RT Book, Section
A1 Mehra, Mandeep R.
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1156562770
T1 Cardiac Transplantation and Prolonged Assisted Circulation
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accessmedicine.mhmedical.com/content.aspx?aid=1156562770
RD 2024/04/19
AB Advanced  heart  failure,  a  distinct  syndrome,  is  characterized  by  refractoriness  to  conventional  therapy  and  represents  a  vexing  clinical  dilemma  that  is  associated  with  an  increased  symptom  burden,  frequent  hospitalization,  a  poor  quality  of  life  and  high  risk  of  death.  Such  individuals  do  not  tolerate  neurohormonal  antagonists  at  recommended  doses,  exhibit  cardiorenal  syndrome,  maintain  markedly  poor  cardiac  reserve  on  cardiopulmonary  stress  testing,  and  typically  display  a  low  cardiac  output  state  with  elevated  pulmonary  pressures.  In  general,  therapeutic  targets  shift  away  from  disease  modifying  neurohormonal  therapy  to  surgical  options  that  attend  directly  to  the  myocardial  stress  and  strain  relationship.  Most  often,  prolonged  circulatory  assistance  using  mechanical  pumps  or  cardiac  transplantation  is  required  to  reliably  improve  quality  of  life  and  long-term  survival.