Received: January 30,2018; Published: February 08,2018
Corresponding author: Fatemeh Fatemifar, Department of Mechanical Engineering, University of Texas at San Antonio, USA, Email: firstname.lastname@example.org
Heart failure (HF) is a growing epidemic that affects about six million people in the United States and more than 23 million worldwide [1,2] .The prevalence of HF is greatest among people aged 65 years or older and has been increasing with the growth of this demographic population [3-6]. Around 50% and 90% of patients with HF die within 5 and 10 years of diagnosis, respectively . Total medical costs attributable to diagnosis, treatment, and prevention of HF in the developed countries are approximately 1% - 2% of the total health care expenditure [7-9]. In the United States, total costs for HF care are more than $39 billion annually .
HF patients suffer from structural or functional heart disease that impairs the ability of the ventricle to fill with or eject blood [10,11]. The symptoms of HF are shortness of breath/orthopnea/ dyspnea, fatigue, weakness, pulmonary congestion, edema, nocturnal cough, and evidence of a decrease in myocardial performance at rest [12,13]. Some of the etiologies that may lead to HF, are myocardial ischemia, hypertension, cardiomyopathies, valvular heart disease, obesity, pulmonary hypertension, abnormal myocyte calcium cycling, excessive or inadequate proliferation of the extracellular matrix, excessive neuro-humoral stimulation, accelerated apoptosis and genetic mutations congenital heart disease [8,11,14].
Classification of HF can be based on the left ventricular Ejection Fraction (EF): HF with Reduced EF (HFrEF) and HF with Preserved EF (HFpEF). In HFrEF patients, the heart is not able to pump enough blood into the circulation due to ventricular systolic dysfunction. The EF in these patients is less than or equal to 40% . HFpEF is primarily caused by LV diastolic dysfunction (impaired relaxation during LV filling) due to the stiffening of the LV wall with EF>50% [8,16,17]. In addition to this classification schemes, HF can be classified based on ACCF/AHA stages of HF (Figure 1) .
Figure 1: ACCF/AHA Stages of HF.
The goal of HF treatment is to reduce the morbidity and mortality in these patients. For stage A and B, changing lifestyle (e.g. regular exercise and restriction of sodium intake), and using antihypertensive agent are recommended [8,10,15]. For stage B, C, and D, pharmacological therapy including diuretic- based antihypertensive therapy, spironolactone, ACE inhibitors, angiotensin receptor blockers, Beta blockers, aldosterone antagonists, hydralazine and isosorbide dinitrates, digoxin, and anticoagulation are recommended. Advanced HF stage might need surgical treatment methods including coronary revascularization, mitral valve repair, ventricular reconstruction, and heart transplantation [8,18].
Bio chemistryUniversity of Texas Medical Branch, USA
Department of Criminal JusticeLiberty University, USA
Department of PsychiatryUniversity of Kentucky, USA
Department of MedicineGally International Biomedical Research & Consulting LLC, USA
Department of Urbanisation and AgriculturalMontreal university, USA
Oral & Maxillofacial PathologyNew York University, USA
Gastroenterology and HepatologyUniversity of Alabama, UK
Department of MedicineUniversities of Bradford, UK
OncologyCirculogene Theranostics, England
Radiation ChemistryNational University of Mexico, USA
Analytical ChemistryWentworth Institute of Technology, USA
Minimally Invasive SurgeryMercer University school of Medicine, USA
Pediatric DentistryUniversity of Athens , Greece
The annual scholar awards from Lupine Publishers honor a selected number Read More...
We know the financial complexity of Individual read more...
The annual scholar awards from Lupine Publishers honor a selected number read more...