title: Palliation of heart failure.
abstract: Heart failure is the major cause of morbidity and mortality in the United States. Stage D heart failure has a greater mortality rate than many cancers and has equivalent symptom burden and severity. There has been a paradigm shift in our understanding of the pathophysiology of heart failure. Progressive heart failure is associated with ventricular remodeling and a maladaptive neurohumoral response. Drug classes have evolved that curtail ventricular remodeling, and blunt neurohumoral responses reduce morbidity and mortality. Despite combination drug and device therapies, the management of Stage D heart failure includes palliation. Both cardiology and palliative specialists need to learn from one another in order to palliate these highly symptomatic patients. Such collaboration will enhance care and are the basis for well-conceived research trials.
authors.affiliation: The Harry R Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio, USA.
authors.forename: Mellar P
authors.initials: MP
authors.lastname: Davis
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Albert
authors.forename: James B
authors.initials: JB
authors.lastname: Young
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D033183:Interdisciplinary Communication; D010166:Palliative Care / Q000592:standards*; D010348:Patient Care Team / Q000592:standards; D010353:Patient Education as Topic / Q000592:standards; D011788:Quality of Life; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*
chemical_list: D002317:Cardiovascular Agents