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Current Treatment Strategies for Heart Failure: Role of Device Therapy and LV Reconstruction

  • Arrhythmia (D Spragg, Section Editor)
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Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion statement

Medical care of heart failure (HF) begins with the determination of the cause of the heart failure and diagnosing potential reversible causes (i.e., coronary heart disease, hyperthyroidism, etc.). Medical therapy includes pharmacological and nonpharmacological strategies that limit and/or reverse the signs and symptoms of HF. Initial behavior modification includes dietary sodium and fluid restriction to avoid weight gain; and encouraging physical activity when appropriate. Optimization of medical therapy is the first line of treatment that includes the use of diuretics, vasodilators (i.e., ACE inhibitors or ARBs), beta blockers, and potentially inotropic agents and anticoagulation depending on the patient’s severity of heart failure and LV dysfunction. As heart failure advances despite optimized medical management, cardiac resynchronization therapy (CRT), and implantable cardioverter defibrillators (ICDs) are appropriate device therapies. The development of progressive end-stage HF, despite maximal medical therapy, necessitates the consideration of mechanical circulatory devices such as ventricular assist devices (VADs) either as a bridge to heart transplantation or as destination therapy. Despite the advances in the treatment of heart failure, there is still a large morbidity and mortality associated with HF, thus the need to develop newer strategies for the treatment of HF.

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Authors and Affiliations

  1. Department of Medicine, University of California San Francisco, San Francisco, CA, USA

    Praneeth Janaswamy MD, Tomos E. Walters MD, Babak Nazer MD & Randall J. Lee MD, PhD

  2. Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA

    Randall J. Lee MD, PhD

  3. Institute for Regeneration Medicine, University of California San Francisco, San Francisco, CA, USA

    Randall J. Lee MD, PhD

  4. University of California San Francisco, Box 1354, San Francisco, CA, 94143, USA

    Randall J. Lee MD, PhD

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  1. Praneeth Janaswamy MD
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  2. Tomos E. Walters MD
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  4. Randall J. Lee MD, PhD
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Correspondence to Randall J. Lee MD, PhD.

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Praneeth Janaswamy, Tomos E. Walters, Babak Nazer, and Randall J. Lee each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Arrhythmia

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Janaswamy, P., Walters, T.E., Nazer, B. et al. Current Treatment Strategies for Heart Failure: Role of Device Therapy and LV Reconstruction. Curr Treat Options Cardio Med 18, 57 (2016). https://doi.org/10.1007/s11936-016-0479-1

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