Tailoring Heart Failure Therapy
http://www.100md.com
《新英格兰医药杂志》
Heart failure is becoming the most important cardiovascular health problem worldwide. Although survival with other cardiovascular diseases is improving significantly, patients who have a compromised myocardium become susceptible to heart failure. Approximately 5 million people suffer from the disease in the United States alone, and half a million new cases are diagnosed every year. An increased life expectancy is adding to the growing number of cases. Annually, heart failure is associated with approximately 15 million hospital visits, 1 million hospital admissions for 6.5 million days, and about 250,000 deaths, and the disease necessitates an annual health care expenditure of approximately $25 billion. The financial burden is bound to increase tremendously as devices such as biventricular pacemakers and defibrillators are implanted more frequently. The enormity of the situation behooves physicians to develop better strategies for the prevention of heart failure and guidelines for the optimal management of the disease, drawing on the lessons learned 50 years ago from the epidemic of coronary artery disease.
Some of the best clinical investigators in the field have written chapters in this book with impeccable literary and technical finesse. Such an approach is welcome in addressing the day-to-day treatment of specific categories of patients with heart failure, since many of these patients — including the elderly, pregnant women, black patients, and patients with renal failure — have different needs and management objectives. The authors also address the subgroups of patients who have coronary artery disease, idiopathic cardiomyopathy, valvular disease, and peripheral vascular disease. The book deals deftly with electrophysiology and the implantation of devices, which has become the most important and attractive subdiscipline within the field, and devotes a full chapter to the causative and consequent role of depression in heart failure. Similarly, a chapter is dedicated to the ongoing saga of diastolic heart failure.
This book, one of several works that have been published recently about heart failure, provides simple reading for internists and primary care physicians but is not intended to deal with such topics as pathogenesis, presentation, and advances in noninvasive techniques of diagnosis. For those who specialize in the care of patients with heart failure, a combination of textbooks may be required for comprehensive management of this disease.
Hein J. Wellens, M.D.
Cardiovascular Research Institute
6211 TG Maastricht, the Netherlands
hwellens@xs4all.nl(Edited by Ronnie Willenhe)
Some of the best clinical investigators in the field have written chapters in this book with impeccable literary and technical finesse. Such an approach is welcome in addressing the day-to-day treatment of specific categories of patients with heart failure, since many of these patients — including the elderly, pregnant women, black patients, and patients with renal failure — have different needs and management objectives. The authors also address the subgroups of patients who have coronary artery disease, idiopathic cardiomyopathy, valvular disease, and peripheral vascular disease. The book deals deftly with electrophysiology and the implantation of devices, which has become the most important and attractive subdiscipline within the field, and devotes a full chapter to the causative and consequent role of depression in heart failure. Similarly, a chapter is dedicated to the ongoing saga of diastolic heart failure.
This book, one of several works that have been published recently about heart failure, provides simple reading for internists and primary care physicians but is not intended to deal with such topics as pathogenesis, presentation, and advances in noninvasive techniques of diagnosis. For those who specialize in the care of patients with heart failure, a combination of textbooks may be required for comprehensive management of this disease.
Hein J. Wellens, M.D.
Cardiovascular Research Institute
6211 TG Maastricht, the Netherlands
hwellens@xs4all.nl(Edited by Ronnie Willenhe)