Letters Congestive heart failure

Advances in management

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c4280 (Published 10 August 2010) Cite this as: BMJ 2010;341:c4280
  1. Jonathan R Dalzell, specialty registrar in cardiology1,
  2. Mark C Petrie, consultant cardiologist2,
  3. Roy S Gardner, consultant cardiologist2
  1. 1Victoria Infirmary, Glasgow G42 9TY
  2. 2Scottish Advanced Heart Failure Unit, Golden Jubilee National Hospital, Glasgow G81 4HX
  1. j.dalzell{at}nhs.net

    Arroll and colleagues’ review of the management of congestive heart failure1 disregards much of the progress made since the previous BMJ review of this topic in 2002.2 They concentrated on established pharmacotherapy at the expense of groundbreaking developments that have occurred over this time.

    Angiotensin II receptor blockade has been shown to benefit patients with low ejection fraction heart failure who already take or are intolerant of angiotensin converting enzyme inhibitors.3 Cardiac resynchronisation therapy now plays a major role in improving morbidity and mortality in patients with advanced4 and, more recently, milder symptoms. Ventricular assist devices have emerged as a life changing treatment in selected patients with end stage heart failure.5

    Despite advances in treatment, morbidity and mortality in heart failure remain high. It is therefore crucial that important advances are relayed promptly and accurately to generalists and non-heart failure specialists involved in the management of heart failure who decide on the appropriateness of potentially crucial specialist referral.


    Cite this as: BMJ 2010;341:c4280


    • Competing interests: None declared.


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