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(Circulation. 1997;95:771-772.)
© 1997 American Heart Association, Inc.

Articles

Fixing the Failing Heart

Claude Lenfant, MD

Correspondence to Claude Lenfant, MD, NHLBI, NIH, 31 Center Dr, Bldg 31, MSC 2486, Bethesda, MD 20892.

Key Words: aging • cardiovascular diseases • heart failure

	Introduction

 
Heart failure has emerged as an enigma in cardiovascular medicine. In contrast to the overall trend of decreasing death rates attributable to heart disease and stroke, the prevalence of heart failure and the resultant death toll are greater than ever before. Moreover, the improved diagnostic, preventive, and therapeutic methods now available for most cardiac disorders have barely made a dent in the prognosis for patients with heart failure. Despite reversal of symptoms, standard treatment for heart failure is associated with only a modest improvement in survival. Transplantation remains the only effective therapy for patients with severe end-stage disease, and that option is very much limited by a shortage of donor organs.

To those of us who are committed to alleviating the health burden of cardiovascular disease in the nation, heart failure represents at once the best, most pressing research opportunity and the worst, most difficult clinical problem. Its increasing prevalence accentuates the gulf between our accomplishments, which have been substantial in improving the nation's cardiovascular health, and the work that is still needed.

Annual heart failure death rates in the United States tripled between 1974 and 1994, and the morbidity from this disease, which leaves patients exhausted and bedridden, is staggering. Ironically, the upward trend in heart failure is likely an undesired outcome of advances in reducing mortality from coronary heart disease, hypertension, and stroke. More Americans than ever before are surviving with what heretofore would have been fatal heart disorders, and these survivors, as well as the elderly population . . . [Full Text of this Article]

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