Heart failure: metabolic derangements and therapeutic rationale.
In the USA, over two-thirds of patients with heart failure (HF) are cared for by primary care practitioners exclusively. Significant progress has been made through basic science and clinical research focusing on the prevention of HF via control of known risk factors. There has also been a great deal of progress in both pharmacologic and nonpharmacologic management of the disease. These therapeutic interventions, however, continue to be underutilized, with seemingly inadequate translation of new evidence and updated guidelines (American College of Cardiology/American Heart Association, European Society of Cardiology, Canadian Cardiovascular Society, and Heart Failure Society of America updates in 2005-2006) into clinical practice. In this review, we discuss the pathophysiology of HF in addition to the metabolic derangements and therapeutic rationale surrounding current treatment options, with a particular focus on the interventions that have been shown and recommended in updated guidelines to prevent the disease or halt its progression.
Gebreegziabher
Yohannes
Y
SUNY Downstate Medical Center, Division of Cardiovascular Medicine, 450 Clarkson Avenue, Brooklyn, NY 11203-2098, USA. yohannes.gebreegziabher@downstate.edu
Makaryus
Amgad N
AN
Makaryus
John N
JN
McFarlane
Samy I
SI
D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000503:physiopathology; D003952:Diagnostic Imaging / Q000379:methods; D004594:Electrophysiology; D005260:Female; D019983:Guideline Adherence; D006333:Heart Failure / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008019:Life Style; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
D002316:Cardiotonic Agents; D000960:Hypolipidemic Agents