However, Yancy noted, "just a few years ago we had nothing we could say that was particularly encouraging. It wasn't a disease for which there was much hope or optimism. But that has totally turned around now."
Fonarow credits the shift to a decade of drug and medical device innovation. On the one hand, there is the advent of whole new classes of medications -- such as ACE inhibitors, beta blockers and aldosterone antagonists -- that help lower the risk for developing heart failure, while expanding treatment options when it does strike.
And, Yancy added, "We also know that cardiac rehabilitation -- namely an exercise regimen -- can also help. Years ago, we told patients to just take it easy. But, now we know that an active vigorous lifestyle is actually a better way to go."
At the same time, Fonarow pointed to the rise of small, affordable and effective implantable electrical devices that have helped physicians better control the sort of electrical disturbances of the heart that can harm normal function.
"Even for the patient with far advanced disease, the utility of mechanical support -- artificial heart pumping devices -- has become remarkable," Fonarow noted. "We can sustain patients for a time sufficiently long enough to not only allow for heart transplantation, but also to serve as definitive therapy and, even more provocatively, to support recovery of heart muscle function."
The result: over the past decade heart failure hospitalizations have actually declined, while the risk of death has plummeted 65 percent to 80 percent, Fonarow said. "What was once a dismal and depressing diagnosis, with an over 50 percent five-year mortality rate, is now a clinical scenario for which optimism and new hope emerges."
The future of heart failure treatment looks even brighter, said Yancy, given developments now under way that r
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