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Winter 2009

Close Monitoring Benefits Patients with Heart Failure


New tools enable doctors to remotely check on patients, potentially lowering the risk of hospitalization and mortality.

Millions of Americans living with heart failure have benefited over the past decade or more from medications such as ACE inhibitors and beta-blockers. Now, heart failure treatment is being further enhanced by the ability of cardiologists to closely monitor how their patients are responding to these therapies and make adjustments accordingly.

“Applying evidence-based therapies for heart failure and closely monitoring these patients can prevent hospitalizations and mortality in this high-risk patient group,” says Gregg C. Fonarow, M.D., director of the UCLA- Ahmanson Cardiomyopathy Center.

New tools are making this closer monitoring possible. For example, tests to determine if certain proteins in the blood, so-called biomarkers, are elevated can indicate a potential worsening of a patient’s condition, even if there are no symptoms. “Research at UCLA and other centers has demonstrated that these blood tests provide important information regarding heart failure patients’ prognosis, and they may help in judging response to therapy,” Dr. Fonarow says.

In addition, implantable devices to treat heart failure are now available with built-in sensors that allow the medical team to remotely monitor heart failure patients while they are at home. The devices can transmit, via the Internet or phone lines, valuable information such as how much fluid might be present in the lungs, whether arrhythmias are developing and how well the devices are functioning.

Dr. Fonarow and his team are studying how managing patients based on the additional data provided by remote monitoring is affecting clinical outcomes. “Already we are seeing impressive examples in which the information we obtain helps us to pick up on early warning signs and proactively manage these patients before they develop more serious symptoms that might lead to their hospitalization,” he says.

Heart failure leads to more than one million hospital admissions each year. Nearly half of discharged patients are rehospitalized within six months, and one-third die within a year of their first hospitalization.

“To be able to follow the patients’ progress in such an unprecedented way, through the use of biomarkers and the built-in monitoring functions in implantable devices, represents a new frontier in our ability to improve the quality of care and survival outcomes for heart failure,” Dr. Fonarow says.

Heart Failure Defined

Heart failure is a condition that develops over time in which the heart can’t pump blood the way it should. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t send blood to the rest of the body with enough force. Some people have both problems. “Heart failure” doesn’t mean that your heart has stopped or is about to stop working. However, it’s a serious condition that requires medical care.

Source: National Heart, Lung and Blood Institute, National Institutes of Health

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