Advances in Treatment for Heart Failure
Known as a silent killer, heart failure is a complex disease with nonspecific symptoms like fatigue and leg swelling, and more obvious ones like chest pain. A condition in which the heart muscle fails to pump enough blood through the body, heart failure is most common in people over 60, but the spectrum of patients diagnosed with this condition range from teenagers to patients in their ‘90s. Treatments could range from simply taking medication to having a heart transplant. Thankfully, the medical field has made significant advances in the treatment of heart failure, with new drug therapies and surgical devices offering patients better outcomes than ever before.
Moving Forward With Drug Therapies
There are a variety of drugs used to treat heart failure, but three classes of drugs comprise the cornerstone of treatment for this chronic condition. While these medications cannot “cure” heart failure, they are very effective in reducing symptoms and even in some cases reversing the disease’s development, allowing the heart to recover near normal functioning. Beta-blockers control symptoms of heart failure by reducing the effects of certain hormones, the body’s natural response to heart failure. Angiotensin II receptor-blockers (ARBs) help widen blood vessels and lower blood pressure, making it easier for blood to flow and thus relieving stress on the heart. Similarly, angiotensin-converting-enzyme (ACE) inhibitors work to treat hypertension and relax blood vessels. Diuretics, or “water pills,” comprise a third class of drugs. These medications help reduce swelling, a common symptom of heart failure, by causing the body to rid itself of excess fluid and sodium through urination.
Used correctly and in combination with lifestyle changes like eating right and exercise, these drugs can help keep patients out of the hospital and living fully. And as medical knowledge continues to increase, physicians have identified the most effective drugs in these classes. For example, in the U.S., the drugs Coreg and Topol XL are beta-blockers most commonly prescribed to treat heart failure, and both are proven to be very successful.
Relatively new drug combinations developed to treat heart failure are the Angiotensin-Receptor Neprilysin Inhibitors (ARNIs). ARNIs combine an ARB (Valsartan) to prevent blood vessels from narrowing with a blood pressure medicine called sacubitril (Entresto) that works by increasing the proteins in the body that widen blood vessels. This medication is one of the more recent developments in drug therapy for heart failure.
New Technology in Surgical Treatments
If a patient’s disease has progressed beyond medication, there are several new medical devices and procedures that can reverse the disease’s progression. One such device is the left ventricular assist device (LVAD). The LVAD is an implantable mechanical pump inserted inside a patient’s chest to help the heart pump blood. The pump is attached to the left ventricle with a tube routing blood to the aorta -- relieving the heart’s workload. A cable extends from the pump and out through the patient’s skin to the device’s external components that power the pump. Traditionally, the LVAD was known as the “bridge to transplant” because patients used this device as an interim treatment while they waited up to several years for a heart transplant to become available. As technology advances and more effective devices are being developed every year, the LVAD is now used as a permanent treatment solution in some cases.
Transcatheter aortic valve replacement (TAVR) is another surgical procedure recently developed to treat aortic stenosis, a narrowing of the aortic valve in the heart. Less invasive than open heart surgery, this procedure was developed for patients that don’t qualify for a more intensive open heart surgery. Aortic stenosis doesn’t always go hand in hand with heart failure, but when it does this can be a viable treatment option for certain patients. If you have heart failure and qualify for a TAVR procedure, talk with your provider about the procedure.
THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.
Jyoti Sharma, MD, is a cardiologist at the
Piedmont Heart Institute in Atlanta, Georgia. She is the co-director of The Women’s Heart
Program, an initiative designed to help women address their risk for heart
disease. View her Healthgrades profile >
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