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(Circulation. 2003;107:1719.)
© 2003 American Heart Association, Inc.

The Key to Unraveling the Mystery of Mortality in Heart Failure

An Integrated Approach

Prakash C. Deedwania, MD

From the Division of Cardiology, Department of Medicine, VA Central California Health Care System and University of California San Francisco Medical Education Program, Fresno, Calif, and University of California San Francisco School of Medicine, San Francisco, Calif.

Correspondence to Prakash C. Deedwania, MD, Division of Cardiology, Department of Medicine, VA Central California Health Care System, UCSF Medical Education Program, 2615 East Clinton Ave (111), Fresno, CA 93703. E-mail deed@ucsfresno.edu

Key Words: Editorials • heart failure • survival • death, sudden • risk factor

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Heart failure (HF) is a growing public health problem in the United States. Nearly 5 million Americans suffer from HF, and an estimated 550 000 new cases of HF are diagnosed each year.¹ HF is the No. 1 discharge diagnosis in patients 65 years of age and results in a substantial burden on healthcare expenditures. It is estimated that in 2001, more than $24 billion was spent as direct cost for the care of patients with HF.¹ Furthermore, HF is associated with a significant increase in morbidity and mortality.

See p 1764

Although considerable progress has been made in our approach to the pharmacological management of patients with HF, most patients remain at increased risk of cardiac death. To further improve outcomes in patients with HF, newer therapeutic modalities, including devices such as biventricular pacemaker, automatic internal cardioverter-defibrillators (AICDs), and left ventricular assist devices, have been increasingly utilized. Several recent randomized controlled trials have shown that such devices can indeed further improve the outcome in patients with HF.^2–4 However, these devices are expensive, and their widespread or injudicious application in unselected patients with HF is likely to have a substantial impact on healthcare expenditures. On the other hand, appropriate use of device therapy in properly selected patients (who are at high risk of mortality) is essential to improve clinical outcome. Thus, there is a need to develop a strategy to accurately identify those patients with HF who are at increased risk of mortality. The paper by Vrtovec and associates⁵ in . . . [Full Text of this Article]

Related Article:

Prolonged QTc Interval and High B-Type Natriuretic Peptide Levels Together Predict Mortality in Patients With Advanced Heart Failure

Bojan Vrtovec, Reynolds Delgado, Aly Zewail, Cynthia D. Thomas, Barbara M. Richartz, and Branislav Radovancevic
Circulation 2003 107: 1764-1769. [Abstract] [Full Text]

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