Tailoring therapy for ischemic cardiomyopathy: is Laplace’s law enough?

The burden of heart failure has long plagued the productive years of the population, with therapeutic advances in the timely treatment of ischemic heart disease decreasing its associated mortality. Angiotensin-converting enzyme inhibitors and β-blockers have impacted heart failure therapeutics in a...

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Bibliographic Details
Published in:Therapeutic advances in cardiovascular disease 2017-09, Vol.11 (9), p.231-234
Main Authors: Adhyapak, Srilakshmi M., Parachuri, V. Rao
Format: Article
Language:English
Subjects:
Cardiac Surgical Procedures - adverse effects
Cardiomyopathies - diagnosis
Cardiomyopathies - etiology
Cardiomyopathies - physiopathology
Cardiomyopathies - therapy
Cardiovascular Agents - adverse effects
Cardiovascular Agents - therapeutic use
Disease Progression
Heart failure
Heart Failure - diagnosis
Heart Failure - etiology
Heart Failure - physiopathology
Heart Failure - therapy
Heart-Assist Devices
Hemodynamics - drug effects
Humans
Models, Cardiovascular
Myocardial Ischemia - complications
Myocardial Ischemia - diagnosis
Myocardial Ischemia - physiopathology
Myocardial Ischemia - therapy
Recovery of Function
Renin-Angiotensin System - drug effects
Risk Factors
Stroke Volume - drug effects
Treatment Outcome
Ventricular Function, Left - drug effects
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Summary:The burden of heart failure has long plagued the productive years of the population, with therapeutic advances in the timely treatment of ischemic heart disease decreasing its associated mortality. Angiotensin-converting enzyme inhibitors and β-blockers have impacted heart failure therapeutics in a revolutionary way. The importance of blockade of the renin–angiotensin system and adrenergic stimulation are fully accepted concepts that apply in young and old, symptomatic and asymptomatic, borderline low and very low Ejection Fraction (EF), left ventricular failure and biventricular failure. Despite several interventions, both pharmaceutical and device based for the treatment of ensuing heart failure, the incidence is increasing in large proportions. Newer molecules like sacubitril show more promise. Despite these novel therapies, several patients relentlessly progress to a stage of advanced heart failure. The use of left-ventricular-assist devices has variable clinical benefit, with some patients progressing to heart transplantation.
ISSN:1753-9447
1753-9455
DOI:10.1177/1753944717718719