Heart Failure is a progressive chronic disorder that results in the inability of the heart to pump blood efficiently to the body’s tissues.
Chronic heart failure is an increasing public health problem; the growing prevalence in industrialised countries means that 1-2% of the adult population of these countries are now thought to have chronic heart failure.1-3 Estimates suggest that the prevalence in Europe, USA and Japan could increase by approximately 16.5% over the next ten years.4
The prevalence of post-myocardial infarction heart failure is less well known as it is difficult to distinguish between pre-existing and incident heart failure. However current estimates suggest that approximately 1 in 5 patients hospitalised with an acute coronary syndrome either present with heart failure or develop heart failure during their hospital stay.5
Many of the signs and symptoms of heart failure are non-specific and vary in severity depending on the disease class. The most common of these are breathlessness, fatigue, exercise intolerance, and fluid retention as evidenced by ankle swelling, peripheral oedema, and an elevated jugular venous pressure.6
Due to the non-specific nature of symptoms, the diagnosis of heart failure can be difficult. Tests can include echocardiogram, ECG, chest X-ray, laboratory tests. Following a positive diagnosis heart failure is classified into functional classes that relate to disease severity.
Management of heart failure involves lifestyle modifications, pharmacological treatment and occasionally surgery. In patients with chronic heart failure, optimal therapy involves treatment with diuretics, ACE inhibitors, certain β-blockers and a mineralocorticoid receptor antagonist.
The Heart Failure Knowledge Centre brings together current information related to chronic heart failure and post-myocardial infarction, including:
Zannad F, et al. Incidence, clinical and etiologic features, and outcomes of advanced chronic heart failure: the EPICAL Study. Journal of the American College of Cardiology 1999; 33(3):734-742.
Cowie MR, et al. The epidemiology of heart failure. European Heart Journal 1997;18(2):208-225.
Mosterd A, Hoes A. Clinical epidemiology of heart failure. Heart 2007; 93:1137-1146.
Decision Resources. Chronic Heart Failure. Cardium Study No.4 A Pharmacor Service. 2008.
Steg PG, Dabbous OH, et al. Determinants and prognostic impact of heart failure complicating acutecoronary syndromes. Observations from the Global Registry of Acute Coronary Events (GRACE). Circulation2004;109:494-9.
NICE Clinical Guideline No 108. Chronic Heart Failure. National clinical guideline for diagnosis and management in primary and secondary care. 2010.
Hepatitis can be caused by many different things including viral infections, parasites, bacteria, chemicals, autoimmunity, drugs or alcohol. Of these, viral infection is the most common cause of chronic (long-term) hepatitis, which can lead to severe liver damage including cirrhosis and liver cancer.
Hepatitis B and C viruses (HBV and HCV) are among the world’s most common infectious pathogens. It is estimated that 500 million people – 1 in 12 of the global population – are chronically infected with one or both of these viruses.1,2 The majority of these people live in the developing world and many of them are unaware that they are infected. Chronically infected patients are at increased risk of developing cirrhosis, hepatic decompensation and hepatocellular carcinoma (HCC), which together account for more than 1 million deaths annually.3
The hepatitis B virus is a resilient virus present in all bodily fluids of infected individuals. It is resistant to breakdown and able to survive outside the body. It can be transmitted effectively through contact with infected bodily fluids in the same way as HIV. However, HBV is 50–100 times more infectious than HIV.
The primary objective of therapy for chronic HBV is to achieve control of viral replication and halt disease progression/improve liver histology. This will decrease pathogenicity and infectivity and thereby stop or reduce hepatic necroinflammation.
Chronic hepatitis C infection may result in severe liver damage leading to liver failure, HCC and death. As a consequence, therapeutic intervention can arrest, and perhaps even reverse, the disease before irreversible liver damage occurs.
1. World Health Organization. World Health Organization Hepatitis B Fact Sheet. 1998. 2. World Hepatitis Alliance. www.aminumber12.org 3. Lai CL, Ratziu V, Yuen MF, Poynard T. Viral hepatitis B. Lancet 2003;362:2089–94
The Anti-Infectives Knowledge Network – Clostridium difficile infections (AIKN-CDI), an initiative by Astellas Pharma EMEA, shares the expertise and experience of thought leaders in the area of anti-infectives.
Opportunity to participate in the second round of the largest ever clinician consensus report through completing a questionnaire. Subsequent recommendations will be made based on the data collected from this questionnaire
Please remember to return often to read updated news, clinical insights, and essential information from the latest congresses.
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