Gambling on Heart Failure Treatments
Gambling on Heart Failure Treatments
April 18, 2002 -- Despite remarkable advances in technology, putting the hopes of heart failure patients in an artificial heart or a heart transplant may be setting them up for disappointment and, in many cases, even death. But by focusing on more practical approaches to treating these patients as their disease progresses, experts say many more lives may be prolonged and improved.
Nearly 5 million Americans suffer from heart failure, a condition that happens when the heart can't pump enough blood to meet the body's needs. People with heart failure initially develop symptoms such as shortness of breath or difficulty performing physical tasks. Eventually, the condition can become so severe that the patient cannot function and is confined to a hospital bed.
The patients with the most advanced type of heart failure are often considered for drastic measures such as a transplant or artificial implant. But there are only about 2,400 transplantable hearts available each year for the 50,000 to 100,000 patients who might benefit from them.
"A heart transplant is the answer to heart failure the way the lottery is the answer to poverty," says Lynne Warner Stevenson, MD, co-director of the cardiomyopathy and heart failure program at Brigham and Women's Hospital in Boston. "Heart transplants are completely limited by donor supply."
Stevenson says a lot of funding and research are going into manufacturing complex medical devices, such as artificial hearts. But at the same time, doctors and nurses are not being adequately trained to provide the best therapies already available to treat heart failure patients as the disease progresses.
When medications such as ACE inhibitors, beta blockers, and diuretics fail to control the symptoms that affect a patient's daily life, more complex treatments may be considered, such as a newly developed wearable mechanical device that help maintains blood flow. But only about 10% of patients with advanced heart disease can even be considered for transplantation or the implant (called a left ventricular assist device). And even fewer opt to undergo the extensive surgery.
"It's a tremendous surgery to go through for a limited benefit," says Stevenson. According to the most recent studies, only 24% of those who receive an implant are still alive after two years.
Gambling on Heart Failure Treatments
April 18, 2002 -- Despite remarkable advances in technology, putting the hopes of heart failure patients in an artificial heart or a heart transplant may be setting them up for disappointment and, in many cases, even death. But by focusing on more practical approaches to treating these patients as their disease progresses, experts say many more lives may be prolonged and improved.
Nearly 5 million Americans suffer from heart failure, a condition that happens when the heart can't pump enough blood to meet the body's needs. People with heart failure initially develop symptoms such as shortness of breath or difficulty performing physical tasks. Eventually, the condition can become so severe that the patient cannot function and is confined to a hospital bed.
The patients with the most advanced type of heart failure are often considered for drastic measures such as a transplant or artificial implant. But there are only about 2,400 transplantable hearts available each year for the 50,000 to 100,000 patients who might benefit from them.
"A heart transplant is the answer to heart failure the way the lottery is the answer to poverty," says Lynne Warner Stevenson, MD, co-director of the cardiomyopathy and heart failure program at Brigham and Women's Hospital in Boston. "Heart transplants are completely limited by donor supply."
Stevenson says a lot of funding and research are going into manufacturing complex medical devices, such as artificial hearts. But at the same time, doctors and nurses are not being adequately trained to provide the best therapies already available to treat heart failure patients as the disease progresses.
When medications such as ACE inhibitors, beta blockers, and diuretics fail to control the symptoms that affect a patient's daily life, more complex treatments may be considered, such as a newly developed wearable mechanical device that help maintains blood flow. But only about 10% of patients with advanced heart disease can even be considered for transplantation or the implant (called a left ventricular assist device). And even fewer opt to undergo the extensive surgery.
"It's a tremendous surgery to go through for a limited benefit," says Stevenson. According to the most recent studies, only 24% of those who receive an implant are still alive after two years.
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