Biography
Biography: Mridula Dhakad
Abstract
Fight against reducing the disability in heart failure patients is on and tremendous advancements in management of such patients with low ejection fraction over past few decades has improved the prognosis. Wealth of research data is available on this, wherein the scientists have delved deep into studying the apoptosis of myocytes and how the failing cells can be brought back into function by targeting the maladaptive neurohormonal pathways. Across the spectrum of the heart failure patients, the following range of pharmacotherapy prescribed over the past years has definitely lowered the hospital admission rates and prolonged survival but still the readmission rates are high and financial burden on the healthcare systems are alarming–diuretics, renin-angiotensin-aldosterone system inhibitors, B-blockers, digoxin and vasodilators being the mainstay of therapy. The discovery of two new classes of drugs has marked a new beginning in the care of chronic heart failure patients. Ivabradine and sacubitril/valsartan seem to be promising agents in improving the functional capacity and quality of life, reducing the hospital readmission rates and mortality. They reduce the stress on the myocardium by reducing the heart rate and improve the blood flow by relaxing the vessels thereby improving clinical outcomes. End stage heart failure patients still queue up for heart transplantation worldwide but lack of available donors necessitates them to use ventricular assist devices (like LVAD) as a bridge therapy in capable centers. ECMO also has been used for short term circulatory support. The key focus in this talk will be on novel drug treatment for systolic heart failure.