Heart Failure

  • Paul J. Mather
  • Gilbert E. D’Alonzo


After studying this chapter, you should be able to: Define congestive heart failure (CHF). Classify the epidemiology of CHF. Understand the morbidity and mortality statistics of CHF. Recognize the signs and symptoms of CHF. Know the major treatment algorithms of CHF. Understand the pharmacology and pathophysiology behind the treatment regimens. Understand the limitations of the treatment regimens.


Heart Failure Cardiac Output Congestive Heart Failure Right Ventricular Diastolic Dysfunction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Rosamond W, Flegal K, Friday G, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:e69-e171.PubMedCrossRefGoogle Scholar
  2. 2.
    Jain P, Massie BM, Gattis WA, Klein L, Gheorghiade M. Current medical treatment for the exacerbation of chronic heart failure resulting in hospitalization. Am Heart J. 2003;145:S3-S17.PubMedCrossRefGoogle Scholar
  3. 3.
    The ADHERE Scientific Advisory Committee and Investigators; Adams KF Jr, Fonarow GC, Emerman CL, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the acute decompensated heart failure national registry (ADHERE). Am Heart J. 2005;149(2):209-216.Google Scholar
  4. 4.
    O’Connor CM, Gattis WA, Uretsky BF, et al. Continuous intravenous dobutamine is associated with an increased risk of death in patients with advanced heart failure: insights from the Flora International Randomized Survival Trial (FIRST). Am Heart J. 1999;138:78-86.PubMedCrossRefGoogle Scholar
  5. 5.
    Cuffe MS, Califf RM, Adams KF Jr, et al. Outcomes of a prospective trial of intravenous milrinone for exacerbations of chronic heart failure (OPTIME-CHF) Investigators. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002;287:1541-1547.PubMedCrossRefGoogle Scholar
  6. 6.
    Swedberg K, Idanpann-Heikkila U, et al. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987;316(23):1429-1435.CrossRefGoogle Scholar
  7. 7.
    SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Eng J Med. 1991;325(5):293-302.Google Scholar
  8. 8.
    Packer M, Gheorghiade M, Young JB, et al. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme inhibitors: RADIANCE Study. N Eng J Med. 1993;329:1-7.CrossRefGoogle Scholar
  9. 9.
    Cooper HA, Dries DL, Davis CE, Shen YL, Domanksi MJ. Diuretics and risk arrhythmic death in patients with left ventricular dysfunction. Circulation. 1999;100:1311-1315.PubMedCrossRefGoogle Scholar
  10. 10.
    Young JB, Gheorghiade M, Uretsky BF, et al. Superiority of “triple” drug therapy in heart failure: insights from the PROVED and RADIANCE trials – prospective randomized study of ventricular function and efficacy of digoxin, randomized assessment of digoxin and inhibitors of angiotensin-converting enzyme. J Am Coll Cardiol. 1998;32(3):686-692.PubMedCrossRefGoogle Scholar
  11. 11.
    Granger CB, McMurray JJ, Yusuf S, et al. Effects of candesartan in patients with chronic heart failure and reduced left ventricular systolic function intolerant to angiotensin-converting enzyme inhibitors: the CHARM-alternative trial. Lancet. 2003;362:767-771.PubMedCrossRefGoogle Scholar
  12. 12.
    The African-American Heart Failure Trial investigators; Taylor AL, Ziesche S, Yancy C, et al. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N Engl J Med. 2004;351:2049-2057.Google Scholar
  13. 13.
    Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure: U.S. Carvedilol Heart Failure Study Group. N Engl J Med. 1996;334:1349-1355.PubMedCrossRefGoogle Scholar
  14. 14.
    MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF) Lancet. 1999 June 12; 353 (9169): 2001-2007.Google Scholar
  15. 15.
    Tousoulis D, Charakida M, Stefanadi E, et al. Statins in heart failure. Beyond the lipid lowering effect. Int J Cardiol. 2007;115:144-150.PubMedCrossRefGoogle Scholar
  16. 16.
    EPOCH Study Group. Effects of pimobendan on adverse cardiac events and physical activities in patients with mild to moderate chronic heart failure. Circ J. 2002;66:149-157.CrossRefGoogle Scholar
  17. 17.
    Gheoreghiade M, Teerlink JR, Mebazaa A. Pharmacology of new agents for acute heart failure syndromes. Am J Cardiol. 2005;96:68-73.CrossRefGoogle Scholar
  18. 18.
    Shin DD, Brandimarte F, De Luca L, et al. Review of current and investigational pharmacologic agents for acute heart failure syndromes. Am J Cardiol. 2007;99:4A-23A.PubMedCrossRefGoogle Scholar
  19. 19.
    Konstam MA, Gheorghiade M. Effects of oral tolvaptan in patients hospitalized for worsening heart failure: The EVEREST outcome trial. JAMA. 2007;297:1319-1331.PubMedCrossRefGoogle Scholar
  20. 20.
    Costanzo MR. Ultrafiltration versus IV diuretics for patients hospitalized for acute decompensated congestive heart failure: a prospective randomized clinical trial: UNLOAD. Presented at the American College of Cardiology Annual Scientific Session. Atlanta, GA; 2006: 11-14, March.Google Scholar
  21. 21.
    Konstam MA, Czerska B, Bohm M, et al. Continuous aortic flow augmentation: hemodynamic and renal responses to a novel percutaneous intervention in patients with decompensated heart failure. Circulation. 2005;112:3107-3114.PubMedCrossRefGoogle Scholar
  22. 22.
    Desvigne-Nickens OH, Miller LW, Gupta Rose EA, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345:1435-1443.PubMedCrossRefGoogle Scholar
  23. 23.
    Mather P, Konstam M. The use of percutaneous mechanical devices in the treatment of heart failure. Curr Heart Failure Rep. 2007;4:43-47.CrossRefGoogle Scholar
  24. 24.
    The Criteria Committee, New York Heart Association, Inc. Diseases of the Heart and Blood Vessels. Nomenclature and Criteria for Diagnosis. 6th ed. Boston: Little, Brown, 1964:114.Google Scholar

Additional Reading

  1. Practice Guideline: Focused Update 2009 Focused update: ACCF/AHA Guidelines for the diagnosis and management of heart failure in adults. A report of the American college of cardiology foundation/American heart association task force on practice guidelines. Circulation. 2009;119:1977-2016.Google Scholar
  2. ACC/AHA Task Force Report. Guidelines for the evaluation and management of heart failure. J Am Coll Cardiol. 1995;26:1376-1398.CrossRefGoogle Scholar
  3. Cohn JN, Archibald DG, Ziesche S, et al. Effect of vasodilator therapy on mortality in chronic congestive heart failure: results of a Veterans Administration Cooperative Study (CONSENSUS). N Engl J Med. 1986;314:1547-1552.PubMedCrossRefGoogle Scholar
  4. Dracup K, Walden JA, Stevenson LW, Brecht ML. Quality of life in patients with advanced heart failure. J Heart Lung Transplant. 1992;11:273-279.PubMedGoogle Scholar
  5. Gillum RF. Epidemiology of heart failure in the United States. Am Heart J. 1993;126:1042-1047.PubMedCrossRefGoogle Scholar
  6. Packer M. The neurohormonal hypothesis: a theory to explain the mechanism of disease progression in heart failure. J Am Coll Cardiol. 1992;20:248-254.PubMedCrossRefGoogle Scholar
  7. The SAVE Investigators; Pfeffer MA, Braunwald E, Moyè LA, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. N Engl J Med. 1992;327:669-677.Google Scholar
  8. Stevenson WG, Stevenson LW, Middlekauff HR, et al. Improving survival for patients with advanced heart failure: a study of 737 consecutive patients. J Am Coll Cardiol. 1995;26:1417-1423.PubMedCrossRefGoogle Scholar
  9. Tresch DD, McGough MF. Heart failure with normal systolic function. A common disorder in older people. J Am Geriatr Soc. 1995;43:1035-1042.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Paul J. Mather
    • 1
  • Gilbert E. D’Alonzo
    • 2
  1. 1.Advanced Heart Failure and Cardiac Transplant CenterJefferson Medical College of Thomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Pulmonary and Critical Care MedicineTemple University School of MedicinePhiladelphiaUSA

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