ABSTRACT
BACKGROUND: A new generation of therapeutic devices has expanded the options for managing advanced heart failure. We examined the outcomes of cardiac contractility therapy in a series of 10 patients with chronic heart failure. METHODS: Ten patients with chronic heart failure were nonrandomly selected to receive cardiac contractility modulation therapy. Hemodynamics, left ventricular ejection fraction, functional capacity, and clinical outcomes were evaluated at baseline and after 6 months of therapy. RESULTS: Eight male and 2 female patients (mean [SD] age, 63.4 [9.4] years) received cardiac contractility modulation therapy. Between baseline and 6-month follow-up, mean (SD) left ventricular ejection fraction improved from 27.1% (4.18%) to 35.1% (9.89%), New York Heart Association class declined from 3.9 (0.32) to 2.44 (0.52), and 6-minute walk test distance increased from 159.2 (93.79) m to 212.4 (87.24) m. Furthermore, the mean (SD) number of hospital admissions within the 6 months before cardiac contractility modulation therapy was 2.4 (2.27) compared with 1 (1.52) during the 6 months after therapy. CONCLUSION: Cardiac contractility modulation therapy improved physical functioning and reduced hospital admissions in these patients.
Subject(s)
Heart Failure , Ventricular Function, Left , Humans , Male , Female , Middle Aged , Stroke Volume , Treatment Outcome , Myocardial Contraction , Heart Failure/diagnosis , Heart Failure/therapy , Chronic DiseaseABSTRACT
In the daily practice of medicine, health care providers oftentimes confront the dilemma of offering 'maximum care' based on available technologies and advances versus ethical concerns about futility. Regardless of cultural backgrounds and differences, most human beings aspire to an illness-free life, or better yet, a life lived with utmost quality and longevity. On account on ongoing advances in science and technology, the possibility of achieving "immortality" (a term used as a metaphor for an extremely long and disease-free life) is increasingly perceived as a realistic goal, which is aggressively pursued by some of the world's wealthiest individuals and corporations. However, this quest is not taking place in a philosophical or religious vacuum, which is why we attempt to evaluate the current state of knowledge on religious beliefs revolving around immortality and their alignments with today's medical advancements. The literature searches were performed using relevant databases including JSTOR and PubMed, as well as primary religious sources. Most religions present longevity as a blessing and believe in some sort of immortality, afterlife or reincarnation for the immortal soul. The quest for immortality beyond life in a "body of death" remains consistent with access to medical care and the legitimate possibility of achieving longevity-as long as certain ethical and religious parameters are preserved.
