Why the study?
Pathologic left ventricular remodeling and valvular heart disease can limit the effectiveness of guideline-directed medical therapy in heart failure, and growing evidence supports transcatheter interventions when surgical options are limited. This scientific statement reviews available and investigational percutaneous strategies for managing these structural contributors.
This scientific statement reviews current and investigational percutaneous strategies for managing structural contributors to heart failure, such as dilated left ventricular cardiomyopathies and valvular heart disease, in patients with persistent symptoms despite optimal medical therapy.
Structural cardiac interventions in heart failure may be feasible; Level 5 data leaves open outcome impact pending prospective trials.
Pathologic left ventricular remodeling and valvular heart disease may contribute to the clinical presentation and outcomes of patients presenting with heart failure, and limit the effectiveness of guideline-directed medical therapy. Although surgical interventions including surgical ventricular restoration techniques and valve repair or replacement are effective therapies, there is growing evidence that transcatheter interventions may be options for patients with persistent symptoms of heart failure despite optimal medical therapy, where surgical options may be limited. This scientific statement will review the current available and investigational percutaneous strategies for the management of structural contributors to heart failure: dilated left ventricular cardiomyopathies and valvular heart disease.
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Hahn et al. (2024) conducted a review in Heart failure with dilated left ventricular cardiomyopathy or valvular heart disease. Transcatheter/percutaneous structural cardiac interventions vs. Guideline-directed medical therapy or surgical interventions was evaluated. Transcatheter structural cardiac interventions are emerging options for patients with persistent heart failure symptoms despite optimal medical therapy when surgical options are limited.
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