title: Heart failure: clinical problem and management issues.
abstract: Heart failure (HF) often presents as dyspnea either with exertion and/or recumbency. Patients also experience dependent swelling and fatigue. Measurement of the left ventricular ejection fraction (LVEF) identifies HF patients who may respond to pharmacologic therapy and/or electrophysiologic device implantation. Angiotension converting enzyme inhibitors, beta blockers, and aldosterone inhibitors can significantly lower the mortality and morbidity of HF in patients with an LVEF less than 35%. Cardiac defibrillators and biventricular pacemakers can also improve outcomes in selected patients with a decreased LVEF. The authors provide a guide for therapeutic decisions based on the inclusion criteria of the major clinical trials.
authors: Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, 1600 East Medical Center Drive, Ann Arbor, MI 48109-5853, USA. jnicklas@med.umich.edu
authors: John M
authors: JM
authors: Nicklas
authors: Barry E
authors: BE
authors: Bleske
authors: Richard
authors: R
authors: Van Harrison
authors: Robert V
authors: RV
authors: Hogikyan
authors: Yeong
authors: Y
authors: Kwok
authors: William E
authors: WE
authors: Chavey
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D000529:Complementary Therapies; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D015438:Health Behavior; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008019:Life Style; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain; D010353:Patient Education as Topic; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002317:Cardiovascular Agents; D000451:Mineralocorticoid Receptor Antagonists; D020097:Natriuretic Peptide, Brain