title: Treatment of advanced heart failure.
abstract: The incidence of chronic heart failure has increased, with a corresponding increase in morbidity and mortality, and has made a substantial financial impact on our society. Improved therapy for heart failure has resulted in a significant prolongation of survival, a decreased number of hospitalizations, and an enhanced quality of life for many patients. It can reasonably be expected, therefore, that adherence to a rational medical regimen for these patients might decrease costs as well. Management of patients with severe heart failure begins with identifying the etiology and educating the patients and their families. Angiotensin-converting enzyme inhibitors are the cornerstone of therapy but only after diagnostic tests are performed to establish the etiology and extent of myocardial dysfunction. Because cardiac transplantation is a therapeutic option for only a limited number of patients, other surgical and medical therapies have to be viewed as the mainstay of a treatment strategy.
authors.affiliation: Heart Failure/Transplantation Program, Hospital of the University of Pennsylvania, 6 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: M
authors.initials: M
authors.lastname: Jessup
authors.forename: S
authors.initials: S
authors.lastname: Brozena
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D014665:Vasodilator Agents / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents; D014665:Vasodilator Agents