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Heart Failure

The disease

Heart failure is a condition where the heart cannot pump enough blood to meet the body's needs. The main symptoms of heart failure are:

  • General fatigue or weakness
  • Shortness of breath
  • Swelling in the legs and ankles

A person's life is significantly changed when living with heart failure. Symptoms, medications and hospital stays can make living difficult, and heart failure patients' physical, mental and social functioning is worse than other severe conditions. 1,2 In fact, heart failure patients report more severe impairment of quality of life than people with a history of:1,2

  • Chronic lung disease
  • Arthritis
  • Angina

And they report a similarly reduced quality of life as patients with: 3

  • Parkinson's
  • Multiple Sclerosis
  • Renal failure

Heart failure can get worse with time, and without effective treatment, there is a risk of death within five years of being diagnosed. 4

Autonomic imbalance plays a major role in the disease progression of patients with heart failure and a reduced ejection fraction. 5,6  Increased sympathetic tone and decreased parasympathetic activity exerts adverse cardiac, vascular and renal effects resulting in pathological myocardial remodelling, peripheral vasoconstriction, and salt and water retention.6

References:
1. Hobbs FDR et al. Impact of heart failure and left ventricular systolic dysfunction on quality of life. European Heart Journal (2002) 23, 1867–1876. 2. Litwin MS. Health related quality of life outcomes in patients treated for metastatic kidney cancer: a pilot study. J Urol. 1997 May;157(5):1608-12. 3. Cleland JG, Swedberg K, Follath F et al. (2003) The EuroHeart Failure survey programme – a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. European heart journal 24:442–63 4. Ho KK et al. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation. 1993 Jul;88(1):107-15.  5. Abraham WT et al. Baroreflex Activation Therapy for the Treatment of Heart Failure With a Reduced Ejection Fraction. JACC Heart Fail. 2015 Jun;3(6):487-96. 6. Zile MR et al. Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction: safety and efficacy in patients with and without cardiac resynchronization therapy. Eur J Heart Fail. 2015 Oct;17(10):1066-74. 

The need for better therapies

Despite advances in medications and treatments, millions of people with systolic heart failure continue to have symptoms. In fact, despite current available therapies, 25%- 35% of patients with heart failure and an LVEF ≤ 35% remain categorized as NYHA III. These patient types are not considered sick enough for end-stage heart failure therapies, such as mechanical circulatory support devices or heart transplantation. 1

In addition, many patients are not candidates for the only currently approved device therapy also known as cardiac resynchronization therapy.  Studies have shown that about 2 out of 3 people with systolic heart failure do not qualify or do not benefit from cardiac resynchronization therapy. 2

References:
1. Abraham WT et al. Baroreflex Activation Therapy for the Treatment of Heart Failure With a Reduced Ejection Fraction. JACC Heart Fail. 2015 Jun;3(6):487-96. 2. Hawkins n et al. Am J cardiol 2015; 116 (2); 318-324.
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