Integrated management of cardiac failure: the cardiac failure clinic

Integrated management of cardiac failure: the cardiac failure clinic

Abstract

The prevalence of the risk factors and the risk of cardiac failure are both increasing in China. This might be the consequence of the changes of the life conditions (emigration to the urban areas, changes in the diet and life style, lack of physical exercise, etc.). The wide range of clinical presentations of cardiac failure (acute or chronic) and of therapeutic approaches (medical or surgical) makes necessary the integration within the same structure of the various experts involved in the diagnosis and the treatment of cardiac diseases. Technologic and human resources required to offer all the options represent a multifaceted commitment which should be focused optimally in dedicated centers. In these centers, collaboration should replace competition between the medical and the surgical cardiac specialists. Development of team work should permit to optimize the cost efficacy of the treatments. Most of all, such a structure will facilitate the translation of innovative therapies between the research centers and clinical facilities.

Keywords

cardiac failure / cardiac transplantation / mechanical circulatory support

参考文献

[1] Report on cardiovascular diseases in China. 2009. Hu Shengshou, Kong Lingzhi editors, National Center of Cardiovascular Diseases Encyclopdia of China Publishing House

[2] Warner-Stevenson L. The evolving role of mechanical circulatory support in advanced heart failure. In: Frazier OH, Kirklin JK, eds. Mechanical circulatory support. ISHLT Monography: Elsevier Publisher, 2006:181–201

[3] Lewis E F, Johnson P A, Johnson W, Collins C, Griffin L, Stevenson L W. Preferences for quality of life or survival expressed by patients with heart failure. J Heart Lung Transplant, 2001, 20(9): 1016–1024

[4] Buckberg G D. Rethinking the cardiac helix—a structure/function journey: overview. Eur J Cardiothorac Surg, 2006, 29(Suppl 1): S2–S3

[5] Kirsch M, Vermes E, Radu C, Streich B, Nakashima K, Mekontso-Dessap A, Loisance D. Impact of preoperative hemodynamic support on early outcome in patients assisted with paracorporeal Thoratec ventricular assist device. Eur J Cardiothorac Surg, 2008, 34(2): 262–267

[6] Rose E A, Gelijns A C, Moskowitz A J, Heitjan D F, Stevenson L W, Dembitsky W, Long J W, Ascheim D D, Tierney A R, Levitan R G, Watson J T, Meier P, Ronan N S, Shapiro P A, Lazar R M, Miller L W, Gupta L, Frazier O H, Desvigne-Nickens P, Oz M C, Poirier V L. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med, 2001, 345(20): 1435–1443

[7] Hill D, Portner P, Loisance D. Positive displacement ventricular assist devices. In: Frazier OH, Kirklin JK eds. Mechanical circulatory support. ISHLT Monography: Elsevier Publisher, 2006: 53–75

[8] Loisance D Y, Pouillart F, Benvenuti C, Deleuze P H, Mazzucotelli J P, Le Besnerais P, Mourtada A. Mechanical bridge to transplantation: when is too early? When is too late? Ann Thorac Surg, 1996, 61(1): 388–390, discussion 391-392

[9] Loisance D. Mechanical circulatory support: a clinical reality. Asian Cardiovasc Thorac Ann, 2008, 16: 416–431

版权

2014 Higher Education Press and Springer-Verlag Berlin Heidelberg