Congestive Heart Failure
Despite continuous improvements in prevention, diagnosis, and treatment of cardiovascular diseases, the prevalence of congestive heart failure (CHF) continues to increase worldwide. With an aging and more sedentary population, CHF is one of the most prevalent chronic diseases in industrialized societies and represents the most common reason for hospitalization in patients who are 65 years and older. In the United States alone, about 5 million Americans are currently affected with the number of patients expected to double by the year 2020 – thus becoming the most common form of heart disease.
The economic impact currently surpasses an estimated $29 billion per year and is expected to rise accordingly. Approximately 60 percent of the cost is taken up by hospitalization-related expenses. Since there is no known cure for CHF (except for a heart transplant), patients are managed with a variety of pharmacologic agents and modification of lifestyle. Ultimately, if patients reach the most advanced stage of heart disease, 50 percent of them die within a year.
CHF occurs when the heart’s output or pumping capacity is insufficient for the body’s needs. The cause for this deficiency may include several underlying diseases such as ischemia, hypertension, obesity and valvular disease. Irrespective of the underlying cause of CHF, in a large percentage of patients, the left ventricle begins to dilate and enlarge, the muscle wall becomes thinner and the chamber looses its proper shape in an effort to compensate pumping capacity. Once it is set in motion, this negative chain of events results in dilated cardiomyopathy (DCM) and cannot be reversed.
Clinical treatment primarily involves the use of various pharmaceuticals aimed at improving symptoms, reducing the workload of the heart and slowing down the progression of the disease. Stem cells are being used experimentally with marginal benefits to regenerate heart muscle. Lastly, a number of invasive devices and pump assist devices are being developed with mixed success aimed at slowing the disease progression.