Heart Failure - Therapeutic Options
Scope
Report Highlights
Reasons to Purchase
Table of Contents
- ABOUT DATAMONITOR HEALTHCARE - page 2
- About the cardiovascular analysis team - page 2
- CHAPTER 1 EXECUTIVE SUMMARY - page 3
- Scope of the analysis - page 3
- Datamonitor insight into available therapies in advanced heart failure - page 4
- Contributing experts - page 5
- CHAPTER 2 HEART FAILURE DEFINITIONS AND PATHOPHYSIOLOGY - page 7
- Definition of heart failure - page 7
- Acute heart failure - page 7
- Chronic heart failure - page 8
- Etiology of heart failure - page 9
- Segmentation of heart failure - page 10
- Disease severity - page 10
- Low versus high output failure - page 15
- Systolic versus diastolic heart failure - page 15
- Age group - page 17
- Segmentation of heart failure - page 10
- Co-morbidities, complications and risk factors - page 17
- Definition of heart failure - page 7
- CHAPTER 3 EPIDEMIOLOGY - page 22
- Epidemiology of heart failure - page 22
- Future incidence of acute heart failure - page 22
- Future prevalence of chronic heart failure - page 23
- Future trends in the incidence and prevalence of heart failure - page 23
- Epidemiology of heart failure - page 22
- CHAPTER 4 DIAGNOSIS AND INVESTIGATION - page 25
- Diagnosis - page 25
- Symptoms - page 25
- Neurohormonal activation markers - page 28
- Novel biomarkers - page 29
- Role of medical imaging in heart failure - page 29
- Chest x-ray - page 30
- Echocardiography - page 30
- Nuclear perfusion tests - page 31
- Role of MRI in coronary heart disease diagnosis - page 33
- Diagnosis - page 25
- CHAPTER 5 BASIC PHARMACOLOGICAL THERAPY - page 34
- Drug classes in heart failure - page 34
- ACE inhibitors - page 34
- Angiotensin II receptor blockers - page 35
- Diuretics - page 36
- Betablockers - page 36
- Digoxin - page 37
- Antithrombotics - page 38
- Calcium channel blockers - page 38
- Drug classes in heart failure - page 34
- CHAPTER 6 DEVICE THERAPIES IN HEART FAILURE - page 40
- Treatment options in advanced heart failure - page 40
- Heart transplantation - page 40
- Fundamental differences between drugs and devices - page 43
- Arrhythmia Devices in Heart Failure - page 44
- Ventricular dyssynchrony - page 44
- Role of ICD therapy - page 45
- Historical development of ICD device therapy - page 46
- Indications and guidelines for ICD therapy - page 52
- Cardiac resynchronization therapy - page 53
- CRT-P vs. CRT-D vs. ICD - page 59
- Limitations of cardiac resynchronization therapy - page 59
- Guidelines and indications - page 60
- Novel technologies - page 61
- Prevention with advanced biosensors - page 61
- Less invasion with leadless technology - page 62
- Cardiac contractility modulation therapy - page 62
- Mechanical circulatory support devices - page 63
- Ventricular Assist Devices - page 64
- Historical developments and design transformation - page 66
- Pulsatile design - page 67
- Rotary design and continuous flow - page 79
- Guidelines and indications for mechanical assistance - page 96
- Total artificial heart devices - page 101
- Counterpulsation devices without blood contact - page 105
- Short-term mechanical assistance - page 107
- Extracorporeal membrane oxygenation (ECMO) - page 107
- Intra-aortic Balloon Pumps - page 108
- Percutaneous transseptal circulatory assist devices - page 109
- Passive containment devices - page 113
- Future technology with artificial heart muscle - page 117
- Problems associated with mechanical circulatory assist devices - page 118
- Biocompatibility, coagulation control and device surfaces - page 119
- Infection and external components - page 120
- Power sources, size and patient mobility - page 122
- Mechanical durability - page 123
- Future directions and industry challenges - page 125
- Summary of design trends - page 126
- Telemedicine for heart failure management - page 127
- Device availability - page 127
- FDA approved devices - page 129
- Ventricular Assist Devices - page 64
- Treatment options in advanced heart failure - page 40
- APPENDIX A - page 132
- Methodology - page 132
- Epidemiology - page 132
- Incidence of acute heart failure - page 132
- Prevalence of chronic heart failure - page 134
- Epidemiology - page 132
- Methodology - page 132
- APPENDIX B - page 137
- Report methodology - page 137
- Bibliography - page 137
- APPENDIX C - page 140
- About Datamonitor - page 140
- About Datamonitor Healthcare - page 140
- About the cardiovascular analysis team - page 141
- Disclaimer - page 142
- List of Tables
- Table 1: Causes of heart failure in the seven major markets (%), 2004 - page 10
- Table 2: Prevalence of chronic heart failure by age group in the seven major markets (000s), 2005 - page 17
- Table 3: Estimated proportion of chronic heart failure patients with co-morbid conditions and risk factors in the seven major markets (%), 2004 - page 18
- Table 4: Estimated incidence of acute heart failure in the seven major markets (000s), 2008-2016 - page 22
- Table 5: Future estimated incidence of chronic heart failure in the seven major markets (000s), 2008-2016 - page 23
- Table 6: Symptoms used in the diagnosis of chronic heart failure in the seven major markets, 2004 - page 25
- Table 7: Symptoms observed in chronic heart failure patients in the seven major markets, 2004 - page 26
- Table 8: Tests used in the diagnosis of chronic heart failure in the seven major markets, 2004 - page 27
- Table 9: Proportion of patients with chronic heart failure receiving each diagnostic test, 2004 - page 28
- Table 10: Historical development of ICD device therapy - page 47
- Table 11: Major clinical trials for CRT - page 54
- Table 12: Indications for CRT-D vs. ICD - page 59
- List of Figures
- Figure 1: Segmentation of diagnosed chronic heart failure patients by disease severity, 2004 - page 11
- Figure 2: ACC/AHA practice guidelines for the evaluation and management of chronic heart failure, 2005 - page 13
- Figure 3: Relationship between cardiac dysfunction, heart failure and heart failure rendered asymptomatic, as defined by the European Society of Cardiology - page 14
- Figure 4: Breakdown of heart failure patients according to whether failure is systolic, diastolic or both in 7MM, 2004 - page 16
- Figure 5: Staging of heart failure and associated interventions - page 42
- Figure 6: Prevalence of atrial fibrillation (AF) in heart failure patients - page 45
- Figure 7: Current CRT devices - page 52
- Figure 8: Ventricular assist devices and components - page 65
- Figure 9: Types of ventricular assist devices - page 66
- Figure 10: Modern pulatile ventricular assist pump - page 68
- Figure 11: Centrifugal flow ventricular assist system - page 83
- Figure 12: Jarvik Heart - page 90
- Figure 13: HeartMate II - page 91
- Figure 14: INCOR BerlinHeart - page 93
- Figure 15: CardioWest Total Artificial Heart - page 102
- Figure 16: Examples of counterpulsation devices - page 107
- Figure 17: TandemHeart pVAD - page 110
- Figure 18: Acorn CorCap - page 115
- Figure 19: Type and rates of device-related complications - page 118
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