title: Mechanical approach in the management of advanced acute and chronic heart failure: the state of the art.
abstract: Despite the progress in medical therapy, advanced heart failure (AHF) remains a global epidemic with high morbidity and mortality. Novel cardiac support strategies such as pharmacologic agents, mechanical circulatory support (MCS), and cell- or matrix-based therapies are promising for these patients. The indications, types, and timing of MCS implantation depend to a large extent on the presentation, clinical status of the patient, underlying etiology, and long-term prospects. The presence or absence of end-organ damage has a significant impact on prognosis following MCS initiation. Although many patients with acute AHF may have end-organ damage, their prospect of recovery, once appropriate therapy is instituted, is better than for patients who had AHF for longer periods of time. We consider the multidisciplinary approaches used for the management of AHF and the novel cardiac support strategies (eg, MCS). Appropriate selection of patient, device, time, and end point is essential for better outcomes.
authors.affiliation: Clinical Medicine, Weill Cornell Medical College, Doha, Qatar Clinical Research, Hamad General Hospital, Doha, Qatar Cardiology Unit, Internal Medicine, Ahmed Maher Teaching Hospital, Cairo, Egypt aymanco65@yahoo.com.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: Cardiothoracic Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Carr
authors.affiliation: Cardiothoracic Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: AlKhulaifi
mesh_terms: D000208:Acute Disease; D058406:Cardiac Resynchronization Therapy / Q000592:standards; D058409:Cardiac Resynchronization Therapy Devices / Q000592:standards; D002908:Chronic Disease; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000592:standards; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011474:Prosthesis Design; D020127:Recovery of Function; D044968:Regenerative Medicine; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: advanced heart failure; mechanical support; multidisciplinary