A treatment strategy of elderly patients with heart failure

Abstract

Abstract:The number of patients with heart failure （HF） has been rapidly increasing with aging.　Despite the recent advancement in medical therapy, mortality rates of heart failure remain still high, and the hospitalization cost of HF is a significant concern worldwide.　This article has focused on valvular heart diseases and cardiac amyloidosis, which are leading causes of HF in the elderly population.　Several randomized trials have demonstrated that transcatheter aortic-valve implantation （TAVI） reduces mortality in high-risk patients with severe aortic stenosis.　Additionally, transcatheter mitral-valve repair （TMVr） improves clinical outcomes in patients with HF who have mitral regurgitation due to left ventricular dysfunction.　Transcatheter approach is much less invasive and can be performed in high-risk patients who are not candidates for surgical replacement.　Furthermore, after transcatheter treatments, patients can be discharged and returned to a normal life earlier than surgical procedures.　Recently, two novel therapeutic agents are available for cardiac amyloidosis.　Randomized clinical trials have shown that tafamidis and patisiran reduce all-cause mortality in patients with transthyretin amyloid cardiomyopathy.　With these advanced medical treatments, our goal is to reduce cardiovascular mortality in Fukushima.