The 4 Stages of Heart Failure
Author: Brian E. Jaski
Foreword by Sidney C. Smith, Jr.
Published March 6, 2015
Format: Paperback and eBook set; eBook
Trim size: 6 x 9 inches
336 pages, full color interior
Print book includes a free digital edition.
Full preview available: cardiotextpublishing.com/4-stages-look-inside/
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This book applies practical clinical concepts to the latest four-stage model of heart failure from preclinical risk and early asymptomatic disease to classic symptomatic heart failure and finally advanced heart failure. This framework emphasizes a tailored approach to ongoing heart failure assessment to guide therapy and improve outcomes.
- Illustrated with over 250 full-color figures
- Specific recommendations backed by clinical trial data
- Practical algorithms for diagnosis and therapy
- Prevention of heart failure
- Identification and treatment of structural heart disease prior to heart failure
- How to combine lifestyle changes, medications, and devices to improve outcomes
- Reversing decompensated heart failure
- Key indicators of advanced heart failure and appropriate treatment options
- Emerging new therapies
Visit Dr. Brian Jaski's Web site on heart failure for patients: http://www.heartfailure.org/
“This book will be valuable to all training and practicing clinicians. He writes as if you and he are both completing patient rounds together. Brian E. Jaski is to be commended for capturing the essence of treating this formidable clinical challenge and demystifying the stages of heart failure.”
--From the foreword by Sidney C. Smith, Jr. MD FACC, FAHA, FESC, FACP
Professor of Medicine, University of North Carolina at Chapel Hill
Past President, American Heart Association
Past President, World Heart Federation
“The culmination of Dr. Jaski’s 25 years of teaching experience and clinical acumen is now available in one highly readable text designed to highlight key information and stimulate the learning process.”
--Dylan E. Wessman, MD, FACC, FACP
Program Director, Cardiovascular Disease Fellowship
Naval Medical Center San Diego
San Diego, California
Brian E. Jaski, MD, FACC
Director of Clinical Research, San Diego Cardiac Center
Medical Director Advanced Heart Failure and Cardiac Transplant
Sharp Memorial Hospital
San Diego, California
About the Author:
Dr. Jaski is a clinical physician, researcher, and teacher. After earning undergraduate degrees in electrical engineering and biology at MIT, he graduated from Harvard Medical School where he subsequently finished his cardiology fellowship at the Brigham and Women’s Hospital. Since 1985, he has been the medical director of the Advanced Heart Failure and Cardiac Transplant program at Sharp Memorial Hospital associated with the San Diego Cardiac Center. He has published extensively in the areas of cardiac pathophysiology, pharmacology, circulatory support devices, and transplant. He is board certified in the subspecialty of Advanced Heart Failure and Cardiac transplant and webmaster of Heart Failure Online (www.heartfailure.org).
Table of Contents
Chapter 1: Heart Failure Diagnosis and Epidemiology
Heart Failure Recognition
Hospitalization Admissions and Readmission
Heart Failure Mortality
Costs of Heart Failure
Chapter 2: Heart Failure Presentations and Functional Types
Heart Failure Designation Based On Left Ventricular Systolic Function
Acute and Chronic Presentations of Heart Failure
Common Causes of Heart Failure
Heart Failure Blunts Exercise Capacity
The Role of Biomarkers BNP and NT-proBNP When Heart Failure Is Suspected
Chapter 3: Stage A: Patients at Risk for Developing Structural Heart Disease
Major Risk Factors and Increasing Prevalence of Heart Failure
Treatable Risk Factors for Heart Failure
Goals for the Management of Heart Failure Risk Factors
Chapter 4: Structural Heart Disease and Progression to Failure: Stages B, C, and D
Morphologic Changes in Heart Failure
Patterns of Maladaptive Hypertrophy
Neurohumoral Circulatory Responses
Intracellular Mechanisms of Progression
Gene Mutations in Heart Failure
Chapter 5: Stage B: Asymptomatic Structural Heart Disease
Who Is the Stage B Pre-Heart Failure Patient?
Neurohumoral Continuum from Stage B to Stage C Systolic Dysfunction
The Continuum from Hypertension to HF-pEF
Cardiac and Noncardiac Interactions
Screening Tests for Stage B Heart Failure
Management of Stage B Patients
Chapter 6: Assessment of Stage C Patients with HF-rEF
The 3 “F”s of Ongoing Heart Failure Assessment
Fit: Do Findings Fit the Diagnosis of Heart Failure?
Function: Is Left Ventricular Systolic Function Abnormal by Echocardiography?
Factors: What Are the Etiologies of Heart Failure?
Important Diagnostic Techniques for Heart Failure
Chapter 7: Assessment of Stage C Patients with HF-pEF
Diagnosis of HF-pEF
Management of Hypertrophic Cardiomyopathy
Restrictive Cardiomyopathy Due to Amyloidosis
Additional Causes of Restrictive Cardiomyopathy
Other Important Causes of Heart Failure Syndrome
Valvular Heart Disease
Congenital Heart Disease
Sleep-Disordered Breathing in Heart Failure
Chapter 8: Stage C: Improving Outcomes in Symptomatic Heart Failure
Evidence-Based Therapies for Patients with HF-rEF
Volume Management with Diuretics
Angiotensin II Inhibition
Beta Adrenoreceptor Blockade
Mineralocorticoid Receptor Antagonists
Neutral Endopeptidase Inhibition
Nitrates and Hydralazine
Electrical Therapies for Heart Failure
Atrial Fibrillation and Heart Failure
Treatment of HF-pEF
Outpatient Hemodynamic Monitoring for Congestion in HF-pEF and HF-rEF Patients
Chapter 9: Stage C: Therapies for Acute Decompensated Heart Failure
Applying The 3 “F”s to Decompensated Heart Failure
Hemodynamic Profiles in Decompensated Heart Failure
Intravenous Vasoactive Drug Therapy and Acute Heart Failure
Comparative Hemodynamic Effects of Intravenous Medications
Mechanical Circulatory Support
Chapter 10: Stage C: Cardiorenal Syndrome
The Cardiorenal Syndrome Definition and Characteristics
Measuring Renal Function
Association of Abnormal GFR and Heart Failure Mortality
Factors Affecting GFR
Management of Heart Failure with Impaired Kidney Function
Chapter 11: Stage D Heart Failure: Options and Opportunities
Who Is the Stage D Heart Failure Patient?
Left Ventricular Assist Device (LVAD)
Chapter 12: A Patient-Oriented Perspective to the 4 Stages of Heart Failure
Outpatient Support and Monitoring
Summary of Therapeutic Approaches to the Four Stages of Heart Failure
Fahad Javed, MD(Ochsner Clinic Foundation)
From a well-known author of multiple publications on cardiovascular disease and research, this book provides comprehensive insights into known etiologies, pathophysiology, clinical presentations, diagnostic procedures, and management strategies for heart failure aimed at clinicians managing these patients and specialists investigating the scientific basis of the various stages of heart failure.
The book fulfills its purpose of providing a deeper understanding of the various stages of heart failure. Its particular strength is the broad, in-depth discussion of clinically relevant topics. Readers will appreciate the illustrative pictures, diagrams, graphs, and tables, which will help in digesting the material.
This is clearly designed for those who routinely care for heart failure patients and advanced level trainees, including cardiologists, researchers, internists, nurse practitioners, and housestaff. The author is an internationally known expert.
After clearly elaborating the epidemiology, morbidity, and mortality associated with heart failure, the book discusses various risk factors that lead to the development of this disease. Then, it provides novel insights into various factors and mechanisms that contribute to the propagation of various stages of heart failure and delivers an overview of available assessment tools and management regimens for each stage of heart failure. Finally, it briefly illustrates how to put the evidence to use in therapeutics for heart failure. It provides the most comprehensive coverage to date of most aspects of the different stages of heart failure, and the interdisciplinary approach makes it valuable to physicians caring for patients with heart failure.
This book underscores the medical importance of recognizing the various stages of heart failure, their economic costs, and the interplay of the various mechanisms/factors involved. It is concise yet comprehensive in its coverage of this important topic. Its spare style lends itself well to the needs of busy physicians who want to quickly look something up related to heart failure.