Natural history of end-stage LV dysfunction: has it improved from the classic Franciosa and Cohn Graph?

Cardiol Clin. 2011 Nov;29(4):485-95. doi: 10.1016/j.ccl.2011.08.012.

Abstract

The pathophysiology of heart failure is complex, and downstream effects cause decline in multiple systems. Medical therapies intended to slow or reverse disease progression have been shown to improve prognosis in prospective trials. Improvement in prognosis has also been observed in large cohorts across time strata. However, near-term mortality for those with advanced disease remains unacceptably high. Prognosis in advanced heart failure may be assessed with the appropriate use of clinical prediction tools. Optimal timing of evaluation for heart transplantation and/or mechanical circulatory support depends on an understanding of these issues.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Benzazepines / therapeutic use
  • Cardiac Resynchronization Therapy
  • Defibrillators, Implantable
  • Heart Failure / diagnosis
  • Heart Failure / etiology*
  • Heart Failure / therapy
  • Heart-Assist Devices
  • Humans
  • Hydralazine / therapeutic use
  • Ivabradine
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Nitrates / therapeutic use
  • Renin-Angiotensin System / physiology
  • Risk Factors
  • Survival Analysis
  • Sympathetic Nervous System / physiology
  • Treatment Outcome
  • Ventricular Dysfunction, Left / etiology*
  • Ventricular Dysfunction, Left / therapy
  • Ventricular Remodeling / physiology

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Benzazepines
  • Mineralocorticoid Receptor Antagonists
  • Nitrates
  • Hydralazine
  • Ivabradine