Skip to main content

Congestive Heart Failure

  • Chapter
  • First Online:
Manual of Outpatient Cardiology

Abstract

Heart failure (HF) is an epidemic disorder that currently affects more than 5 million people in the United States, with an estimated 550,000 new diagnoses each year. Given the increasing age of the population and the improved survival of patients from acute myocardial infarctions and other diseases, the incidence of heart failure will undoubtedly continue to grow. Current data from the NHLBI’s Framingham Heart Study suggests that at age 40, the lifetime risk of developing heart failure for both men and women is approximately one in five (or 20%), and 1- and 5-year mortality is about 30% and 50%, respectively. The Framingham study suggests that patients with heart failure have mortality rates four to eight times higher compared to the general population of the same age. Hospital discharges for HF rose from 877,000 in 1996 to 1,106,000 in 2006. Furthermore, the estimated cost of HF in the United States for 2010 is $39.2 billion. However, appropriate recognition and early treatment of heart failure, risk factors, and use of evidence-based therapies in patients already diagnosed with heart failure can help to prevent this expected increase in HF incidence and reduce the mortality, number of hospitalizations, and health care costs associated with this disorder.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 64.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 84.99
Price excludes VAT (USA)
  • Compact, lightweight 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

Suggested Reading

  1. Abraham WT, Adams KF, Fonarow GC, et al. In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: an analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). J Am Coll Cardiol. 2005;46:57–64.

    Article  PubMed  Google Scholar 

  2. Bardy GH, Lee KL, Mark DB, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352:225–37.

    Article  PubMed  CAS  Google Scholar 

  3. Bristow MR, Saxon LA, Boehmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350(21):2140–50.

    Article  PubMed  CAS  Google Scholar 

  4. CIBIS-II Investigators. The cardiac insufficiency bisoprolol study II (CIBIS-II): a randomized trial. Lancet. 1999;353:9–13.

    Article  Google Scholar 

  5. Cleland JGF, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539–49.

    Article  PubMed  CAS  Google Scholar 

  6. 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. N Engl J Med. 1986;314(24):1547–52.

    Article  PubMed  CAS  Google Scholar 

  7. Cohn JN, Tognoni G. Valsartan heart failure trial investigators. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med. 2001;345:1667–75.

    Article  PubMed  CAS  Google Scholar 

  8. CONSENSUS Trial Study Group. 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):1429–35.

    Article  Google Scholar 

  9. Crow S, John R, Boyle A, et al. Gastrointestinal bleeding rates in recipients of nonpulsatile and pulsatile left ventricular assist devices. J Thorac Cardiovasc Surg. 2009;137:208–15.

    Article  PubMed  CAS  Google Scholar 

  10. Cuculich PS, Kates AM, editors. Cardiology subspecialty consult, vol. 2. Philadelphia: Wolters Kluwer/Lippincott Williams and Wilkins; 2009. p. 19–23, 112–161.

    Google Scholar 

  11. Cuff MS, Califf RM, Adams KF, et al. Short-term intravenous milrinone for acute exacerbation of chronic heart failure. JAMA. 2002;287(12):1541–7.

    Article  Google Scholar 

  12. Dargie HJ et al. Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomized trial. Lancet. 2001;357:1385–90.

    Article  PubMed  CAS  Google Scholar 

  13. Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 1997;336(8):525–33.

    Article  Google Scholar 

  14. Felker GM, Benza RL, Chandler AB, et al. Heart failure etiology and response to milrinone in decompensated heart failure: results from the OPTIME-CHF study. J Am Coll Cardiol. 2003;41:997–1003.

    Article  PubMed  CAS  Google Scholar 

  15. Goldhaber JI, Hamilton MA. Role of inotropic agents in the treatment of heart failure. Circulation. 2010;121:1655–60.

    Article  PubMed  Google Scholar 

  16. 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;362:772–6.

    Article  PubMed  CAS  Google Scholar 

  17. Griffin BP, Topol EJ, editors. Manual of cardiovascular medicine. 3rd ed. Philadelphia: Wolters Kluwer/Lippincott Williams and Wilkins; 2009. p. 105–90.

    Google Scholar 

  18. He J, Ogden LG, Bazzano LA, et al. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med. 2001;161(7):996–1002.

    Article  PubMed  CAS  Google Scholar 

  19. Ho KK, Anderson KM, Kannel WB, et al. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation. 1993;88(1):107–15.

    PubMed  CAS  Google Scholar 

  20. Hohnloser S, Kuck KH, Dorian P, et al. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med. 2004;351:2481–8.

    Article  PubMed  CAS  Google Scholar 

  21. Hunt S, Abraham WT, Chin MH, et al. ACC/AHA 2005 Guideline Update for the diagnosis and management of chronic heart failure in the adult: a Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2005;112:154–235.

    Article  Google Scholar 

  22. Januzzi Jr JL, Camargo CA, Anwaruddin S, et al. The N-terminal pro-BNP investigation of dyspnea in the emergency department (PRIDE) study. Am J Cardiol. 2005;95(8):948–54.

    Article  PubMed  CAS  Google Scholar 

  23. Levy WC, Mozaffarian D, Linker DT, et al. The seattle heart failure model: prediction of survival in heart failure. Circulation. 2006;113:1424–33.

    Article  PubMed  Google Scholar 

  24. Libby P, Bonow RO, editors. Braunwald’s heart disease: a textbook of cardiovascular medicine. 8th ed. Philadelphia: WB Saunders; 2008. p. 509–727.

    Google Scholar 

  25. Lindenfeld J, Mann DL, et al. Executive summary: HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010;16(6):475–539.

    Article  Google Scholar 

  26. McKee PA, Castelli WP, McNamara PM, et al. The natural history of congestive heart failure: the Framingham study. N Engl J Med. 1971;285(26):1441–5.

    Article  PubMed  CAS  Google Scholar 

  27. McMurray JJ, Ostergren J, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added Trial. Lancet. 2003;362:767–71.

    Article  PubMed  CAS  Google Scholar 

  28. 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;353:2001–7.

    Article  Google Scholar 

  29. Moss AJ, Hall WJ, Cannom DS, et al. Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med. 2009;361(14):1329–38.

    Article  PubMed  Google Scholar 

  30. Moss AJ, Hall WJ, Cannom DS, For the Multicenter Automatic Defibrillator Implantation Trial Investigators. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med. 1996;335(26):1933–40.

    Article  PubMed  CAS  Google Scholar 

  31. Moss AJ, Zareba W, Hall WJ, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346(12):877–83.

    Article  PubMed  Google Scholar 

  32. Nohria A, Mielniczuk LD, Stevenson LW. Evaluation and monitoring of patients with acute heart failure syndromes. Am J Cardiol. 2005;96(6):32–40.

    Article  Google Scholar 

  33. Packer M, Coats AJ, Fowler MB, et al. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med. 2001;344:1651–8.

    Article  PubMed  CAS  Google Scholar 

  34. Pfeffer MA, Braunwald E, Moye LA, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 1992;327(10):669–77.

    Article  PubMed  CAS  Google Scholar 

  35. Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348(14):1309–21.

    Article  PubMed  CAS  Google Scholar 

  36. Pitt B, Zannad F, Remme WJ. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999;341(10):709–17.

    Article  PubMed  CAS  Google Scholar 

  37. Rose EA, Gelijns AC, et al. Long-term mechanical left ventricular assistance for end-stage heart failure. N Engl J Med. 2001;345(20):1435–43.

    Article  PubMed  CAS  Google Scholar 

  38. Ryden L, Armstrong PW, Cleland JGF, et al. Efficacy and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus. Eur Heart J. 2000;21(23):1967–78.

    Article  PubMed  CAS  Google Scholar 

  39. Slaughter MS. Hematologic effects of continuous flow left ventricular assist devices. J Cardiovasc Transl Res. 2010;3(6):618–24. Epub 2010 Sep 11.

    Article  PubMed  Google Scholar 

  40. Slaughter MS, Rogers JG, Milano CA, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009;361:1–11.

    Article  Google Scholar 

  41. SOLVD Investigators. Effect if enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325(5):293–302.

    Article  Google Scholar 

  42. Steinhart B, Thorpe KE, Ahmed BM, et al. Improving the diagnosis of acute heart failure using a validated prediction model. J Am Coll Cardiol. 2009;54(16):1515–21.

    Article  PubMed  CAS  Google Scholar 

  43. Taylor AL, Ziesche S, Yancy C, et al. African-American heart failure trial investigators. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N Engl J Med. 2004;351(20):2049–57.

    Article  PubMed  CAS  Google Scholar 

  44. Young JB, Abraham WT, Stevenson LW, For the VMAC Study Group. Results of the VMAC trial: vasodilation in the management of acute congestive heart failure. Circulation. 2000;102:2794.

    Google Scholar 

  45. Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003;362:777–81.

    Article  PubMed  CAS  Google Scholar 

  46. Zannad F, McMuray JV, Krum H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med. 2011;364:11–21.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Susan F. Lien .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag London Limited

About this chapter

Cite this chapter

Lien, S.F., Alexis, J.D. (2012). Congestive Heart Failure. In: Bisognano, J., Beck, R., Connell, R. (eds) Manual of Outpatient Cardiology. Springer, London. https://doi.org/10.1007/978-0-85729-944-4_11

Download citation

  • DOI: https://doi.org/10.1007/978-0-85729-944-4_11

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-0-85729-943-7

  • Online ISBN: 978-0-85729-944-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics