Heart failure
Epidemiology
In France, approximately 1 million people are affected by heart failure , 120,000 new cases are diagnosed each year , 20% of the population will develop HF or approximately 150,000 hospitalizations per year are due to CI and it continues to increase, it is considerable: theheart failure is a major public health problem.
It is a pathology mainly in adults linked to all the risk factors for cardiovascular and metabolic diseases and aging.
Causes / Risk factors
The main causes of heart failure are acquired : coronary insufficiency with in particular after a myocardial infarction, arterial hypertension, cardiomyopathies, aging, valve pathologies, inflammation of the heart such as myocarditis, certain anti-cancer chemotherapies, alcoholism, etc.
There are also genetic causes responsible for so-called familial or primary cardiomyopathies. There are several forms of cardiomyopathy: hypertrophic, dilated, restrictive or infiltrative, and arrhythmogenic right ventricular dysplasia.
Symptoms and severity
The main consequence of heart failure is a limitation in the exercise capacity of patients. This ranges from a drop in athletic performance to a limitation in daily activities. Clinically, this limitation is manifested by shortness of breath, weight gain, edema and fatigue; these symptoms are often of little concern to patients who blame them on a lack of physical activity or aging. It’s a serious illness since despite improved care, approximately 1 in 2 patients will die 5 years after diagnosis , and hospitalizations are frequent during flare-ups. The causes of death are linked either to progressive and terminal deterioration of the pump, or to sudden death linked to the unexpected occurrence of a cardiac arrhythmia.
How is it treated?
Over the past 30 years, considerable progress has been made in the treatment of heart failure.
Alongside the old drug treatments, diuretics, venous vasodilator, digitalis, progress has come from the advent of new classes of drugs: inhibitors of the renin angiotensin system and aldosterone which control the salt and water content of the drug. ‘organization; beta-blockers which are antagonists of the sympathetic system, more recently inhibitors of the degradation of natriuretic peptides and inhibitors of cellular transporters of sodium and glucose. These different therapeutic classes have shown that they are capable of prolonging survival and reducing the risk of hospitalization.
Resynchronization
Thanks to the implantation of a particular pacemaker, we can allow the heart to contract harmoniously, this is resynchronization, a real therapeutic revolution.
A defibrillator can be implanted to prevent sudden death, a leading cause of death in patients with heart failure.
Resumption of physical activity, therapeutic education, remote monitoring
The resumption of physical activity is one of the pillars of the treatment of heart failure, its effectiveness on quality of life is perfectly established, that on survival very probable. Therapeutic education and patient support programs play a significant role in helping patients cope with their disease on a daily basis. Telemedicine monitoring of patients is expanding
Heart transplant
It is the ultimate solution reserved for a small number of patients because it is limited by the number of grafts available. The development of circulatory assistance technologies, which make it possible to overcome severe heart failure or sometimes to be permanently implanted, makes it possible to compensate for the lack of available grafts. These techniques consist in the implantation of a pump which will overcome the dysfunction of the heart.
Is there any research on this pathology?
This is one of the most active fields of cardiovascular research, from molecular and cellular bases, in particular the identification of genes, to new treatments and the development of multidisciplinary care pathways between city and hospital. It is a very dynamic sector of telemedicine.
ICAN's response
From basic research to patient care, the IHU teams are at the forefront. They were pioneers in the identification of genes involved in the primitive forms of cardiomyopathies and in the use of certain biomarkers. They have also contributed to better understanding the molecular and cellular bases of heart failure, one of the outstanding results was the identification of the first target for gene therapy in heart failure.
First heart transplant center in France , among the first for the care of heart failure patients, reference center for family health, every day the teams continue to advance the care and care pathway for patients with heart failure.
