National Heart Failure Awareness Week: Emory Heart Failure Specialist
Says Cases Of Heart Failure On Rise -- But So Is Hope
ATLANTA - According to the Heart Failure Society of America, which is
sponsoring this week's National Heart Failure Awareness Week, about
555,000 new cases of heart failure are diagnosed each year in the U.S.
-- and the numbers are expected to rise.
"One reason for the increase
is that more people than ever before are surviving heart attacks, but
they are left with damaged hearts leading to heart failure," notes Andrew
Smith, MD, Medical Director of the Centers for Heart Failure Therapy
at Emory and Emory Crawford Long Hospitals, where over 1,500 patients
are seen for severe cardiac dysfunction.
"Our aging population is
also increasing and congestive heart failure (CHF) is more common in
people over 70. Congenital heart defects are another cause of heart
failure. Diabetes, kidney disease, high blood pressure and alcohol abuse
also increase the risk of CHF," he adds.
Dr. Smith points out that
heart failure does not mean the heart suddenly fails and stops working.
Instead, heart failure occurs when the heart loses some of its ability
to pump blood through the body. Systolic heart failure results when
the heart's ability to contract decreases - blood returning to the heart
from the lungs can back up, causing fluid to leak into the lungs, a
condition known as pulmonary congestion. Diastolic heart failure occurs
when the heart cannot properly fill with blood because the muscle has
lost its ability to relax. Symptoms of heart failure include shortness
of breath, fatigue, difficulty sleeping due to breathing problems, a
swollen and/or tender abdomen, loss of appetite, increased urination
at night and swelling of the feet and legs.
Although heart failure can
be debilitating and even fatal -- it causes almost 40,000 deaths a year
in the U.S. and is a contributing factor in another 225,000 deaths --
there has been significant progress over the few years in relieving
symptoms and even improving the heart's pumping abilities. "Expertise
in prescribing and titrating medications in patients with CHF is key
to helping many of these people maintain -- and often improve -- their
quality of life for as long as possible. For example, although beta
blockers were previously avoided in the treatment of heart failure,
research has shown their efficacy in CHF when started at a low dosage
that is steadily increased," says Dr. Smith. "And the class of drugs
called ACE inhibitors has been shown to decrease hospitalizations by
30 percent. When combined with beta blockers, there is an additional
40 percent reduction. "
Emory cardiologists and researchers
have the largest clinical experience in evaluating and implanting biventricular
pacemakers -- devices which offer hope to many people with severe chronic
heart failure. Known as cardiac resynchronization therapy, the pacemakers
stimulate the heart's ventricles to beat at the same time, improving
the heart's ability to increase blood flow to the body.
implanted the first biventricular pacemaker in Georgia in l997 and have
since implanted more than 800 of the devices in patients with CHF --
more than any other medical center in the world. Documented results
have included a dramatic improvement in quality of life, exercise tolerance
and heart function. Although Emory performed over 85% of adult heart
transplants in the state last year, the heart failure treatment and
heart transplant team is seeing a significant decrease in the numbers
of patients on the transplant waiting list due to improved therapy for
The American College of Cardiology
now recommends that patients with ongoing heart failure symptoms be
considered for referral to specialized heart failure centers. The Emory
Centers for Heart Failure Therapy offer a unique program in Georgia
dedicated to the treatment of patients with severe heart failure and
offer not only the most advanced high tech and medical therapies, but
also comprehensive patient and family education.
"Our nursing staff works
with patients and their families to educate them on lifestyle changes,
such as reducing salt, and monitoring their fluid status and weight
daily so they can report any change in symptoms promptly. Patient education
increases therapy compliance and we have seen even some of the sickest
patients gradually improve, "says Dr. Smith.
Dr. Smith adds that CHF patients
can find hope in the continuing research into new ways to help fight
heart failure. "We are currently involved in a number of clinical trials,
including a multi-center National Institutes of Health sponsored study
of cardiac rehabilitation treatment strategies, " notes Dr. Smith. "
We are continuing to learn a great deal about heart failure and we are
committed to applying what we are learning to help our patients live
the healthiest, best quality lives possible."