Professor von Lewinski discusses why cardiac index and frequency are key features in heart failure. What differences are there in preload and afterload in a normal heart compared to a failing heart and what can be done to overcome this?
Although AdHF syndrome is now well defined and characterised, guideline-directed therapy is by definition inadequate. Dr Yerly explains when heart transplantation, left ventricular assist device (LVAD), or use of inotropes should be considered and why.
In AdHF and AHF, hospitalisations for worsening symptoms are significant predictors of increased mortality. Can a window of opportunity be harnessed to avert haemodynamic deterioration? Is intermittent levosimendan a viable option to avoid rehospitalisation?
Dr Dimitrios presents an insightful case study and looks at the rationale for the patient’s course of treatment in the CCU, on ward and at discharge. A particular focus is given to the pleiotropic effects of levosimendan and its unique triple mechanism of action which is an advantage in treating AHF due to ACS.
Can disease outcomes of New York Heart Association (NYHA) Class 4 patients be improved with inotropic or vaso-active drugs? Dr Karason explores the pathophysiology of AHF taking a closer look at the effect of disturbances in haemodynamic balance at the central, local renal and microvascular level. Which interventions and inotropes should be used in different clinical settings?