medicine - Woodruff Health Sciences Center - Emory University

mon causes and a few less common, even rare, causes.”
Heart failure occurs when the heart muscle loses pumping
strength and no longer supplies enough oxygenated
blood to the rest of the body. The body responds to a weak
heart the same way it would to low blood volume from
dehydration or bleeding. When there is too little to go
around the entire body, blood diverts from peripheral vessels
and arteries to sustain the heart and brain. Arteries and
blood vessels throughout the body eventually narrow to
keep blood pressure up.
Those with heart failure feel exhausted and short of
breath. Their kidneys hold onto salt, making them constantly
thirsty. They crave salt and fluid, which leaves them
more congested, creating a vicious cycle. Over time, every
organ system in the body suffers, including the heart itself.
Addressing underlying causes
No one lives forever, but keeping heart disease risk factors
at bay can help people make the most of their later years,
says Butler.
“Without diabetes, obesity, smoking, or high blood
pressure by the age of 50, a person is very unlikely to have
clinical symptoms from heart disease for the rest of their
lives,” says Butler, who is deputy chief science officer for the
American Heart Association. “But obesity and diabetes epidemics
continue to worsen, contributing to even more heart
failure. Also people who are treated for heart attack survive
longer now but in turn live with a weaker heart. We need to
focus on prevention and treatment in a comprehensive way.”
In the past, he says, heart failure specialists “let the proverbial
elephant get by while focusing solely on treating the
resulting heart disease.” Because heart failure is a complex
chronic disease, prevention and successful treatment are
related to psychosocial factors such as patients’ literacy level,
their comprehension of their treatment regimen, and their
level of social support.
“We need to collect data for a variety of different players
on the health care team,” he says. “Surgeons, nurses, and
social workers all look at heart failure from a different angle.”
Butler has developed an infrastructure for a comprehensive
cohort study of patients with heart failure.
Researchers already have begun collecting comprehensive
baseline data on patients at Emory hospitals and at Grady
Hospital. Patients in the study return to the clinic every six
months for follow-up.
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