AHF can be defined as the sudden or gradual onset of the signs or symptoms of heart failure resulting in a need for urgent therapy or hospitalisation.1 It is a life-threatening condition which requires immediate medical attention.
Heart failure occurs when the heart loses its ability to pump blood efficiently through the body and vital organs. 2 Heart failure is a growing problem worldwide with more than 23 million people around the globe being affected by the disease. 3,4 In 2009, there were 4.3 million hospitalisations in the USA and 3.5 million in the EU. 5 The prognosis of heart failure is substantially worse than with most cancers; fewer than half will survive five years; 70% will die within ten. 6 This problem will get progressively worse over time as societies become more developed, populations live for longer and medical research advances further. The American Heart Association estimated the total cost of this chronic disease approached $39.2 billion in 2010. 7
The typical signs of AHF are dyspnoea (shortness of breath) and lower extremity oedema (swelling). AHF might also manifest itself as pulmonary oedema, hypoperfusion (decreased blood flow through an organ) or cardiogenic shock (inability of the heart to pump enough blood to meet the body’s needs).
The quality of life of patients hospitalised with AHF is low (e.g. self-care problems, walking difficulties) and nearly half of those hospitalised with AHF are re-hospitalised within one year. Prognosis is poor, with approximately 30% of patients dying within a year. 8 Therefore, there is an unmet need for new treatments for the early management of AHF that may improve both short- and long-term outcomes.
The treatment of AHF has remained the same for decades. However, new scientific understanding is building momentum towards a paradigm shift in the way AHF is managed, focusing on initiating treatment much earlier (similar to a heart attack) to improve both short-term (alleviate symptoms and stabilise haemodynamics) and long-term (prevent recurrence and improve survival) outcomes for people with AHF.
1. Jessup. M, et al. 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. Circulation. 2009 Apr 14;119(14):1977-2016.
2. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. ESC Guidelines. European Heart Journal doi:10/1093/eurheartj/ehs104
3. Fang J, Mensah GA, Croft JB, Keenan NL. Heart failure-related hospitalization in the U.S.,1979 to 2004. J Am Coll Cardiol 2008;52(6):428-34.
4. McMurray JJ, Petrie MC, Murdoch DR, Davie AP. Clinical epidemiology of heart failure: public and private health burden. Eur Heart J 1998; 19 Suppl P:P9.
5. Decision Base 2009; Acute Heart Failure, p 50, Decision Resources, 260 Charles Street, Waltham, Massachusetts, USA
6. Eur Heart J Supplements 2002; 4 (Suppl D):D50-D58 - http://eurheartjsupp.oxfordjournals.org/content/4/suppl_D/D50.full.pdf
7. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics – 2010 update: a report from the American Heart Association. Circulation 2010;121:e46-215
8. NICE Guidelines: Chronic heart failure 2010: http://www.nice.org.uk/nicemedia/live/13099/50517/50517.pdf