Ventricular Dysfunction & Heart Failure

Chronic heart failure is a major healthcare problem associated with high morbidity and mortality. In the European population, the prevalence of heart failure is 2-3%; in 70-80 year old people the prevalence rises to 10-20%. Common causes of heart failure are coronary artery disease (70%), valvular disease (10%) and cardiomyopathies (10%). The prognosis of heart failure patients is poor: around 40% of patients admitted to the hospital with heart failure are dead or readmitted within 1 year and 50% of patients die within 4 years.

Currently, there is a broad variety of treatment options for heart failure patients consisting of lifestyle changes, pharmacological therapy, cardiac resynchronization therapy, revascularization, surgical left ventricular reconstruction, valve surgery, left ventricular assist devices, heart transplantation and cell therapy. In order to select the optimal treatment strategy for each individual patient the Leiden Mission! Heart failure program was developed in 2005. This multidisciplinary structured screening protocol aims to determine the etiology of heart failure and select the optimal treatment modality for each individual patient in line with the most recent guidelines. Furthermore, it comprises a follow-up protocol to monitor the effectiveness of the therapeutic interventions.

Based on the broad experience in heart failure treatment the Heartcenter Leiden performs extensive research based on which patient selection and therapeutic modalities itself are constantly being improved. Especially, with the use of multimodality imaging patient selection for cardiac resynchronization therapy, surgical left ventricular reconstruction and mitral valve surgery is being optimized. Furthermore, clinical research is being performed to evaluate the effectiveness of cardiac cell therapy in patients with heart failure and left ventricular dysfunction. At the same time, pre-clinical research aims to optimize the effect of the transplanted cells and understand the mechanisms of complications in heart failure surgery. These research lines aim to continuous improve and innovate the clinical treatment of heart failure in the Heartcenter Leiden.