Medical Management of Advanced Heart Failure

Abstract

Heart failure has emerged as a major health challenge, increasing in prevalence as age-adjusted rates of myocardial infarction and stroke decline.¹ Affecting 4 to 5 million people in the United States with more than 2 million hospitalizations each year, heart failure alone accounts for 2% to 3% of the national health care budget. Developments heralded in the news media increase public expectations but focus on decreasing disease progression in mild to moderate stages^2,3 or supporting the circulation mechanically for limited periods in end-stage disease.⁴ Most of the burden of this disease is borne between these 2 boundaries by patients with advanced heart failure, a quarter of the diagnosed heart failure population.