Heart Failure. A Comprehensive Guide to Diagnosis and Treatment

Preface......Page 10
Contents......Page 12
Contributors......Page 16
GENETIC METHODS......Page 20
Genetic Linkage......Page 21
Clinical Diagnosis and Genetic Mapping......Page 22
Positional Cloning......Page 23
Modifiers of Simple Traits......Page 24
Diagnosis-History......Page 25
Diagnosis-Clinical Evaluation......Page 27
Prognosis......Page 28
Definitions and Clinical Features......Page 29
Etiology of DCM......Page 30
Molecular Genetics and Pathophysiology......Page 31
Definitions and Clinical Features......Page 33
Clinical Genetics......Page 34
Disease Models......Page 35
REFERENCES......Page 36
INTRODUCTION......Page 42
THE SIGNAL AT THE CELL MEMBRANE......Page 43
Humoral Factors......Page 44
Reprogramming of Gene Expression......Page 45
In-Depth Evaluation of Calcineurin-Nuclear Factor of Activated T-Cell Signaling......Page 46
Targeted Inhibition of Calcineurin Attenuates Hypertrophy......Page 48
Clinical Use of CsA and FK506......Page 49
Evaluation of mTOR......Page 50
The PI3-K Pathway......Page 51
Other Pathways Involved in Growth Regulation......Page 52
ALTERATIONS IN SIGNALING IN THE DISEASED HUMAN HEART......Page 54
REFERENCES......Page 56
MORPHOLOGIC FEATURES OF CELL DEATH......Page 64
CELL DEATH BY NECROSIS IN HEART FAILURE......Page 65
CELL DEATH BY APOPTOSIS IN THE FAILING MYOCARDIUM......Page 68
ROLE OF UBIQUITIN-PROTEOSOME PATHWAY IN MYOCYTE DEATH IN HEART FAILURE......Page 73
CROSS-TALK IN DEATH PATHWAYS......Page 74
REFERENCES......Page 76
EXCITATION-CONTRACTION COUPLING......Page 80
Electrical Activity in the Heart......Page 84
Regulation of Contractility in the Heart......Page 85
Calcium Handling in Failing Hearts......Page 86
Contractile Proteins......Page 89
Energetics......Page 90
REFERENCES......Page 91
B-ADRENERGIC RECEPTORS-MORE THAN REGULATORS OF CARDIAC CONTRACTILITY......Page 94
TARGETS OF B-ADRENERGIC RECEPTOR STIMULATION......Page 98
CHANGES OF  B-ADRENERGIC SIGNAL TRANSDUCTION IN HEART FAILURE......Page 102
B-BLOCKERS AS THERAPEUTIC PRINCIPLE IN HEART FAILURE......Page 103
MUTATIONS IN ADRENERGIC RECEPTOR GENES LEADING TO ALTERED SIGNALING PROPERTIES......Page 105
REFERENCES......Page 107
PATHOGENESIS OF VENTRICULAR REMODELING......Page 116
FUNCTIONAL CHANGES......Page 117
NEUROHORMONAL ACTIVATION......Page 118
EXTRACELLULAR MATRIX DEGRADATION......Page 120
MYOCYTE HYPERTROPHY AND APOPTOSIS......Page 121
REMODELING CHANGES ON THE MACROSCOPIC LEVEL......Page 122
SECONDARY VALVULAR DYSFUNCTION......Page 125
REFERENCES......Page 127
INTRODUCTION......Page 136
RENIN ANGIOTENSIN ALDOSTERONE SYSTEM......Page 137
SYMPATHETIC ACTIVATION......Page 139
CYTOKINE ACTIVATION......Page 140
REGULATION OF PLASMA VOLUME......Page 143
VASCULAR REACTIVITY......Page 144
CLINICAL HETEROGENEITY IN HEART FAILURE: IMPACT OF GENETIC DIVERSITY......Page 145
SUMMARY......Page 148
REFERENCES......Page 149
Morphology and Pathology......Page 156
Etiology......Page 157
Clinical Presentation......Page 160
Evaluation......Page 161
Epidemiology and Natural History......Page 162
Etiology......Page 163
Clinical Presentation......Page 164
Management......Page 165
Morphology and Pathology......Page 166
Epidemiology, Natural History, and Etiology......Page 167
Clinical Presentation......Page 168
REFERENCES......Page 170
PATHOPHYSIOLOGY OF DIASTOLIC HEART FAILURE......Page 176
Objective Evidence of Congestive Heart Failure......Page 179
Objective Evidence of Normal Left Ventricular Systolic Function......Page 180
Objective Evidence of Left Ventricular Diastolic Dysfunction......Page 181
Clinical Improvement by Treating Precipitating Factors......Page 183
PREVALENCE......Page 184
Hypertension......Page 186
Left Ventricular Hypertrophy......Page 187
Obesity......Page 188
Restrictive Cardiomyopathy......Page 189
Hypothyroidism......Page 190
PROGNOSIS OF DIASTOLIC HEART FAILURE......Page 191
REFERENCES......Page 192
Classification......Page 200
Incidence and Prevalence......Page 201
Economics......Page 202
Normal Integrated Function of the Heart......Page 203
Heart Failure......Page 204
Diastolic Heart Failure......Page 206
Symptoms and Signs......Page 208
Classification and Interpretation of the Clinical Presentation......Page 209
Diagnostic Laboratory Modalities......Page 211
Functional Limitation and Exercise Capacity......Page 213
Clinical Assessment of Functional and Exercise Capacity......Page 215
Sleep Apnea......Page 217
Cardiac Cachexia......Page 218
Psychiatric......Page 219
PROGNOSIS......Page 220
CONCLUSION......Page 221
REFERENCES......Page 222
PURPOSES OF PROGNOSTIC FACTORS/FEATURES......Page 234
MAJOR OUTCOMES PREDICTED......Page 236
CLASSIFYING PROGNOSTIC FACTORS AND FEATURES......Page 237
VENTRICULAR STRUCTURE AND FUNCTION......Page 238
Filling Pressures......Page 239
Cardiac Output......Page 241
Clinical Assessment......Page 242
Biochemical Markers......Page 244
Markers of Dysrhythmia Risk......Page 247
CLINICAL INTEGRATORS Clinical Class......Page 248
FUNCTIONAL ASSESSMENT......Page 249
RESPONSES AFTER THERAPY......Page 250
SELECTION FOR END-STAGE THERAPIES......Page 251
THE PROGNOSIS FOR CHANGE......Page 253
REFERENCES......Page 254
Diuretics......Page 258
Vasodilator Therapy......Page 262
Digitalis......Page 269
REFERENCES......Page 274
BENEFICIAL EFFECTS OF BETA ADRENERGIC BLOCKERS......Page 278
Ventricular Remodeling......Page 279
DRUG CLASSES OF BETA BLOCKERS: ARE THESE DRUGS INTERCHANGEABLE?......Page 281
Effects on Mortality......Page 282
BETA BLOCKER USE IN SPECIAL POPULATIONS......Page 287
CLINICAL CONSIDERATIONS IN SELECTION OF A SPECIFIC BETA BLOCKER......Page 290
Asymptomatic Left Ventricular Dysfunction......Page 291
CONCLUSION......Page 292
REFERENCES......Page 293
INTRODUCTION......Page 296
RATIONALE FOR THE USE OF ARBS IN HEART FAILURE......Page 297
Effects on Hematocrit......Page 299
The Question of Dose......Page 300
The Losartan Meta-Analysis......Page 301
CHARM-Alternative......Page 303
CHARM-Preserved......Page 311
I-PRESERVE......Page 312
LANDMARK TRIALS PRINCIPALLY DESIGNED TO COMPARE ARBS WITH PLACEBO IN THE PRESENCE OF AN ACE INHIBITOR......Page 313
Val-HeFT......Page 315
CHARM-Added......Page 317
VALIANT......Page 318
ELITE (Evaluation of Losartan in the Elderly Study)......Page 319
OPTIMAAL......Page 324
VALIANT......Page 325
To Reduce Hospitalization......Page 326
Adverse Effects......Page 327
Are the benefits and side effects of ARBs dose related?......Page 328
Are There Important Interactions Between ARBs and Other Classes of Drug Used in Heart Failure?......Page 329
REFERENCES......Page 330
INTRODUCTION......Page 338
THE EFFECT OF ALDOSTERONE RECEPTOR ANTAGONISTS ON SODIUM EXCRETION AND DIURESIS......Page 340
EFFECTS OF MR ANTAGONISTS ON VENTRICULAR REMODELING......Page 341
ALDOSTERONE AS AN INFLAMMATORY MEDIATOR......Page 343
PREVENTION OF SUDDEN CARDIAC DEATH......Page 344
EMERGING THEMES IN MR ANTAGONISM: IS IT THE LIGAND, THE RECEPTOR, OR BOTH?......Page 345
REFERENCES......Page 347
INTRODUCTION......Page 352
Specific Cytokine Antagonism......Page 353
Broad-Spectrum Immunotherapy......Page 355
ENDOTHELIN-1 AS A THERAPEUTIC TARGET......Page 361
Et-1 Antagonists In Chronic Congestive Heart Failure......Page 362
Et-1 Antagonism in Acute Heart Failure Exacerbations......Page 363
Nesiritide......Page 366
VASOPEPTIDASE INHIBITORS......Page 369
Omapatrilat......Page 370
Conivaptan......Page 373
Tolvaptan......Page 374
REFERENCES......Page 375
TERMINOLOGY......Page 382
PATHOPHYSIOLOGY......Page 383
DIAGNOSTIC CRITERIA......Page 384
MANAGEMENT......Page 386
Acute Diastolic Heart Failure......Page 387
Long-Term Management......Page 390
SUMMARY......Page 395
REFERENCES......Page 396
INTRODUCTION......Page 400
Increased Left Ventricular Filling Time......Page 401
Left Ventricular Reverse Remodeling......Page 402
PATH-CHF......Page 403
MUSTIC......Page 404
MIRACLE......Page 405
MIRACLE ICD......Page 406
CONTAK CD......Page 407
COMPANION......Page 408
LIMITATIONS OF CARDIAC RESYNCHRONIZATION THERAPY......Page 409
REFERENCES......Page 410
ANTIARRHYTHMIC DRUGS......Page 414
Amiodarone......Page 415
Dofetilide......Page 416
SUPRAVENTRICULAR TACHYCARDIAS......Page 417
Atrial Fibrillation......Page 418
Atrial Flutter......Page 419
VENTRICULAR ARRHYTHMIAS AND SUDDEN CARDIAC DEATH......Page 421
Monomorphic Ventricular Tachycardia......Page 422
Chronic Therapy for Sustained Monomorphic VT......Page 424
Torsades de Pointes......Page 425
PRIMARY PREVENTION OF SUDDEN DEATH IN HEART FAILURE......Page 426
Coronary Artery Disease with Depressed LV Function and Nonsustained VT......Page 427
Nonischemic Dilated Cardiomyopathy......Page 429
Heart Failure Severity and ICDs......Page 430
Bradycardia Pacing with ICDs......Page 431
Continuing Care......Page 432
Antiarrhythmic Drug Interactions with ICDs......Page 434
REFERENCES......Page 435
INTRODUCTION......Page 444
Women......Page 445
Elderly......Page 450
Ethnic Minorities......Page 453
Renal Disease......Page 460
Pulmonary Disease......Page 462
Thyroid Disease......Page 463
REFERENCES......Page 464
SYNOPSIS......Page 468
PRACTICE GUIDELINES AND QUALITY OF CARE......Page 469
Evaluation of Patients......Page 471
Therapy......Page 474
Patients Without Left Ventricular Dysfunction......Page 476
Exercise......Page 477
GUIDELINE IMPLEMENTATION......Page 479
MEASUREMENT OF QUALITY FOR THE PURPOSE OF IMPROVEMENT......Page 481
CONCLUSION......Page 482
REFERENCES......Page 483
INTRODUCTION......Page 486
CORONARY BYPASS SURGERY......Page 487
Mitral Regurgitation......Page 491
Aortic Insufficiency......Page 493
LEFT VENTRICULAR RECONSTRUCTION FOR ISCHEMIC CARDIOMYOPATHY......Page 495
ALTERNATIVE DEVICE THERAPIES......Page 498
Myocor Myosplint......Page 499
SUMMARY......Page 500
REFERENCES......Page 501
INTRODUCTION......Page 506
Patient Selection......Page 507
Mechanical Circulatory Support Systems......Page 508
Novacor Left Ventricular Assist System......Page 509
HeartMate Left Ventricular Assist System......Page 512
Thoratec Ventricular Assist System......Page 513
CardioWest Total Artificial Heart......Page 515
Complications with Mechanical Circulatory Support......Page 516
Clinical Results of MCS as Bridges to Transplant......Page 518
Long-Term MCS as a Transplant Alternative......Page 520
Historical Overview......Page 522
Cardiac Transplant Recipient......Page 523
Complications of Cardiac Transplantation......Page 532
Results of Cardiac Transplantation......Page 533
SUMMARY......Page 536
REFERENCES......Page 537
INTRODUCTION......Page 546
VECTORS FOR CARDIAC GENE DELIVERY......Page 547
Plasmid DNA......Page 548
Concerns and Limitations......Page 550
CALCIUM HANDLING IN HEART FAILURE......Page 551
GENE TRANSFER OF CALCIUM HANDLING PROTEINS......Page 552
-ADRENERGIC SIGNALING......Page 554
SURVIVAL SIGNALING......Page 556
REFERENCES......Page 557
TYPE OF CELLS TO BE CONSIDERED FOR INTRAMYOCARDIAL TRANSPLANTATION......Page 564
Fetal Cardiomyocytes......Page 565
Skeletal Myoblasts......Page 566
Bone Marrow-Derived Cells......Page 567
Catheter-Based Approach......Page 570
The Problem of Cell Death......Page 571
Skeletal myoblasts......Page 572
Bone Marrow-Derived Cells......Page 573
ADDENDUM......Page 574
REFERENCES......Page 575
Index......Page 580
Back cover......Page 602