Neurohormonal blockade

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Newly diagnosed heart failure patients may benefit from medications called neurohormonal blockades, especially if they are given in the first three months after diagnosis.

When you have heart failure, your heart may be thickened or stiff, or it may be weak, so it can’t pump blood as well as it should. Your body responds by increasing sympathetic nervous system activity to help protect the heart’s functioning. The sympathetic nervous system is responsible for increasing heart rate, especially in dangerous situations, among other things. If left untreated, these responses to heart failure actually can change the size, shape and effectiveness of the heart. That is why it is important to move quickly on treatment for heart failure.

What makes the Norton Heart & Vascular Institute Myocardial Recovery Program unique is our ability to see patients often enough in the first three-month window to be sure they are responding to the treatment and to manage their medications effectively.

Scheduling patients into busy clinical practices can be challenging. Fortunately, our program is designed with the staff and resources to offer frequent follow-up and specialized treatment as needed. If a patient is discharged from the hospital with a diagnosis of heart failure, care in the first three weeks is critical to better outcomes and reducing risk for readmission. Our program strives to see patients within seven to 10 days, or less.

What is a neurohormonal blockade?

Neurohormonal refers to the hormones released by the nervous system. These hormones regulate various processes in the body such as heart rate, circulation and how the heart pumps blood through the body.

As the sympathetic nervous system ramps up in response to heart failure, and the heart muscle responds, various hormones are released into the body. These can cause increased heart rate, narrowed blood vessels, high blood pressure and stroke. These conditions are also known as myocardial failure. Myocardial means related to the heart muscle.

Certain drugs can stop neurohormones from damaging the heart. They can slow heart rate, control blood pressure and more.

Using neurohormonal drugs for heart failure

The Norton Heart & Vascular Institute Myocardial Recovery Program follows the four pillars of heart failure management:

  • Betabloqueantes
  • Renin-angiotensin-aldosterone neurohormonal blockade agents
  • Mineralocorticoid receptor antagonist
  • Sodium-glucose cotransporter-2 (SGLT-2) inhibitors

We see our heart failure patients frequently and have multiple touch points so we can achieve the best medication dose for you. The average time it takes to achieve myocardial recovery is 4.2 months, based on our experience.

Our nationally recognized program is the first and only myocardial recovery program of its kind. More than 1,500 patients have gone through our recovery process, and our recovery rate is greater than 50%. The national average for myocardial recovery is about 10%. Fewer than 5% of our patients in our myocardial recovery program have been readmitted to the hospital for heart failure symptoms in the initial three-month window.

Who should have neurohormonal blockade?

One of the signs of heart failure is reduced ejection fraction. This describes how well your heart pumps blood. It is the amount of blood pumped out of your heart’s lower chambers (ventricles) each time it contracts. Ejection fraction in a healthy heart is 50% to 70%. With each heartbeat, 50% to 70% of the blood in your left ventricle gets pumped out to your body.

Patients with ejection fraction under 40% who have been on medical therapy for fewer than three months are candidates for the Norton Heart & Vascular Institute Myocardial Recovery Program. Patients can be referred from their primary care provider, cardiologist or nephrologist.

It is possible to recover from heart failure, especially if we catch it in time. With proper medical care, expert guidance and a customized plan for your needs, you can stay heart healthy.

Atención de la insuficiencia cardíaca diseñada para la recuperación del corazón

  • Same-day appointments are available for new patients at locations in downtown Louisville and on the campuses of Norton Audubon Hospital and Norton Brownsboro Hospital.
  • Our compassionate and dedicated team includes specially trained heart failure cardiologists and advanced practice providers, a social worker, nurse navigators and dedicated pharmacist to help create a custom plan for care and make sure you and your family’s questions are answered at every step.
  • When diagnosed promptly, more than 50% of patients with heart failure that wasn’t caused by heart attacks or blockages are cured, compared with about 10% nationally.
  • Our program has advanced heart failure monitoring technology to detect signs of a weakening heart before you feel symptoms, with a goal of preventing hospital stays.
  • We are a DNV-accredited provider of ventricular assist devices and are recognized as High Performing in Heart Failure by U.S. News & World Report.
  • Our advanced care for severe heart failure includes ventricular assist device implants, extracorporeal membrane oxygenation (ECMO) support to give your heart a rest and time to heal, and access to heart transplants with ongoing aftercare.
  • Medicare, Medicaid and most major commercial insurance plans are accepted.
  • Book appointments, get alerts when an earlier appointment becomes available, communicate with your medical provider, refill prescriptions and more through your free Norton MyChart account.

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