Heart Failure
Authors: Barbara Turner
Journal: Annals of Internal Medicine (2010)

In the Clinic1 June 2010Heart FailureBarbara Turner, MD, MSED, Sankey Williams, MD, Darren Taichman, MD, PhD, and Lee R. Goldberg, MD, MPHBarbara Turner, MD, MSEDSearch for more papers by this author, Sankey Williams, MDSearch for more papers by this author, Darren Taichman, MD, PhDSearch for more papers by this author, and Lee R. Goldberg, MD, MPHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-11-201006010-01006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Approximately 5 million persons in the United States have heart failure, and according to the National Heart Lung and Blood Institute, the number is increasing. Heart failure is the most frequent cause of hospitalization in U.S. patients older than 65 years and leads to about 300 000 deaths per year (1). Heart failure is a major problem in the rest of the world as well, but few accurate data are available. The most common cause of heart failure in industrialized countries is ischemic cardiomyopathy, whereas other causes, such as infectious diseases, assume a larger role in underdeveloped countries. Despite recent ...References1. Writing group members. Heart disease and stroke statistics-2010 update: a report from the American Heart Association. Circulation. 2010;121:e46-e215. [PMID: 20019324] Google Scholar2. Loehr LR, Rosamond WD, Chang PP, et al. Heart failure incidence and survival (from the Atherosclerosis Risk in Communities study). Am J Cardiol. 2008;101:1016-22. [PMID: 18359324] Google Scholar3. Hunt SA, Abraham WT, Chin MH, et al. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119:e391-479. [PMID: 19324966] Google Scholar4. Centers for Disease Control and Prevention (CDC). Mortality from congestive heart failure-United States, 1980-1990. MMWR Morb Mortal Wkly Rep. 1994;43:77-81. [PMID: 8295629] Google Scholar5. He J, Ogden LG, Bazzano LA, et al. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med. 2001;161:996-1002. [PMID: 11295963] Google Scholar6. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-72. [PMID: 12748199] Google Scholar7. HOPE Investigators. Effects of ramipril on coronary events in high-risk persons: results of the Heart Outcomes Prevention Evaluation Study. Circulation. 2001;104:522-6. [PMID: 11479247] Google Scholar8. Thrainsdottir IS, Aspelund T, Thorgeirsson G, et al. The association between glucose abnormalities and heart failure in the population-based Reykjavik study. Diabetes Care. 2005;28:612-6. [PMID: 15735197] Google Scholar9. Walsh CR, Larson MG, Evans JC, et al. Alcohol consumption and risk for congestive heart failure in the Framingham Heart Study. Ann Intern Med. 2002;136:181-91. [PMID: 11827493] Google Scholar10. Sacks FM, Pfeffer MA, Moye LA, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators. N Engl J Med. 1996;335:1001-9. [PMID: 8801446] Google Scholar11. Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med. 2001;344:501-9. [PMID: 11172193] Google Scholar12. Fadel BM, Ellahham S, Ringel MD, et al. Hyperthyroid heart disease. Clin Cardiol. 2000;23:402-8. [PMID: 10875028] Google Scholar13. Coleman HN III, Taylor RR, Pool PE, et al. Congestive heart failure following chronic tachycardia. Am Heart J. 1971;81:790-8. [PMID: 5088355] Google Scholar14. Peters KG, Kienzle MG. Severe cardiomyopathy due to chronic rapidly conducted atrial fibrillation: complete recovery after restoration of sinus rhythm. Am J Med. 1988;85:242-4. [PMID: 3400701] Google Scholar15. Grogan M, Smith HC, Gersh BJ, et al. Left ventricular dysfunction due to atrial fibrillation in patients initially believed to have idiopathic dilated cardiomyopathy. Am J Cardiol. 1992;69:1570-3. [PMID: 1598871] Google Scholar16. Levy D, Larson MG, Vasan RS, et al. The progression from hypertension to congestive heart failure. JAMA. 1996;275:1557-62. [PMID: 8622246] Google Scholar17. Dargie HJ. Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial. Lancet. 2001;357:1385-90. [PMID: 11356434] Google Scholar18. Bradley TD, Floras JS. Obstructive sleep apnoea and its cardiovascular consequences. Lancet. 2009 Jan 3;373(9657):82-93. Epub 2008 Dec 26. [PMID: 19101028] Google Scholar19. Shahar E, Whitney CW, Redline S, et al. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med. 2001;163:19-25. [PMID: 11208620] Google Scholar20. Tkacova R, Rankin F, Fitzgerald FS, et al. Effects of continuous positive airway pressure on obstructive sleep apnea and left ventricular afterload in patients with heart failure. Circulation. 1998;98:2269-75. [PMID: 9826313] Google Scholar21. Lung Health Study Research Group. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005;142:233-9. [PMID: 15710956] Google Scholar22. Goldberg LR, Jessup M. Stage B heart failure: management of asymptomatic left ventricular systolic dysfunction. Circulation 2006 Jun 20;113(24):2851-60. [PMID 16785351] Google Scholar23. Owan TE, Hodge DO, Herges RM, et al. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355(3):251-9. [PMID: 16855265] Google Scholar24. Bhatia RS, Tu JV, Lee DS, et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006;355(3):260-9. [PMID: 16855266] Google Scholar25. Morrison LK, Harrison A, Krishnaswamy P, et al. Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea. J Am Coll Cardiol. 2002;39:202-9. [PMID: 11788208] Google Scholar26. Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347:161-7. [PMID: 12124404] Google Scholar27. Wang TJ, Larson MG, Levy D, et al. Impact of obesity on plasma natriuretic peptide levels. Circulation. 2004;109:594-600. [PMID: 14769680] Google Scholar28. Dao Q, Krishnaswamy P, Kazanegra R, et al. Utility of B-type natriuretic peptide in the diagnosis of congestive heart failure in an urgent-care setting. J Am Coll Cardiol. 2001;37:379-85. [PMID: 11216950] Google Scholar29. de Lemos JA, McGuire DK, Drazner MH. B-type natriuretic peptide in cardiovascular disease. Lancet. 2003;362:316 -22. [PMID: 12892964] Google Scholar30. Myers J, Madhavan R. Exercise testing with gas exchange analysis. Cardiol Clin. 2001;19:433-45. [PMID: 11570115] Google Scholar31. The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987;316:1429-35. [PMID: 2883575] Google Scholar32. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325:293-302. [PMID: 2057034] Google Scholar33. The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327:685-91. [PMID: 1463530] Google Scholar34. Pitt B, Segal R, Martinez FA, et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE). Lancet. 1997;349:747-52. [PMID: 9074572] Google Scholar35. Pitt B, Poole-Wilson PA, Segal R, et al. Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial-the Losartan Heart Failure Survival Study ELITE II. Lancet. 2000;355:1582-7. [PMID: 10821361] Google Scholar36. Cohn JN, Tognoni G. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med. 2001;345:1667-75. [PMID: 11759645] Google Scholar37. Maggioni AP, Anand I, Gottlieb SO, et al.; Val-HeFT Investigators (Valsartan Heart Failure Trial). Effects of valsartan on morbidity and mortality in patients with heart failure not receiving angiotensin-converting enzyme inhibitors. J Am Coll Cardiol. 2002;40:1414-21. [PMID: 12392830] Google Scholar38. Granger CB, McMurray JJ, Yusuf S, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. Lancet. 2003;362:772-6. [PMID: 13678870] Google Scholar39. Loeb HS, Johnson G, Henrick A, et al. Effect of enalapril, hydralazine plus isosorbide dinitrate, and prazosin on hospitalization in patients with chronic congestive heart failure. The V-HeFT VA Cooperative Studies Group. Circulation. 1993;87:VI78-87. [PMID: 8500244] Google Scholar40. Johnson G, Carson P, Francis GS, et al. Influence of prerandomization (baseline) variables on mortality and on the reduction of mortality by enalapril. Veterans Affairs Cooperative Study on Vasodilator Therapy of Heart Failure (V-HeFT II). V-HeFT VA Cooperative Studies Group. Circulation. 1993;87:VI32-9. [PMID: 8500237] Google Scholar41. African-American Heart Failure Trial Investigators. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N Engl J Med. 2004;351:2049-57. [PMID: 15533851] Google Scholar42. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. N Engl J Med. 1996;334:1349-55. [PMID: 8614419] Google Scholar43. CIBIS Investigators and Committees. A randomized trial of beta-blockade in heart failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). Circulation. 1994;90:1765-73. [PMID: 7923660] Google Scholar44. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet. 1999;353:9-13. [PMID: 10023943] Google Scholar45. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999;353:2001-7. [PMID: 10376614] Google Scholar46. Packer M, Coats AJ, Fowler MB, et al. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med. 2001;344:1651-8. [PMID: 11386263] Google Scholar47. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999;341:709-17. [PMID: 10471456] Google Scholar48. Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study Investigators. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348:1309-21. [PMID: 12668699] Google Scholar49. Juurlink DN, Mamdani MM, Lee DS, et al. Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med. 2004;351(6):543-51. [PMID: 15295047] Google Scholar50. Murray MD, Deer MM, Ferguson JA, et al. Open-label randomized trial of torsemide compared with furosemide therapy for patients with heart failure. Am J Med. 2001;111:513-20. [PMID: 11705426] Google Scholar51. The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 1997;336:525-33. [PMID: 9036306] Google Scholar52. Khand AU, Rankin AC, Kaye GC, Cleland JG. Systematic review of the management of atrial fibrillation in patients with heart failure. Eur Heart J. 2000;21:614-32. [PMID: 10731399] Google Scholar53. Adams KF Jr, Gheorghiade M, Uretsky BF, et al. Clinical benefits of low serum digoxin concentrations in heart failure. J Am Coll Cardiol. 2002;39:946-53. [PMID: 11897434] Google Scholar54. Rathore SS, Wang Y, Krumholz HM. Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med. 2002;347:1403-11. [PMID: 12409542] Google Scholar55. How to diagnose diastolic heart failure. European Study Group on Diastolic Heart Failure. Eur Heart J. 1998;19:990-1003. [PMID: 9717033] Google Scholar56. Dunkman WB, Johnson GR, Carson PE, et al. Incidence of thromboembolic events in congestive heart failure. The V-HeFT VA Cooperative Studies Group. Circulation. 1993;87:VI94-101. [PMID: 8500246] Google Scholar57. Al-Khadra AS, Salem DN, Rand WM, et al. Warfarin anticoagulation and survival: a cohort analysis from the Studies of Left Ventricular Dysfunction. J Am Coll Cardiol. 1998;31:749-53. [PMID: 9525542] Google Scholar58. Sullivan MJ, Cobb FR. The anaerobic threshold in chronic heart failure. Relation to blood lactate, ventilatory basis, reproducibility, and response to exercise training. Circulation. 1990;81:II47-58. [PMID: 2295152] Google Scholar59. Myers J, Gianrossi R, Schwitter J, et al. Effect of exercise training on postexercise oxygen uptake kinetics in patients with reduced ventricular function. Chest. 2001;120:1206-11. [PMID: 11591562] Google Scholar60. Sullivan MJ, Cobb FR. Central hemodynamic response to exercise in patients with chronic heart failure. Chest. 1992;101:340S-346S. [PMID: 1576862] Google Scholar61. OÕConnor CM, Whellan DJ, Lee KL, et al. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA 2009; 301:1439-1450. [PMID: 19351941] Google Scholar62. Moss AJ, Zareba W, Hall WJ, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877-83. [PMID: 11907286] Google Scholar63. Bardy GH, Lee KL, Mark DB, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352:225-37. [PMID: 15659722] Google Scholar64. Kadish A, Dyer A, Daubert JP, et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med. 2004;350:2151-8. [PMID: 15152060] Google Scholar65. Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. Multicenter InSync ICD Randomized Clinical Evaluation (MIRACLE ICD) Trial Investigators. JAMA. 2003;289:2685-94. [PMID: 12771115] Google Scholar66. Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539-49. [PMID: 15753115] Google Scholar67. Moss AJ, Hall WJ, Cannom DS, et al. Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med 2009;361:1329-1338. [PMID: 19723701] Google Scholar68. American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary. Circulation. 2001;104:2996-3007. [PMID: 11739319] Google Scholar69. American College of Cardiology. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112:e154-235. [PMID: 16160202] Google Scholar70. Heart Failure Society of America. HFSA 2006 Comprehensive Heart Failure Practice Guideline. J Card Fail. 2006;12:e1-2. [PMID: 16500560] Google Scholar71. Pharmacy Benefits Management Strategic Healthcare Group and the Medical Advisory Panel; Department of Veterans Affairs, Veterans Health Administration. The Pharmacologic Management of Chronic Heart Failure. Accessed at www.oqp.med.va.gov/cpg/CHF/CHF_Base.htm on 11 October 2007. Google Scholar Author, Article, and Disclosure InformationAuthors: Barbara Turner, MD, MSED; Sankey Williams, MD; Darren Taichman, MD, PhD; Lee R. Goldberg, MD, MPH Previousarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA Review of the Molecular Mechanisms Underlying the Development and Progression of Cardiac RemodelingComprehensive Geriatric Assessment 1 June 2010Volume 152, Issue 11 Page: ITC6-1 Keywords ACE inhibitors Diuretics Ejection fraction Exercise Heart failure Hospitalizations Hypertension Medical risk factors ePublished: 1 June 2010 Issue Published: 1 June 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...