In 2018, 6.2 million people were living with HF in the United States alone, and HF accounted for 13% of total mortality 10. Despite these improvements in the standard of care, advanced HF remains associated with significant morbidity and mortality 10. This includes treatment with beta blockers 1, renin-angiotensin-aldosterone system antagonists 2 3 4, angiotensin receptor-neprilysin inhibitors (ARNI) 5, implantable cardiac defibrillator (ICD) use 6, cardiac resynchronisation therapy (CRT) 7 and more recently, the use of sodium-glucose cotransporter-2 (SGLT-2) inhibitors 8 9. There have been significant advances in the management of patients living with HF, particularly HF with reduced ejection fraction (HFrEF). Heart failure (HF) is a progressive syndrome characterised by maladaptive remodelling of cardiac chambers, increased wall stress and neurohumoral activation that perpetuate increased myocardial wall stress with volume overload and a risk of end-stage pump failure.
In this review, we will explore the physiology, rationale, and current stages of the clinical development of the existing procedures. They target well-defined mechanistic and pathophysiological processes critical to the progression of heart failure including left ventricular remodelling, neurohumoral activation, and congestion. In the last decade, there has been a rapid rise in the use of non-valvular catheter-based therapies for the management of chronic heart failure to complement existing guideline-directed management.
There is a growing need for research and development of additional modalities to fill the management and treatment gaps, reduce hospitalisations and improve the quality of life for patients living with heart failure. Additionally, pet insurance options are available to provide added financial security for your pets' healthcare needs.Despite significant advances in the medical management of patients living with heart failure, there continues to be significant morbidity and mortality associated with the condition.
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