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Manual of Heart Failure
Kanu Chatterjee
CHAPTER 1:
Heart Failure: Epidemiology
INTRODUCTION
EPIDEMIOLOGY
PREVALENCE
INCIDENCE
RACIAL DIFFERENCES
GEOGRAPHIC DIFFERENCES
GENDER DIFFERENCES
SECULAR TRENDS
CHAPTER 2:
Heart Failure: Diagnosis
ANALYSIS OF SYMPTOMS
PHYSICAL EXAMINATION
ELECTROCARDIOGRAM
CHEST RADIOGRAPH
ECHOCARDIOGRAPHY
RADIONUCLIDE VENTRICULOGRAPHY
CARDIAC MAGNETIC RESONANCE
CARDIAC TOMOGRAPHY
ROUTINE LABORATORY TESTS
BIOMARKERS
EXERCISE TESTS
SIX-MINUTE WALK TEST
CORONARY ARTERIOGRAPHY
MYOCARDIAL ISCHEMIA
ENDOMYOCARDIAL BIOPSY
GENETIC STUDIES
CHAPTER 3:
Systolic Heart Failure (Heart Failure with Reduced Ejection Fraction)
INTRODUCTION
HISTORICAL PERSPECTIVE
DEFINITIONS
RISK FACTORS
VENTRICULAR REMODELING
FUNCTIONAL DERANGEMENTS AND HEMODYNAMIC CONSEQUENCES
INITIAL TREATMENT OF SYSTOLIC HEART FAILURE
SYMPTOMATIC SYSTOLIC HEART FAILURE
PHARMACOLOGIC TREATMENTS
NONPHARMACOLOGIC TREATMENTS
FOLLOW-UP EVALUATION
CHAPTER 4:
Diastolic Heart Failure (Heart Failure with Preserved Ejection Fraction)
INTRODUCTION
DEFINITION
EPIDEMIOLOGY
PATHOPHYSIOLOGY
VENTRICULAR REMODELING
NEUROHORMONAL CHANGES
FUNCTIONAL DERANGEMENTS
HEMODYNAMIC CONSEQUENCES
CLINICAL PRESENTATION
DIAGNOSIS
PROGNOSIS
TREATMENT STRATEGIES
FUTURE DIRECTIONS
CHAPTER 5:
Anemia in Patients with Chronic Heart Failure (Prevalence, Mechanism, Significance, and Treatment)
OVERVIEW OF THE PROBLEM
PREVALENCE OF ANEMIA IN HEART FAILURE PATIENTS
MECHANISMS UNDERLYING ANEMIA IN HEART FAILURE PATIENTS
PROGNOSTIC SIGNIFICANCE OF ANEMIA IN HEART FAILURE PATIENTS
SHOULD ANEMIA BE TREATED IN HEART FAILURE PATIENTS?
SAFETY CONCERNS RELATED TO ESPs IN A VARIETY OF ANEMIC PATIENTS
TREATMENT OF ANEMIA IN HEART FAILURE PATIENTS
ERYTHROPOIETIN-STIMULATING PROTEINS (ESPs)
IRON DEFICIENCY AND IRON REPLACEMENT IN HEART FAILURE
SUMMARY AND CONCLUSION
CHAPTER 6:
Hyponatremia and Congestive Heart Failure
INTRODUCTION
MECHANISMS CAUSING HYPONATREMIA IN HEART FAILURE
SYMPATHETIC NERVOUS SYSTEM
RENIN–ANGIOTENSIN–ALDOSTERONE SYSTEM
ARGININE VASOPRESSIN
TREATMENT OF HYPONATREMIA
ROLE OF DIURETIC THERAPY IN HYPONATREMIA
ROLE OF VASOPRESSIN RECEPTOR ANTAGONISTS IN HYPONATREMIA
TOLVAPTAN
LIXIVAPTAN
CONIVAPTAN
CONCLUSION
CHAPTER 7:
Cardiorenal Syndrome: The Interplay Between Cardiac and Renal Function in Patients with Congestive Heart Failure
INTRODUCTION
EPIDEMIOLOGY OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH HEART FAILURE
PROGNOSIS OF WORSENING RENAL FUNCTION
DEFINITION OF THE CARDIORENAL SYNDROME
PATHOPHYSIOLOGY OF THE CARDIORENAL SYNDROME
ROLE OF DECREASED CARDIAC OUTPUT
ROLE OF ELEVATED CENTRAL VENOUS PRESSURE
ROLE OF EVIDENCE-BASED THERAPIES IN PATIENTS WITH HEART FAILURE AND THE CARDIORENAL SYNDROME
DIURETICS
Loop Diuretics
Distal Convoluted Tubule Diuretics
Potassium-sparing Diuretics
Effect of Diuretic Use on Morbidity and Mortality
ACE-I AND ARB
INOTROPES
Dobutamine
Milrinone
Levosimendan
Dopamine
ROLE OF ULTRAFILTRATION ON DIURETIC RESISTANCE AND THE CARDIORENAL SYNDROME
TREATMENT OF THE CARDIORENAL SYNDROME: AN APPROACH TO THE INDIVIDUAL PATIENT
CHAPTER 8:
Acute Heart Failure Syndromes
INTRODUCTION
DEFINITION
EPIDEMIOLOGY
PATIENT'S CHARACTERISTICS
CLASSIFICATION
PATHOPHYSIOLOGY
CONGESTION
MYOCARDIAL INJURY
RENAL IMPAIRMENT
VASCULAR FAILURE
CARDIAC METABOLISM
UNTOWARD DRUG EFFECTS
VIABILITY
ACUTE HEART FAILURE SYNDROMES MANAGEMENT
STABILIZATION PHASE
Diagnosis
Treatment According to Clinical Profile
Precipitants for Admission
Disposition
Goals of Stabilization Phase
TRANSITION TO EVIDENCE-BASED PHASE
Goals of Transitional Phase
Quality Measures
RECONSTRUCTION PHASE
Vulnerable Phase
CLINICAL TRIALS IN ACUTE HEART FAILURE SYNDROMES
T1 TRANSLATIONAL PHASE
CONCLUSION
CHAPTER 9:
Cardiopulmonary Exercise Testing and Training in Heart Failure
INTRODUCTION
NORMAL RESPONSE TO EXERCISE
EXERCISE RESPONSE IN HEART FAILURE
CENTRAL FACTORS
PERIPHERAL FACTORS
CARDIOPULMONARY EXERCISE TESTING
TECHNICAL ASPECTS
EXERCISE MEASUREMENTS BY CPX
Oxygen Uptake
Ventilatory Threshold or Anaerobic Threshold
Oxygen Pulse
Respiratory Exchange Ratio (RER)
Ventilatory Efficiency
Ventilation
CONDUCTING THE EXERCISE TEST
INDICATIONS FOR CPX TESTING IN HEART FAILURE
PEAK VO2 AND PROGNOSIS
EVALUATION OF DYSPNEA: PRESENCE OF VENTILATORY LIMITATIONS
EXTENT OF DECONDITIONING AND DERIVING AN EXERCISE PRESCRIPTION
EXERCISE TRAINING IN HEART FAILURE
DELETERIOUS EFFECTS OF BED REST
HISTORY OF EXERCISE TRAINING IN HEART FAILURE
BENEFITS OF EXERCISE TRAINING IN HEART FAILURE
SAFETY
MORTALITY AND MORBIDITY
GUIDELINE RECOMMENDATION
EXERCISE PRESCRIPTION RECOMMENDATION
SUMMARY
CHAPTER 10:
Hibernating Myocardium
INTRODUCTION
HISTORICAL PERSPECTIVE
DEFINITION
PATHOPHYSIOLOGY
HIBERNATION AND STUNNING: CLINICAL PREVALENCE
DETECTION OF HIBERNATING MYOCARDIUM
RATIONALE
TECHNIQUES
REVASCULARIZATION OF HIBERNATING MYOCARDIUM AND CHANGES IN VENTRICULAR FUNCTION
REVASCULARIZATION OF HIBERNATING MYOCARDIUM AND CHANGES IN PROGNOSIS
SUMMARY
CHAPTER 11:
Advanced Cardiac Therapies for End-stage Heart Failure: Cardiac Transplantation and Mechanical Circulatory Support
INTRODUCTION
IDENTIFYING CANDIDATES FOR ADVANCED CARDIAC THERAPIES
RECOGNITION OF ADVANCED HEART FAILURE WITH POOR PROGNOSIS
PROGNOSTIC DETERMINANTS AND RISK SCORES IN HEART FAILURE
PROGNOSTIC SCORES
FUNCTIONAL ASSESSMENT
A PERSPECTIVE ON OPTIMAL MEDICAL MANAGEMENT
EVALUATION OF PATIENT REFERRED FOR ADVANCED CARDIAC THERAPIES
GENERAL APPROACH TO PREOPERATIVE ASSESSMENT OF ADVANCED CARDIAC THERAPIES
HEART TRANSPLANTATION
INDICATIONS AND CONTRAINDICATIONS FOR CARDIAC TRANSPLANTATION
Management of Patients on the Transplant List
DONOR SELECTION AND PERIOPERATIVE PERIOD
Donor Management21
Organ Explantation and Preservation
Donor Heart Implantation
Immediate Post-transplant Physiology and Management
Hemodynamic Stabilization
Early Immunosuppressive and Antimicrobial Management
Long-term Management of Transplant Patients
Cardiac Retransplantation
SURVIVAL WITH CARDIAC TRANSPLANTATION
MECHANICAL CIRCULATORY SUPPORT
SELECTION OF A VENTRICULAR ASSIST DEVICE PATIENT
INDICATIONS AND CONTRAINDICATIONS FOR MECHANICAL CIRCULATORY SUPPORT
DESIGN OF VENTRICULAR ASSIST DEVICE AND IMPACT ON POST-IMPLANT PHYSIOLOGY
Design of a Ventricular Assist Device
Physiology of Ventricular Assist Devices
Structural and Molecular Effects of Mechanical Unloading
CARING FOR THE MECHANICAL CIRCULATORY SUPPORT DEVICE RECIPIENT
Preoperative Management
Intraoperative Management
POSTOPERATIVE PATIENT AND DEVICE MANAGEMENT
Hemodynamic Stabilization
Anticoagulation
Pump Management
Long-term Management of Ventricular Assist Device Patients
SURVIVAL WITH MECHANICAL CIRCULATORY SUPPORT
MYOCARDIAL RECOVERY WITH DEVICE EXPLANTATION
FUTURE DIRECTIONS
CONCLUSION
CHAPTER 12:
Palliative Medicine and End-of-life Care in Heart Failure
INTRODUCTION
EPIDEMIOLOGY OF HEART FAILURE
ECONOMIC IMPACT OF HEART FAILURE
HISTORY OF PALLIATIVE CARE/DEFINITIONS
FEASIBILITY OF THE USE OF PALLIATIVE CARE IN HEART FAILURE
ISSUES OF PROGNOSTICATION
COMMUNICATION AND PATIENT'S UNDERSTANDING OF THEIR DISEASE
SUFFERING IN END-STAGE HEART FAILURE
SYMPTOM MANAGEMENT IN HEART FAILURE
DYSPNEA
PAIN: ANGINAL AND NONANGINAL
EDEMA
FATIGUE
ANOREXIA/CACHEXIA
DEPRESSION
MANAGEMENT OF IMPLANTABLE CARDIAC DEVICES
CONCLUSION
ACKNOWLEDGMENTS
INDEX
TOC
Index
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