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Emerging Therapies in Heart Failure

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Heart Failure

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Traditionally, heart failure has been thought secondary to impaired left ventricular pump performance. According to this view, systolic dysfunction is secondary to contractile failure. Recently, a new view of heart failure has been developed where systolic dysfunction is thought secondary to a structural increase in ventricular chamber volume. Instead of contractile failure leading to chamber dilatation, chamber dilatation occurs as an early response that results in decreased wall motion that is mandated to generate a normal stroke volume from a larger end-diastolic volume. Remodeling is the term used to refer to the pathologic change in chamber length and shape, not related to a preload-mandated increase in sacromere length. As the heart remodels and dilates, the radius of curvature increases, increasing wall tension, leading to increased myocardial oxygen consumption, decreased subendocardial blood flow, impaired energetics, and increased arrhythmias. Overall, poor prognosis directly correlates with the degree of remodeling (1).

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Authors
  1. David Zeltsman MD
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  2. Michael A. Acker MD
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Editor information

Editors and Affiliations

  1. Heart Failure/Transplant Program, University of Pennsylvania Health System, Philadelphia, PA, USA

    Mariell L. Jessup MD, FACC, FAHA

  2. University of Pennsylvania Health System, Philadelphia, PA, USA

    Evan Loh MD, FACC, FAHA

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© 2003 Humana Press Inc., Totowa, NJ

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Zeltsman, D., Acker, M.A. (2003). Emerging Therapies in Heart Failure. In: Jessup, M.L., Loh, E. (eds) Heart Failure. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-347-7_16

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  • DOI: https://doi.org/10.1007/978-1-59259-347-7_16

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9759-5

  • Online ISBN: 978-1-59259-347-7

  • eBook Packages: Springer Book Archive

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