Heartfelt with Dr Melissa Walton-ShirleyView all posts »
Congestive Heart Failure Outlook Still ENCOURAGING: Remains a HOT topic for ACC 09Apr 2, 2009 07:36 EDT
Not until I sat down to enumerate the number of CHF related ACC topics did I understand just how many trials were presented this year that could potentially impact our practices. For excellent commentary and insight on these presentations provided by Dr. Clyde Yancy, the AHA's 2008-2009 president elect, please watch for the upcoming Heart Failure segment on the Cardiology show.
Just to give you a preview: The peptide Vaodilator Relaxin was utilized in acute heart failure in a dose finding study. REVERSE , a European trial in which CRT was utilized in mild heart failure patients demonstrated a benefit. We discussed the STITCH trial and whether there are truly STITCH patients still out there who should not be orphaned by a trial that did not distinguish between dykinesia and akinesia. I was particularly excited about the new LVAD, Ventrassit and its durability and broader application to other chest dimensions. Fix-HF 5 taught us a new phrase, cardiac contracility modulation which hints at yet another device driven application for reducing CHF symptoms and PRIMA questions the utilization of using proBNP in our post discharge acute HF patients. Another trial proved that cancer patients treated with anthracyclines are NOT being referred for timely echocardiography and worse yet, not being treated with beta blockers EVEN WHEN they already have baseline LV dysfunction. We need to speak to our oncolocy colleagues about that.
I commented to Dr. Yancy that in the old days, I dreaded to go to the bedside of a CHF patient. Besides fluid and sodium restriction, there was only Lasix and perhaps nitrates and hydralazine to offer. Now, I actually look forward to going into those rooms, rolling up my sleeves as I walk.
I'm amazed at how far we have come. The ACC 2009 gives us a window into the future of how far we may be going.