Heart failure

OVERVIEW

  • Heart failure (HF) is a complex clinical syndrome characterized by dyspnea or exertional limitation due to impairment of ventricular filling or ejection of blood, or a combination of both
  • Carries significant morbidity and mortality
    • in patients with chronic heart failure, 1-year mortality rate is 7.2% and 1-year hospitalization rate is 31.9%
    • in patients hospitalized for acute heart failure, 1-year mortality rate is 17.4% and 1-year hospitalization rate is 43.9%
  • HF has traditionally been subclassified according to the left ventricular ejection fraction (LVEF) into 3 categories
    • heart failure with preserved ejection fraction (LVEF50%)
    • heart failure with mid-range ejection fraction (LVEF 41%-49%)
    • heart failure with reduced ejection fraction (HFrEF, in which the LVEF is 40%)

EPIDEMIOLOGY

  • HF affects an estimated 6.5 million adults in the US accounting for an estimated 1 million hospitalizations each year, of which ~ 50% are caused by HFrEF
  • incidence and prevalence of HF are increasing reflecting an aging population, improved survival from myocardial infarction and other cardiovascular diseases, and the increasing prevalence of predisposing risk factors such as diabetes and obesity

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