Abstract: Heart failure affects over 5 million people and carries a high rate of mortality. Ivabradine, a new agent has been added to the current medical options for managing heart failure. It is a selective inhibitor of sino-atrial node and slows its firing rate, prolonging diastolic depolarization without any negative inotropic effects. In 2006, BEAUTIFUL trial evaluated patients with stable coronary artery disease and heart failure and found a significant reduction of coronary events, coronary revascularization and fatal and nonfatal myocardial infarction in patients with heart rate of >70 bpm. SHIFT trial observed patients with chronic heart failure with low ejection fraction and showed significantly reduced rate of hospitalization and deaths due to heart failure with Ivabradine. These trials resulted in this agent’s approval in Europe for chronic stable angina and chronic heart failure and in USA for reducing hospitalizations with chronic heart failure. Ivabradine has also been tried in other conditions like inappropriate sinus tachycardia, cardiogenic shock and is in phase II trial for patients with newly diagnosed multiple organ dysfunction syndrome. Background and Mechanism of Action Heart failure is a common cardiovascular condition affecting over 5 million individuals in USA. About 400,000 to 700,000 new cases of heart failure are diagnosed each year and carry a mortality of up to 250,000 per year (1). The current treatment options for managing heart
The prevalence of congestive heart failure is on the increase both in the United States and all over the world, and it is the leading cause of hospitalization in the elderly population. Congestive heart failure is a progressive disease generally seen in the elderly, which if not properly managed, can lead to repeated hospital admissions or death. Heart failure means that the heart muscle is weakened. A weakened heart muscle may not be strong enough to pump an adequate amount of blood out of its chambers. To compensate for its diminished pumping capacity, the heart may enlarge. Commonly, the heart's pumping inefficiency causes a buildup of blood in the
Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).
There are approximately 5.7 million people in the United States diagnosed with heart failure and about half of those diagnoses will die due to causes related to heart failure within five years (“Heart Failure”, 2016). Heart failure related deaths vary by geographic locations; however, they are most predominant among men and offer a greater risk to women if left untreated. Heart failure is a serious medical condition, if diagnosed and treated early enough, the chance of preventing death increase.
Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).
Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,
Congestive heart failure is a chronic condition that is responsible for the highest number of hospitalizations among adults. Readmission rates after hospitalization also remain high, with 50% of patients being readmitted within 6 months of discharge. (Desai & Stevenson, 2012). The Affordable Care Act penalizes hospitals with readmissions within 30 days after discharge, making readmissions a focus of hospitals nationwide. Several factors including discharge planning, patient education, diet restrictions, and early follow up appointments can help to reduce readmissions, but continuous monitoring is necessary to catch early signs of decompensation. (Desai & Stevenson, 2012).
Varying patients may present to their clinician or the emergency department for treatment with heart failure. It is important to understand that there is more than one type of heart failure; primarily the focus is placed on diastolic heart failure and systolic heart failure. Depending upon the cause of heart failure and what areas are affected dictates the treatment plan needed. While there are similarities with both kinds of heart failure, there are also differences that can help the clinician distinguish the diagnosis needed to fit the patient. Once a diagnosis is made the clinician can move forward in determining if the patient is at risk for use of diuretics and then look towards prescribing ACEIs, ARBs, and beta-blockers.
Heart failure (HF) is defined as a multifaceted clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. In HF, the heart may not provide tissues with adequate blood for metabolic needs, and cardiac-related elevation of pulmonary or systemic venous pressures may result in organ congestion1. In the United States, HF is increasing in incidence with about 5.1 million people suffering from HF and half of people who develop HF die within 5years 2. Over 75% of existing and new cases occurred in individuals over 65 years of age, < 1% in individuals below 60 years, nearly 10% in those over 80 years of age. HF costs the
Heart failure (HF) is one of the leading causes of hospital admissions and readmissions in the United States (Desai & Stevenson, 2012; Gheorghiade, Vaduganathan, Fonarow, & Bonow, 2013). It is a condition that accounts for a very high morbidity and mortality (Bakal, McAlister, Liu, & Ezekowitz, 2014). Every hospital admission for heart failure patients results in disease progression and poor prognosis. For chronic HF patients, a hospitalization is one of the strongest prognostic predictors for increased mortality (Gheorghiade et al., 2013). Factoring in re-hospitalizations, especially at 30-day to 90-day mark, it is increasingly detrimental to patient prognosis.
There is no cure for heart failure at this time so it is important for you to take good care of yourself. One way to do that is to make sure you follow the treatment plan set by your health care provider. If you are living with heart failure, there are ways to help you manage the disease.
As congestive heart failure continually increases among people worldwide it is a medical condition that is beginning to become more of a concern even for people at younger ages. It is typically a disease addressed by late age and elderly patients but many cases of earlier age have been shown. Because congestive heart failure has evolved when it comes to treatment, patients experience a remarkable difference on quality of life even over the last ten years. Although signs and symptoms remain the same, it has become easier to diagnose with technology and greater knowledge over the last decade. Congestive heart failure has many different types of heart failure. Many risk factors play a role in congestive heart failure that are
Almost every one in the United States knows a person suffering from congestive heart failure. This disease has manifested its way into the lives of so many—the statistics are astounding. According to the National Heart, Lung and Blood Institute, nearly 5 million people are affected and it is the main reason for hospital admission in older adults over the age of 65. This is a great cause for concern. In order to reduce the morbidity and control this epidemic, we must first understand the risks and causes of this condition. It is of the upmost importance to first understand the risks and causes of this condition. Education plays a key role in order to recognize the clinical manifestations and necessary actions to best treat
Congestive heart failure (CHF) is a commonly seen in the hospital setting. CHF results in patients having difficulty breathing and can go in to respiratory arrest. There is decreased cardiac output and labs will show increased BNP. Patients who have CHF history will have chest x-ray and EKG. Therapy for CHF is to correct the abnormal labs and keep the patient from arresting and being placed on a vent. This paper will look at the molecular make up of CHF all the way to how to take care of the patient with advanced CHF. Patients are placed on medications to help with fluid overload and blood pressures. At times patients may have to be placed on cardiac drips. Patients with CHF are prone to pulmonary complications such as pulmonary edema, and
In year 2000 and 2010, an estimated 1 million hospitalizations for Congestive Heart Failure (CHF), of which most of these hospitalizations were for those aged 65 and over, the share of CHF hospitalizations for those under age 65 increased from 23% to 29% over this time period (Hall, Levant, & DeFrances, 2012). According to Held (2009), acute decompensated heart failure (ADHF) ensues when cardiac output fails to meet the demand of the body’s metabolic needs. The fluid volume overload makes the unstable condition necessitates instant treatment for the reason that it impairs perfusion to systemic organs, endangering their function.
As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)