BOOK
Heart Failure in Older Adults, An Issue of Heart Failure Clinics, E-Book
(2017)
Additional Information
Book Details
Abstract
This issue of Heart Failure Clinics, edited by Drs. Wilbert Aronow and Ali Ahmed, will cover a wide array of topics related to Heart Failure in Older Adults. Subjects covered include, but are not limited to: Epidemiology, Pathophysiology, and Prognosis of Heart Failure in the Older Adult; DEFEAT Heart Failure: Clinical Manifestations, Diagnostic Assessment, and Etiology of Geriatric Heart Failure; Heart Failure with Preserved Ejection Fraction in the Older Adult; Heart Failure—Complicating Acute Myocardial Infarction; Interventional Therapies for Heart Failure in the Older Adult; Cardiac Resynchronization Therapy for Treatment of Heart Failure in the Older Adult; and Left Ventricular Assist Devices in Treatment of Heart Failure in the Older Adult, among others.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Heart Failure in OlderAdults\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Heart Failure in Older Adults | vii | ||
| Epidemiology, Pathophysiology, and Prognosis of Heart Failure in Older Adults | vii | ||
| Diagnosis and Management of Heart Failure in Older Adults | vii | ||
| Role of Echocardiography in the Diagnostic Assessment and Etiology of Heart Failure in Older Adults: Opacify, Quantify, and ... | vii | ||
| Treatment of Heart Failure with Abnormal Left Ventricular Systolic Function in Older Adults | vii | ||
| Heart Failure with Preserved Ejection Fraction in Older Adults | viii | ||
| Use of Diuretics in the Treatment of Heart Failure in Older Adults | viii | ||
| Heart Failure Complicating Acute Myocardial Infarction | viii | ||
| The Role of Positive Inotropic Drugs in the Treatment of Older Adults with Heart Failure and Reduced Ejection Fraction | viii | ||
| Interventional Therapies for Heart Failure in Older Adults | ix | ||
| Surgical Revascularization in Older Adults with Ischemic Cardiomyopathy | ix | ||
| Cardiac Resynchronization Therapy in Older Adults with Heart Failure | ix | ||
| Treatment of Ventricular Arrhythmias and Use of Implantable Cardioverter-Defibrillators to Improve Survival in Older Adult ... | ix | ||
| Exercise Therapy for Older Heart Failure Patients | x | ||
| Left Ventricular Assist Device in Older Adults | x | ||
| End-of-Life Care in the Treatment of Heart Failure in Older Adults | x | ||
| HEART FAILURE CLINICS\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| October 2017 | xi | ||
| January 2018 | xi | ||
| RECENT ISSUES | xi | ||
| April 2017 | xi | ||
| January 2017 | xi | ||
| October 2016 | xi | ||
| Preface\r | xiii | ||
| Heart Failure in Older Adults | xiii | ||
| Epidemiology, Pathophysiology, and Prognosis of Heart Failure in Older Adults | 417 | ||
| Key points | 417 | ||
| INTRODUCTION | 417 | ||
| EPIDEMIOLOGY | 418 | ||
| Identification of Heart Failure | 418 | ||
| Incidence of Heart Failure | 418 | ||
| Prevalence of Heart Failure | 418 | ||
| Heart Failure with Preserved Ejection Fraction | 419 | ||
| PATHOPHYSIOLOGY | 419 | ||
| PROGNOSIS | 421 | ||
| Mortality | 421 | ||
| Hospitalization and Rehospitalization | 422 | ||
| SUMMARY | 423 | ||
| REFERENCES | 423 | ||
| Diagnosis and Management of Heart Failure in Older Adults | 427 | ||
| Key points | 427 | ||
| HEART FAILURE: A GERIATRIC SYNDROME | 427 | ||
| CLINICAL PRESENTATION OF HEART FAILURE IN OLDER ADULTS | 427 | ||
| DEFINITION OF HEART FAILURE | 428 | ||
| STAGES OF HEART FAILURE | 428 | ||
| DESCRIPTIVE CLASSIFICATIONS OF HEART FAILURE | 428 | ||
| Left-Sided Versus Right-Sided Heart Failure | 428 | ||
| Backward Versus Forward Heart Failure | 431 | ||
| High-Output Versus Low-Output Heart Failure | 432 | ||
| Acute Versus Chronic Heart Failure | 432 | ||
| DIAGNOSTIC ASSESSMENT OF HEART FAILURE IN OLDER ADULTS | 432 | ||
| CLINICAL DIAGNOSIS OF HEART FAILURE | 432 | ||
| DETERMINATION OF ETIOLOGIC FACTORS OF HEART FAILURE | 435 | ||
| DETERMINATION OF FLUID VOLUME STATUS | 435 | ||
| DETERMINATION OF LEFT VENTRICULAR EJECTION FRACTION | 438 | ||
| OTHER DIAGNOSTIC ASSESSMENTS | 440 | ||
| TREATMENT OF HEART FAILURE | 440 | ||
| SUMMARY | 440 | ||
| REFERENCES | 441 | ||
| Role of Echocardiography in the Diagnostic Assessment and Etiology of Heart Failure in Older Adults | 445 | ||
| Key points | 445 | ||
| LEFT VENTRICULAR SYSTOLIC FUNCTION | 446 | ||
| ANATOMIC FINDINGS (1-, 2-, AND 3-DIMENSIONAL ECHOCARDIOGRAPHY) | 446 | ||
| LEFT VENTRICULAR DIASTOLIC FUNCTION | 450 | ||
| SPECIFIC CARDIOMYOPATHIES | 456 | ||
| VALVULAR HEART DISEASE | 457 | ||
| RIGHT VENTRICLE | 458 | ||
| CARDIAC RESYNCHRONIZATION THERAPY | 460 | ||
| HEMODYNAMIC ASSESSMENT | 460 | ||
| Hemodynamic Data (Conventional and Tissue Doppler) | 460 | ||
| SUMMARY | 462 | ||
| REFERENCES | 463 | ||
| Treatment of Heart Failure with Abnormal Left Ventricular Systolic Function in Older Adults | 467 | ||
| Key points | 467 | ||
| TREATMENT OF STAGE A HEART FAILURE | 467 | ||
| TREATMENT OF STAGE B HEART FAILURE | 468 | ||
| GENERAL MEASURE FOR TREATMENT OF STAGE C HEART FAILURE | 468 | ||
| DIURETICS | 468 | ||
| ANGIOTENSIN-CONVERTING ENZYME INHIBITORS | 470 | ||
| ANGIOTENSIN RECEPTOR BLOCKERS | 472 | ||
| β-BLOCKERS | 473 | ||
| ALDOSTERONE ANTAGONISTS | 474 | ||
| ISOSORBIDE DINITRATE PLUS HYDRALAZINE | 474 | ||
| DIGOXIN | 475 | ||
| OTHER NEUROHORMONAL ANTAGONISTS | 475 | ||
| SACUBITRIL/VALSARTAN | 476 | ||
| CALCIUM CHANNEL BLOCKERS | 476 | ||
| IVABRADINE | 476 | ||
| SYNCHRONIZED PACING AND CARDIOVERTER-DEFIBRILLATORS | 476 | ||
| INOTROPIC THERAPY | 477 | ||
| NESIRITIDE | 477 | ||
| SURGICAL THERAPY | 477 | ||
| END-STAGE HEART FAILURE | 478 | ||
| REFERENCES | 478 | ||
| Heart Failure with Preserved Ejection Fraction in Older Adults | 485 | ||
| Key points | 485 | ||
| INTRODUCTION | 485 | ||
| Clinical Significance | 485 | ||
| Diagnostic Dilemma of Heart Failure with Preserved Ejection Fraction in Older Adults | 486 | ||
| Why Is Heart Failure with Preserved Ejection Fraction Increasing in Prevalence as the Population Ages? | 486 | ||
| Aging associated with heart failure with preserved ejection fraction epidemic | 486 | ||
| Why Is Heart Failure with Preserved Ejection Fraction so Common Among Elderly Women? | 486 | ||
| Aging-related body changes/skeletal muscle changes | 486 | ||
| Marked increase in prevalence of cardiac and noncardiac comorbidities with aging and heart failure with preserved ejection ... | 487 | ||
| Cardiac comorbidities: coronary artery disease and atrial fibrillation | 487 | ||
| Noncardiac comorbidities and the epidemic of obesity | 487 | ||
| Key Knowledge Gaps | 489 | ||
| Pharmacologic Interventions | 489 | ||
| Summary of traditional clinical trials | 489 | ||
| Why have clinical pharmacologic intervention trials fail to meet their primary endpoints? | 492 | ||
| Novel pharmacotherapies in heart failure with preserved ejection fraction | 493 | ||
| Sildenafil | 493 | ||
| Nitrates | 493 | ||
| Neprilysin inhibitors | 493 | ||
| Statins | 493 | ||
| Ivabradine | 493 | ||
| Riociguat | 493 | ||
| Ranolazine | 494 | ||
| Alagebrium (ALT-711) | 494 | ||
| Sitaxsentan | 494 | ||
| New drugs in development or testing | 494 | ||
| Anakinra | 494 | ||
| Inhibitors of sodium-glucose cotransporters type 2 | 494 | ||
| Nifedipine and isosorbide dinitrate/hydralazine | 494 | ||
| Device Therapy | 494 | ||
| What Treatments Have Worked so Far? | 495 | ||
| Exercise training | 495 | ||
| How Does Exercise Training Improve Exercise Intolerance in Heart Failure with Preserved Ejection Fraction Patients? | 495 | ||
| Key Knowledge Gaps | 495 | ||
| Dietary Caloric Restriction | 495 | ||
| Current guidelines in heart failure with preserved ejection fraction: what is the evidence? | 495 | ||
| SUMMARY | 496 | ||
| REFERENCES | 497 | ||
| Use of Diuretics in the Treatment of Heart Failure in Older Adults | 503 | ||
| Key points | 503 | ||
| OVERVIEW | 504 | ||
| TREATMENT ALGORITHM FOR DIURETIC USE IN HEART FAILURE | 504 | ||
| INDIVIDUAL CLASSES OF DIURETICS | 504 | ||
| Carbonic Anhydrase Inhibitors | 504 | ||
| Loop Diuretics | 505 | ||
| Thiazide Diuretics | 506 | ||
| Distal Potassium-Sparing Diuretics | 506 | ||
| SPECIAL CONSIDERATIONS WITH DIURETIC THERAPY | 507 | ||
| NEUROHUMORAL RESPONSES TO DIURETICS | 508 | ||
| ADVERSE EFFECTS OF DIURETICS | 508 | ||
| Hyponatremia | 508 | ||
| Acid–Base Changes | 508 | ||
| Hyperuricemia | 508 | ||
| Hypokalemia and Hyperkalemia | 509 | ||
| Hypomagnesemia | 509 | ||
| SUMMARY | 510 | ||
| REFERENCES | 510 | ||
| Heart Failure Complicating Acute Myocardial Infarction | 513 | ||
| Key points | 513 | ||
| GENERAL MEASURES | 514 | ||
| HEMODYNAMIC MONITORING | 514 | ||
| OXYGEN | 514 | ||
| MORPHINE | 515 | ||
| DIURETICS | 515 | ||
| NITROGLYCERIN | 515 | ||
| ANGIOTENSIN-CONVERTING ENZYME INHIBITORS | 516 | ||
| ANGIOTENSIN II RECEPTOR BLOCKERS | 517 | ||
| ALDOSTERONE ANTAGONISTS | 517 | ||
| BETA-BLOCKERS | 517 | ||
| CALCIUM CHANNEL BLOCKERS AND MAGNESIUM | 519 | ||
| DIGOXIN | 519 | ||
| POSITIVE INOTROPIC DRUGS | 519 | ||
| TREATMENT OF ARRHYTHMIAS | 519 | ||
| MECHANICAL COMPLICATIONS | 520 | ||
| CARDIAC RESYNCHRONIZATION THERAPY AND IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS | 520 | ||
| REFERENCES | 520 | ||
| The Role of Positive Inotropic Drugs in the Treatment of Older Adults with Heart Failure and Reduced Ejection Fraction | 527 | ||
| Key points | 527 | ||
| INTRODUCTION | 527 | ||
| POSITIVE INOTROPIC DRUGS | 528 | ||
| ADRENERGIC AGONISTS | 528 | ||
| Dobutamine | 528 | ||
| Dopamine | 528 | ||
| PHOSPHODIESTERASE INHIBITORS | 530 | ||
| Milrinone | 530 | ||
| Enoximone | 530 | ||
| PHOSPHODIESTERASE INHIBITORS WITH CALCIUM SENSITIZATION | 531 | ||
| Pimobendan | 531 | ||
| Levosimendan | 531 | ||
| CARDIAC GLYCOSIDES | 531 | ||
| Digoxin | 531 | ||
| SUMMARY | 532 | ||
| INPATIENT SETTINGS | 532 | ||
| Cardiogenic Shock | 532 | ||
| OUTPATIENT SETTING | 532 | ||
| Stage D Refractory Heart Failure | 532 | ||
| Palliative Care | 532 | ||
| REFERENCES | 532 | ||
| Interventional Therapies for Heart Failure in Older Adults | 535 | ||
| Key points | 535 | ||
| INTRODUCTION | 535 | ||
| INTERVENTIONAL THERAPIES FOR HEART FAILURE | 536 | ||
| Revascularization for Ischemic Cardiomyopathy | 536 | ||
| Percutaneous coronary intervention | 536 | ||
| Hybrid coronary revascularization | 538 | ||
| Percutaneous Mechanical Circulatory Support | 538 | ||
| High-risk percutaneous coronary intervention | 538 | ||
| Cardiogenic shock | 539 | ||
| Right ventricular failure | 539 | ||
| Interventional Therapies for Heart Failure Secondary to Valvular Heart Disease and Septal Defects | 539 | ||
| Transcatheter aortic valve replacement | 539 | ||
| Transcatheter mitral valve repair | 540 | ||
| Percutaneous mitral annuloplasty | 540 | ||
| Transcatheter mitral valve replacement | 540 | ||
| Transcatheter tricuspid valve interventions | 540 | ||
| Percutaneous closure of atrial septal defect and paravalvular leak | 540 | ||
| Other Interventional Therapies for Heart Failure | 546 | ||
| Implantable hemodynamic monitors | 546 | ||
| Right ventricular pressure monitor | 551 | ||
| Left atrial pressure monitor | 551 | ||
| Pulmonary artery pressure monitor | 554 | ||
| Transcatheter interatrial shunt devices | 554 | ||
| Percutaneous left ventricle restoration devices | 559 | ||
| Interventional and device-based autonomic modulation | 560 | ||
| Catheter-directed thrombolysis for acute right ventricular failure secondary to massive/submassive pulmonary embolism | 560 | ||
| SUMMARY | 564 | ||
| REFERENCES | 564 | ||
| Surgical Revascularization in Older Adults with Ischemic Cardiomyopathy | 571 | ||
| Key points | 571 | ||
| ISCHEMIC CARDIOMYOPATHY | 572 | ||
| RATIONALE FOR REVASCULARIZATION | 572 | ||
| CORONARY ARTERY BYPASS GRAFT SURGERY — THE PRE “SURGICAL TREATMENT FOR ISCHEMIC HEART FAILURE TRIAL” ERA | 573 | ||
| SURGICAL TREATMENT FOR ISCHEMIC HEART FAILURE TRIAL | 573 | ||
| PATIENT SELECTION —VIABILITY, ISCHEMIA, ANGINA, OR ANATOMY? | 574 | ||
| CORONARY ARTERY BYPASS GRAFT SURGERY AND AGE | 576 | ||
| SUMMARY | 578 | ||
| REFERENCES | 578 | ||
| Cardiac Resynchronization Therapy in Older Adults with Heart Failure | 581 | ||
| Key points | 581 | ||
| CASE PRESENTATION | 581 | ||
| INTRODUCTION | 581 | ||
| EVOLUTION OF CARDIAC RESYNCHRONIZATION THERAPY | 582 | ||
| CLINICAL EFFICACY OF CARDIAC RESYNCHRONIZATION THERAPY IN OLDER PATIENTS | 584 | ||
| IMPACT OF COMORBIDITIES ON THE EFFICACY OF CARDIAC RESYNCHRONIZATION THERAPY | 585 | ||
| COMPLICATIONS OF IMPLANTATION | 585 | ||
| COST EFFECTIVENESS OF CARDIAC RESYNCHRONIZATION THERAPY | 585 | ||
| BIVENTRICULAR PACING ALONE IN OLDER ADULTS | 586 | ||
| SUMMARY: CLINICAL DECISION | 586 | ||
| REFERENCES | 586 | ||
| Treatment of Ventricular Arrhythmias and Use of Implantable Cardioverter-Defibrillators to Improve Survival in Older Adult ... | 589 | ||
| Key points | 589 | ||
| INTRODUCTION | 589 | ||
| SUBSTRATE AND MECHANISM OF VENTRICULAR ARRHYTHMIAS | 589 | ||
| MEDICAL THERAPY | 590 | ||
| Antiarrhythmic Drugs | 590 | ||
| Ventricular ectopy and nonsustained ventricular tachycardia | 590 | ||
| Sustained ventricular tachycardia/fibrillation and aborted sudden death | 591 | ||
| Implantable cardioverter-defibrillator shock reduction | 591 | ||
| β-Blockers | 592 | ||
| Nonantiarrhythmic Drugs | 592 | ||
| Fish oil | 592 | ||
| Antianginal agents | 592 | ||
| Implantable Cardiac Defibrillator | 592 | ||
| Primary prevention trials | 593 | ||
| Secondary prevention trials | 595 | ||
| Implantable Cardioverter-Defibrillator in the elderly | 595 | ||
| SHOCK MORBIDITY AND MORTALITY | 596 | ||
| SHOCK PREVENTION | 596 | ||
| ABLATION | 597 | ||
| AUTONOMIC MODULATION | 599 | ||
| SUMMARY | 599 | ||
| REFERENCES | 599 | ||
| Exercise Therapy for Older Heart Failure Patients | 607 | ||
| Key points | 607 | ||
| REDUCED AEROBIC CAPACITY: A CENTRAL FEATURE OF NORMATIVE AGING AND HEART FAILURE | 607 | ||
| DO OLDER PEOPLE WITHOUT HEART FAILURE RESPOND TO AEROBIC TRAINING LIKE YOUNGER ADULTS? | 608 | ||
| EXERCISE THERAPY IN PATIENTS WITH HEART FAILURE: STATE OF THE EVIDENCE | 609 | ||
| AEROBIC EXERCISE TRAINING IN OLDER HEART FAILURE PATIENTS: CLINICAL TRIAL EVIDENCE IN HEART FAILURE WITH REDUCED EJECTION F ... | 610 | ||
| CLINICAL TRIAL EVIDENCE IN OLDER PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION | 612 | ||
| RESISTANCE TRAINING STUDIES IN OLDER PATIENTS WITH HEART FAILURE | 612 | ||
| IS EXERCISE THERAPY SAFE IN OLDER PATIENTS WITH HEART FAILURE? | 614 | ||
| LIMITATIONS OF EXISTING TRAINING STUDIES IN OLDER HEART FAILURE PATIENTS | 614 | ||
| CHALLENGES AND UNANSWERED QUESTIONS | 614 | ||
| SUMMARY | 615 | ||
| REFERENCES | 615 | ||
| Left Ventricular Assist Device in Older Adults | 619 | ||
| Key points | 619 | ||
| INTRODUCTION | 619 | ||
| OUTCOME WITH HOME INOTROPY | 620 | ||
| HISTORY OF LEFT VENTRICULAR ASSIST DEVICES | 620 | ||
| RISK PREDICTORS OF LEFT VENTRICULAR ASSIST DEVICE MORBIDITY AND MORTALITY | 621 | ||
| Risk Factor Selection Scale | 621 | ||
| Risk Factor Summation Scale | 621 | ||
| Interagency Registry for Mechanically Assisted Circulatory Support Score | 621 | ||
| Seattle Heart Failure Risk Score | 622 | ||
| HeartMate II Risk Score | 623 | ||
| POSTIMPLANTATION RIGHT VENTRICULAR FAILURE | 623 | ||
| LEFT VENTRICULAR ASSIST DEVICE SELECTION CRITERIA AND TIMING IN ELDERLY PATIENTS | 624 | ||
| Destination Therapy | 626 | ||
| Bridge to Transplant | 626 | ||
| Preoperative Assessment | 626 | ||
| RISK STRATIFICATION FOR LEFT VENTRICULAR ASSIST DEVICE SUPPORT IN ELDERLY INDIVIDUALS | 626 | ||
| One-Year to 2-Year Risk | 627 | ||
| Operative Risk | 627 | ||
| Selection and Risk Scores with Focus on the Right Ventricle | 627 | ||
| Timing Based on Acuity | 628 | ||
| Interagency registry for mechanically assisted circulatory support level I | 628 | ||
| Interagency registry for mechanically assisted circulatory support levels 2 and 3 | 628 | ||
| Interagency registry for mechanically assisted circulatory support 4 to 6 | 628 | ||
| OUTCOMES AFTER LEFT VENTRICULAR ASSIST DEVICE | 628 | ||
| Survival | 628 | ||
| Quality of Life | 628 | ||
| Complications Following an Left Ventricular Assist Device | 628 | ||
| Bleeding | 629 | ||
| Left ventricular assist device thrombosis | 629 | ||
| Strokes | 629 | ||
| Infections | 629 | ||
| Summary of Outcomes after a Left Ventricular Assist Device | 629 | ||
| CASE CORRELATION | 629 | ||
| SUMMARY | 630 | ||
| REFERENCES | 630 | ||
| End-of-Life Care in the Treatment of Heart Failure in Older Adults | 633 | ||
| Key points | 633 | ||
| HOW DO WE KNOW WE HAVE ARRIVED? | 633 | ||
| IMPROVING COMMUNICATION | 634 | ||
| PALLIATIVE CARE IN HEART FAILURE | 636 | ||
| DEVICE THERAPY | 637 | ||
| CARDIOPULMONARY RESUSCITATION | 638 | ||
| PALLIATIVE SEDATION | 639 | ||
| CAVEATS OF PALLIATIVE CARE | 640 | ||
| SUMMARY | 640 | ||
| REFERENCES | 641 |