Therapeutic options and heart failure survival score predictability in an academic heart failure center: an analysis of 120 consecutive patients during a 1-year period.
BACKGROUND
the incidence and prevalence of patients with advanced heart failure is increasing worldwide and the number of cardiac transplantations remains limited.


OBJECTIVE
it was the aim of the study to describe our experience with the increasing number of available medical, interventional and cardiac surgery options, and to assess heart failure survival score predictability in an academic heart failure center within a 1-year follow-up.


RESULTS
in all patients who were referred for cardiac transplant evaluation within a 12-month period between April 1998 and March 1999 at our Interdisciplinary Heart Failure and Transplant Program, our team assessed all medical interventions as well as interventional and surgical treatment options that were available, based on the clinical profile on initial presentation. In 92% of the 120 patients referred for cardiac transplantation evaluation, drug therapy could be optimized. A considerable number of patients could be subjected to an organ-preserving intervention or surgery, either PTCA (n=11), CABG (n=4), valve repair (n=7), multisite pacing (n=7), or partial ventricular resection (n=5). Only a small group of patients with the worst heart failure survival score were listed for heart transplantation (n=17) or received a ventricular assist device (n=3).


CONCLUSIONS
within a contemporary cohort of advanced heart failure patients, only a small number of patients will undergo cardiac transplantation, which is predictable by the heart failure survival score. Most patients will undergo optimized medical therapy and a considerable number will be subjected to interventional or surgical treatment options.
Gradaus
Rainer
R
Universitätsklinikum Münster, Medizinische Klinik und Poliklinik, Innere Medizin C (Kardiologie und Angiologie), D-48129, Münster, Germany. gradaus@uni-muenster.de
Kerber
Sebastian
S
Böcker
Dirk
D
Scheld
Hans H
HH
Breithardt
Günter
G
Deng
Mario C
MC
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000401:mortality* / Q000628:therapy*; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors