psychosocial Aspects of Advanced Heart Disease in Pediatrics

660

(1)

References

660

(3)

Surgical Management of Pediatric Heart Failure

663

(18)

Luca A. Vricella

Duke E. Cameron

Introduction

663

(1)

Heart Failure in Children: Surgical Indications for Device Implantation

664

(2)

Choice of Ventricular Assist Device

666

(1)

Specific Ventricular Assist Devices

666

(10)

Conclusions

676

(1)

References

676

(5)

Index

681

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Treatment of Advanced Heart Disease

Summary

Table of Contents

Supplemental Materials