Revolutionary heart failure treatments are extending life
Yogita M. Rochlani, MD, FACC, Assistant Professor of Medicine–Cardiology, for Montefiore Einstein
Today, breakthrough therapies are revolutionizing the way we treat heart failure. The latest treatments and surgical advances, with healthy lifestyle habits, alleviate symptoms, slow the disease’s progression, and help people with the condition live longer, healthier lives. Several of the latest advances have come from the benefits of newer medications for diabetes, obesity, and high blood pressure — all key risk factors for heart failure.
New promise in heart failure treatment
Twenty years ago, a patient with advanced heart failure had only a 10% chance of living for one year. Now that rate is 90%, thanks to a greater understanding of the condition, the latest medications, advances in surgical procedures, and the use of innovative devices to assist the failing heart.
The latest treatments
While diet and healthy lifestyle habits are the foundation of heart failure treatment, the use of the latest medications is changing the way we approach heart failure.
SGLT2 inhibitors: Originally developed to lower blood sugar in people with diabetes, these medications have produced surprisingly positive effects when given to people with heart failure, including controlling blood pressure and significantly improving vascular and heart muscle function, regardless of whether or not someone has diabetes.
GLP-1 agonists: These medications are receiving lots of attention for helping people with diabetes and obesity lose weight and successfully keep it off, and now they’ve also been shown to help people suffering from heart failure by improving cardiac metabolism and reducing the risk of heart attack and stroke.
ARNIs: These medications help control blood pressure by preventing blood vessels from contracting and are replacing ACE inhibitors because they’re more than 20% more effective at reducing not only the risk of hospitalization but also heart-failure-related death.
Surgical advances and devices
When healthy lifestyle habits and medications aren’t enough, newer surgical options are available to help with heart failure by correcting abnormal rhythms and repairing damaged valves.
ICDs: Implantable cardiac defibrillators are tiny devices a heart surgeon can place in the chest to maintain regular heart rhythm.
Ablation: This technique involves “zapping” tissue in the heart to disrupt any faulty electrical signals causing arrhythmia.
Mitral valve clips: A newer technology that can help when heart failure is caused by a damaged or leaky mitral valve, the clips are placed during a minimally invasive procedure to restore proper blood flow.
How to spot heart failure
Unlike a heart attack, which is caused by a blocked artery, heart failure is when the heart is unable to pump efficiently enough to meet the body’s needs. It can happen during a heart attack, but it’s often a chronic, long-term condition. Heart failure is most often caused by damage from a heart attack, coronary artery disease, chronic high blood pressure, cardiomyopathy (heart muscle disease), an irregular heartbeat, or drug or alcohol abuse. Treatment is essential because when the heart isn’t pumping efficiently, the body’s organs may not be receiving the blood they need, which means heart failure can lead to further complications such as kidney disease, liver damage, chronic obstructive pulmonary disease (COPD), and increased risk of stroke.
Heart failure can come on so gradually that its early symptoms are easily overlooked. Speak with your doctor if you notice any of these common symptoms, which may signal that your heart is not pumping normally.
- Shortness of breath during activity or at rest
- Persistent coughing or wheezing
- Swelling in the feet, ankles, legs, fingers, or elsewhere
- Fatigue or tiredness
- Nasua or lack of appetite
- Confusion
- Unexplained weight changes
Call 911 or emergency medical help if you are experiencing any of the following:
- Chest pain
- Fainting or severe weakness
- Rapid or irregular heartbeat and shortness of breath, chest pain, or fainting
- Sudden, severe shortness of breath and coughing up foamy mucus
Though these symptoms can be due to heart failure, they can also be signs of other conditions. See your doctor rather than trying to diagnose yourself.
Know the causes and the signs
Fatigue, shortness of breath, and swelling in the legs are signals that the heart may be weakening and less able to pump blood efficiently. These symptoms call for a conversation with your doctor about screening for heart failure. Here’s what you need to know:
- Heart failure is most common in people over 65 because aging can weaken the heart muscle, and often people have health conditions for many years that contribute to heart failure. The main drivers include high blood pressure, diabetes, high cholesterol, cardiometabolic disorders, heart rhythm disorders, heart inflammation, cardiomyopathy (heart muscle disease), irregular heartbeat, and coronary artery disease.
- African Americans are more likely to have heart failure and to develop symptoms at a younger age than other races. They have more hospital visits due to the condition and are more likely to die from heart failure.
- People who are overweight have higher rates of heart failure because excess weight makes the heart work harder. They are also more likely to have type 2 diabetes and heart disease, which lead to heart failure.
- People who have had a heart attack, which damages and weakens the heart muscle, are more likely to have heart failure as a result.
- Family history is very significant, so if anyone in your immediate or even extended family has heart failure, tell your doctor. At the same time, it’s important for family members to know if you are diagnosed with heart failure, so they can share this information with their care providers and be screened.
Healthy lifestyle habits than can help slow the progression of heart failure
If you are at risk or have already experienced heart failure, there are steps you can take to optimize care and slow the progression of heart failure by:
- Controlling high blood pressure. This is the number-one priority.
- Eating a low-sodium diet, which helps with blood pressure control and reduces fluid retention.
- Engaging in regular physical activity, which contributes to overall health and benefits the heart.
- Managing diabetes and excess body weight, both of which damage or weaken the heart.
- Minimizing alcohol use and zero smoking
Making healthy lifestyle choices and maintaining overall health are crucial components of any heart failure treatment plan. Talk to your doctor about creating the plan that will work best for you.
Montefiore Einstein is ranked in the top 1% of all hospitals in the nation for heart and vascular care by U.S. News & World Report
Montefiore Einstein’s nationally recognized Center for Heart and Vascular Care is leading the fight against heart failure with its Center for Advanced Cardiac Therapy, using an integrated team approach to provide treatment that is individualized for each patient, and we continue to expand our cardiac surgery program across the region, including the Montefiore Einstein Cardiac Surgery Program at White Plains Hospital, in Westchester.
The Montefiore Einstein Advanced Heart Failure Program is one of only 15 in the entire country participating in the American College of Cardiology’s Patient Navigator program which supports a team of caregivers assisting each patient during and after hospital stays to ease recovery and reduce the risk of readmission, enhancing long-term wellness. Medical and surgical advances, including implanted devices to assist heart function, are available along with access to exclusive studies of promising new therapies for advanced heart disease. Our world-renowned surgeons offer a full spectrum of surgical therapies for advanced heart failure, including leading treatment using ventricular assist devices (VADs) for the treatment of heart failure.
Our Center for Heart and Vascular Care is an international referral site for heart failure, arrhythmia, and mechanical circulatory support, including procedures such as cardiac device implantation and catheter ablation, performing more than 1,300 ablation procedures annually. Our center also serves as a rigorous educational facility for medical fellows, taking great pride in training the next generation of innovative electrophysiologists.
Montefiore Einstein is restoring lives through innovative heart care for our patients every day. Our unique patient care model provides comprehensive, individualized treatment; and leverages the vast resources available to our specialists, including groundbreaking proprietary research and state-of-the-art diagnostic and treatment technology.
Developing the first transvenous cardiac pacemaker and performing the first coronary bypass operation was only the beginning of Montefiore Einstein’s more than 60 years of leadership in heart care — and we’re not slowing down.
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