Skip to main content

Therapies in Heart Failure, Tomorrow May Be Too Late

  • Chapter
  • First Online:
Heart Failure Management: The Neural Pathways

Abstract

Heart failure (HF) is a well-recognized, worldwide major and growing health problem. It is known to be the most common and the most socially and economically expensive end product of several clinical conditions that are prevalent in Western societies. Among the many disorders leading to HF are hypertension, chronic kidney disease, diabetes, and, paradoxically, those cardiac diseases that have benefitted most from recent treatments that have lowered mortality in patients with valve diseases, congenital heart diseases, and acute myocardial infarction. Moreover, the incidence of heart failure is intimately related to progressively increasing life expectancy [1] that is the most relevant achievement of the unprecedented quality-of-life improvement enjoyed by Western communities since the end of World War II.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Stewart S, MacIntyre K, Capewell S, McMurray JJ. Heart failure and the aging population: an increasing burden in the 21st century? Heart. 2003;89:49–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Brown Physician Exec. Halfway technologies. 1996;22:44–5.

    Google Scholar 

  3. Fürstenwerth H. Why whip the starving horse when there is oats for the starving myocardium? Am J Ther. 2014 [Epub ahead of print].

    Google Scholar 

  4. Mann DL, Bristow MR. Mechanisms and models in heart failure: the biomechanical Model and Beyond. Circulation. 2005;111:2837–49.

    Article  PubMed  Google Scholar 

  5. Buber J, Klein H, Moss AJ, McNitt S, Eldar M, Padeletti L, Vogt J, Meine M, Brown MW, Barsheshet A, Zareba W, Goldenberg I. Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT. Eur Heart J. 2011;32:2697–704.

    Article  PubMed  Google Scholar 

  6. Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, Francis GS, Simon AB, Rector T. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med. 1984;311(13):819–23.

    Article  CAS  PubMed  Google Scholar 

  7. Lowes BD, Gilbert EM, Abraham WT, Minobe WA, Larrabee P, Ferguson D, Wolfel EE, Lindenfeld J, Tsvetkova T, Robertson AD, Quaife RA, Bristow MR. Myocardial gene expression in dilated cardiomyopathy treated with beta-blocking agents. N Engl J Med. 2002;346:1357–65.

    Article  CAS  PubMed  Google Scholar 

  8. Bristow MR, Feldman AM, Adams Jr KF, Goldstein SJ. Selective versus nonselective beta-blockade for heart failure therapy: are there lessons to be learned from the COMET trial? J Card Fail. 2003;9:444–53.

    Article  CAS  PubMed  Google Scholar 

  9. Floras JS. Sympathetic nervous system activation in human heart failure: clinical implications of an updated model. J Am Coll Cardiol. 2009;54:375–85.

    Article  CAS  PubMed  Google Scholar 

  10. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999;353:2001–7.

    Google Scholar 

  11. The Cardiac Insufficiency Bisoprolol Study II (CIBIS II): a randomised trial. Lancet. 1999;353(9164):9–13.

    Google Scholar 

  12. Packer M, Coats AJ, Fowler MB, Katus HA, Krum H, Mohacsi P, Rouleau JL, Tendera M, Castaigne A, Roecker EB, Schultz MK, DeMets DL, Carvedilol Prospective Randomized Cumulative Survival Study Group. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med. 2001;344:1651–8.

    Article  CAS  PubMed  Google Scholar 

  13. Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, Tavazzi L. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539–49.

    Article  CAS  PubMed  Google Scholar 

  14. Goldenberg I, Moss AJ, Hall WJ, McNitt S, Zareba W, Andrews ML, Cannom DS. Multicenter Automatic Defibrillator Implantation Trial (MADIT) II Investigators. Causes and consequences of heart failure after prophylactic implantation of a defibrillator in the multicenter automatic defibrillator implantation trial II. Circulation. 2006;113:2810–7.

    Article  PubMed  Google Scholar 

  15. O’Connor CM, Stough WG, Gallup DS, Hasselblad V, Gheorghiade M. Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: observations from the IMPACT-HF registry. J Card Fail. 2005;11:200–5.

    Article  PubMed  Google Scholar 

  16. Costanzo MR, Guglin ME, Saltzberg MT, Jessup ML, Bart BA, Teerlink JR, Jaski BE, Fang JC, Feller ED, Haas GJ, Anderson AS, Schollmeyer MP, Sobotka PA, UNLOAD Trial Investigators. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am Coll Cardiol. 2007;49:675–83.

    Article  CAS  PubMed  Google Scholar 

  17. Schrier RW. Blood urea nitrogen and serum creatinine: not married in heart failure. Circ Heart Fail. 2008;1:2–5.

    Article  CAS  PubMed  Google Scholar 

  18. Butler J, Forman DE, Abraham WT, Gottlieb SS, Loh E, Massie BM, O’Connor CM, Rich MW, Stevenson LW, Wang Y, Young JB, Krumholz HM. Relationship between heart failure treatment and development of worsening renal function among hospitalized patients. Am Heart J. 2004;147:331–8.

    Article  PubMed  Google Scholar 

  19. Petersson M, Friberg P, Eisenhofer G, Lambert G, Rundqvist B. Long-term outcome in relation to renal sympathetic activity in patients with chronic heart failure. Eur Heart J. 2005;26:906–13.

    Article  PubMed  Google Scholar 

  20. Ljungam S, Kjekshus J, Swedberg K. Renal function in severe congestive heart failure during treatment with enalapril (the Cooperative North Scandinavian Enalapril Survival Study [CONSENSUS] Trial). Am J Cardiol. 1992;70:479.

    Article  Google Scholar 

  21. Heywood JT, Fonarow GC, Costanzo MR, Mathur VS, Wigneswaran JR, Wynne J. High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database. J Card Fail. 2007;13:422–30.

    Article  PubMed  Google Scholar 

  22. Hillege HL, Girbes AR, de Kam PJ, Boomsma F, de Zeeuw D, Charlesworth A, Hampton JR, van Veldhuisen DJ. Renal function, neurohormonal activation, and survival in patients with chronic heart failure. Circulation. 2000;102:203–10.

    Article  CAS  PubMed  Google Scholar 

  23. Shlipak MG, Massie BM. The clinical challenge of cardiorenal syndrome. Circulation. 2004;110:1514–7.

    Article  PubMed  Google Scholar 

  24. Stella A, Zanchetti A. Functional role of renal afferents. Physiol Rev. 1991;71:659–82.

    CAS  PubMed  Google Scholar 

  25. Schlaich MP, Socratous F, Hennebry S, Eikelis N, Lambert EA, Straznicky N, Esler MD, Lambert GW. Sympathetic activation in chronic renal failure. J Am Soc Nephrol. 2009;20:933–9.

    Article  PubMed  Google Scholar 

  26. Schrier RW. Use of diuretics in heart failure and cirrhosis. Semin Nephrol. 2011;31:503–12.

    Article  CAS  PubMed  Google Scholar 

  27. Gottlieb SS, Brater DC, Thomas I, Havranek E, Bourge R, Goldman S, Dyer F, Gomez M, Bennett D, Ticho B, Beckman E, Abraham WT. BG9719 (CVT-124), an A1 adenosine receptor antagonist, protects against the decline in renal function observed with diuretic therapy. Circulation. 2002;105:1348–53.

    Article  CAS  PubMed  Google Scholar 

  28. Bayliss J, Norell M, Canepa-Anson R, Sutton G, Poole-Wilson P. Untreated heart failure: clinical and neuroendocrine effects of introducing diuretics. Br Heart J. 1987;57:17–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Felker GM, O’Connor CM, Braunwald E. Loop diuretics in acute decompensated heart failure. Necessary? Evil? A necessary evil? Circ Heart Fail. 2009;2:56–62.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Januzzi LJ, Troughton R, Are Serial BNP. Measurements useful in heart failure management? Serial natriuretic peptide measurements are useful in heart failure management. Circulation. 2013;127:500–8.

    Article  PubMed  Google Scholar 

  31. Januzzi Jr JL, Rehman SU, Mohammed AA, Bhardwaj A, Barajas L, Barajas J, Kim HN, Baggish AL, Weiner RB, Chen-Tournoux A, Marshall JE, Moore SA, Carlson WD, Lewis GD, Shin J, Sullivan D, Parks K, Wang TJ, Gregory SA, Uthamalingam S, Semigran MJ. Use of amino-terminal pro-B type natriuretic peptide to guide outpatient therapy of patients with chronic left ventricular systolic dysfunction. J Am Coll Cardiol. 2011;58:1881–9.

    Article  CAS  PubMed  Google Scholar 

  32. Neyt M, Van den Bruel A, Smit Y, De Jonge N, Vlayen J. The cost-utility of left ventricular assist devices for end-stage heart failure patients ineligible for cardiac transplantation: a systematic review and critical appraisal of economic evaluations. Ann Cardiothorac Surg. 2014;3:439–49.

    PubMed  PubMed Central  Google Scholar 

  33. Levy MN, Martin PJ, Stuesse SL. Neural regulation of the heart beat. Annu Rev Physiol. 1981;43:443–53.

    Article  CAS  PubMed  Google Scholar 

  34. Ledwidge M, Gallagher J, Conlon C, Tallon E, O’Connell E, Dawkins I, Watson C, O'Hanlon R, Bermingham M, Patle A, Badabhagni MR, Murtagh G, Voon V, Tilson L, Barry M, McDonald L, Maurer B, McDonald K. Natriuretic peptide-based screening and collaborative care for heart failure: the STOP-HF randomized trial. JAMA. 2013;310:66–74.

    Article  CAS  PubMed  Google Scholar 

  35. Adler ED, Goldfinger JZ, Kalman J, Park ME, Meier DE. Palliative care in the treatment of advanced heart failure. Circulation. 2009;120:2597–606.

    Article  PubMed  Google Scholar 

  36. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetière P. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med. 2005;352:1951–8.

    Article  CAS  PubMed  Google Scholar 

  37. Lown B, Verrier RL. Neural activity and ventricular fibrillation. N Engl J Med. 1976;294:1165–70.

    Article  CAS  PubMed  Google Scholar 

  38. Schwartz PJ, La Rovere MT, Vanoli E. Autonomic nervous system and sudden cardiac death: experimental basis and clinical observations for post-myocardial infarction risk stratification. Circulation. 1992;85(Suppl):I-77–91.

    CAS  Google Scholar 

  39. Schwartz PJ. The autonomic nervous system and sudden death. Eur Heart J. 1998;19(Suppl F):F72–80.

    PubMed  Google Scholar 

  40. La Rovere MT, Bigger Jr JT, Marcus FI, Mortara A, Schwartz PJ. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet. 1998;351(9101):478–84.

    Article  PubMed  Google Scholar 

  41. Mortara A, La Rovere MT, Pinna GD, Prpa A, Maestri R, Febo O, Pozzoli M, Opasich C, Tavazzi L. Arterial baroreflex modulation of heart rate in chronic heart failure: clinical and hemodynamic correlates and prognostic implications. Circulation. 1997;96:3450–8.

    Article  CAS  PubMed  Google Scholar 

  42. La Rovere MT, Pinna GD, Maestri R, Robbi E, Caporotondi A, Guazzotti G, Sleight P, Febo O. Prognostic implications of baroreflex sensitivity in heart failure patients in the beta-blocking era. J Am Coll Cardiol. 2009;53:193–9.

    Article  PubMed  Google Scholar 

  43. Gademan MG, van Bommel RJ, Ypenburg C, Haest JC, Schalij MJ, van der Wall EE, Bax JJ, Swenne CA. Biventricular pacing in chronic heart failure acutely facilitates the arterial baroreflex. Am J Physiol Heart Circ Physiol. 2008;295:H755–60.

    Article  CAS  PubMed  Google Scholar 

  44. Ellenbogen KA, Mohanty PK, Szentpetery S, Thames MD. Arterial baroreflex abnormalities in heart failure. Reversal after orthotopic cardiac transplantation. Circulation. 1989;79:51–8.

    Article  CAS  PubMed  Google Scholar 

  45. De Ferrari GM, Crijns HJ, Borggrefe M, Milasinovic G, Smid J, Zabel M, Gavazzi A, Sanzo A, Dennert R, Kuschyk J, Raspopovic S, Klein H, Swedberg K, Schwartz PJ, CardioFit Multicenter Trial Investigators. Chronic vagus nerve stimulation: a new and promising therapeutic approach for chronic heart failure. Eur Heart J. 2011;32:847–55.

    Article  PubMed  Google Scholar 

  46. Zannad F, De Ferrari GM, Tuinenburg AE, Wright D, Brugada J, Butter C, Klein H, Stolen C, Meyer S, Stein KM, Ramuzat A, Schubert B, Daum D, Neuzil P, Botman C, Caste MA, D’Onofrio A, Solomon SD, Wold N, Ruble SB. Chronic vagal stimulation for the treatment of low ejection fraction heart failure: results of the neural cardiac therapy for heart failure (NECTAR-HF) randomized controlled trial. Eur Heart J. 2015;36:425–33.

    Article  PubMed  Google Scholar 

  47. Premchand RK, Sharma K, Mittal S, Monteiro R, Dixit S, Libbus I, DiCarlo LA, Ardell JL, Rector TS, Amurthur B, KenKnight BH, Anand IS. Autonomic regulation therapy via left or right cervical vagus nerve stimulation in patients with chronic heart failure: results of the ANTHEM-HF trial. J Card Fail. 2014;20:808–16.

    Article  PubMed  Google Scholar 

  48. Camm AJ, Savelieva I. Vagal nerve stimulation in heart failure. Eur Heart J. 2015;36:404–6.

    Article  PubMed  Google Scholar 

  49. Bisognano JD, Bakris G, Nadim MK, Sanchez L, Kroon AA, Schafer J, de Leeuw PW, Sica DA. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from the double-blind, randomized, placebo-controlled rheos pivotal trial. J Am Coll Cardiol. 2011;58:765–73.

    Article  PubMed  Google Scholar 

  50. Bisognano JD, Kaufman CL, Bach DS, Lovett EG, de Leeuw P, DEBuT HT, Rheos Feasibility Trial Investigators. Improved cardiac structure and function with chronic treatment using an implantable device in resistant hypertension: results from European and United States trials of the Rheos system. J Am Coll Cardiol. 2011;57:1787–8.

    Article  PubMed  Google Scholar 

  51. Gronda E, Seravalle G, Quarti-Trevano F, Costantino G, Casini A, Alsheraei A, Lovett EG, Vanoli E, Mancia G, Grassi G. Long-term chronic baroreflex activation: Persistent efficacy in patients with heart failure and reduced ejection fraction. J Hyperten. 2015 (accepted).

    Google Scholar 

  52. Abraham WT, Zile MR, Weaver FA, Butter C, Ducharme A, Halbach M, Klug D, Lovett EG, Müller-Ehmsen J, Schafer JE, Senni M, Swarup V, Wachter R, Little WC. Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction. JACC Heart Fail. 2015;3(6):487–96.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Edoardo Gronda MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Gronda, E., Abraham, W.T. (2016). Therapies in Heart Failure, Tomorrow May Be Too Late. In: Gronda, E., Vanoli, E., Costea, A. (eds) Heart Failure Management: The Neural Pathways. Springer, Cham. https://doi.org/10.1007/978-3-319-24993-3_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-24993-3_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24991-9

  • Online ISBN: 978-3-319-24993-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics