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Herzinsuffizienz und Lebenserwartung

von NFI Redaktion

Don’t be misled by the name if you are diagnosed with heart failure. Your heart has not failed. Instead, you are suffering from a condition where your heart has difficulty pumping oxygen-rich blood to the rest of your body.

„This can lead to fluid building up in the lungs and congesting in the lungs, causing shortness of breath, chest pain, and fatigue, as well as fluid accumulating in other parts of the body,“ says Dr. Brent Lampert, a cardiologist at the Wexner Medical Center at Ohio State University in Columbus.

Depending on the severity of your heart failure, you might notice swelling in your ankles and legs. Your heart may beat faster than usual or its rhythm may not be as regular. Your abdomen may swell, and you might lose your appetite.

It’s a serious diagnosis. But doctors have learned a lot about how to carefully treat heart failure, often including a combination of prescription medications that most effectively relieve the symptoms.

And life expectancy is increasing: According to a study, about half of those diagnosed today can expect to live for at least five more years, compared to 41% in 2000.

Special calculators provide an estimate of your life expectancy with heart failure. Using an online tool called the Seattle Heart Failure Model, you can input your lab results and the type of treatment you are receiving to predict your chances.

However, keep in mind that these calculators are based on large groups of people and may not consider the latest research, says Dr. Gregg Fonarow, a cardiologist who heads the Ahmanson-UCLA Cardiomyopathy Center in Los Angeles.

Some things that affect your life expectancy with heart failure are beyond your control, such as your age. Others, such as a healthy lifestyle, are not.

Factors that can affect life expectancy include:

Ejection fraction. To get a better picture of your heart health, your doctor will check how well a section of your heart called the left ventricle pumps blood. An echocardiogram is a commonly used test. It scans the heart and takes measurements to determine what percentage of your blood is pumped out with each heartbeat. For example, an ejection fraction of 55% means that 55% of your blood is squeezed out with each beat. According to the American Heart Association, a normal result is usually between 50 and 70%.

People with a reduced ejection fraction suffer from one type of this disease. This is known as heart failure with reduced ejection fraction. In the other type, heart failure with preserved ejection fraction, the percentage is not below normal. However, there are other changes, such as the heart becoming stiffer. „After the heart has squeezed the blood and pumped it forward, it needs to relax to fill with blood,“ says Lampert. „If the heart muscle is stiff or unable to relax while blood is flowing in and filling it, it’s not very compliant, and so you can get the same results as fluid builds up in the lungs and other parts of the body.“

If your heart failure is accompanied by a reduced ejection fraction, your doctor will closely monitor this number. If the value drops significantly to 35% or below, there is an increased risk of a potentially life-threatening arrhythmia.

Staging. There are four stages of heart failure, indicating how serious your condition might be.

  • Stage A: You do not have full heart failure, but there are some risk factors. You may have a family member with heart failure. Or you have other conditions such as high blood pressure, alcohol abuse, diabetes, or heart disease.
  • Stage B: Tests show your heart is damaged, but you do not notice any symptoms. You most likely had a below-average result in a heart function test. Most people in stage B have an ejection fraction of 40% or less.
  • Stage C: You have some symptoms that may come and go, such as fatigue. You may be less able to exercise, have swollen or weak legs, or experience shortness of breath.
  • Stage D: Your symptoms are more severe and do not improve with medication and other treatments.

Lifestyle decisions. There are things you can do today to improve your quality of life and possibly extend it, says Lampert. Smokers should try to quit, and he advises avoiding alcohol. „I generally advise people to try to avoid it.“

Stay as active as possible under medical guidance or in a heart program, says Lampert. Follow the recommendations for limiting sodium and the amount of fluid you drink.

Even these small dietary steps can have a big impact, says Lampert.

„One factor associated with a shorter life expectancy are recurrent hospital stays,“ he says. „Each hospital stay shortens life expectancy. If you can control fluid and sodium intake and stay out of the hospital, it can certainly improve both the quality and quantity of life.“

Keeping up with medications. This may seem obvious, but both Lampert and Fonarow emphasize the importance of not skipping medications. You will likely have to take several medications for your heart failure. They may have side effects and their effectiveness may change as your condition changes.

„If you develop symptoms, report them and stay in close contact with your doctor,“ says Lampert. „So if there’s a decline, they can react quickly.“

The good news is that recent research shows that taking a combination of medications for heart failure helps extend the life expectancy of people with reduced ejection fraction, says Fonarow. In a study, the combination of medications extended the survival rate in all age groups by an average of 6 years.

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