05 Nov 06
When the failing, end-stage heart is not end-stage
By DG Renlund, and AG Kfoury
Heart failure is increasing in incidence and prevalence, is expensive to treat, and is associated with substantial morbidity and mortality.1 In the nomenclature of the guidelines of the American Heart Association and the American College of Cardiology, the majority of patients with heart failure are classified as having stage C heart failure, characterized by structural heart disease that is or has been symptomatic.2 Numerous drugs (e.g., angiotensin converting–enzyme [ACE] inhibitors or angiotensin-receptor blockers, beta-blockers, and aldosterone blockers) and electrophysiological devices may temporarily halt, slow, or even reverse the pathophysiological processes in patients with stage C heart failure. Reversion of the heart toward more normal shape and function is called reverse remodeling.