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P&S Journal

P&S Journal: Spring 1994, Vol.14, No.2
Centering on Heart Failure

By Robin Eisner
Millions of people with high blood pressure or who have recovered from heart attacks or strokes are living longer with the help of drugs and other treatments. Unfortunately, though, hearts affected by these problems weaken over time. Drugs and angioplasty do not cure; they only delay deterioration of the heart muscle and circulatory system. Eventually the pumping action of the heart is impaired, limiting the ability of a patient to walk or carry out daily living activities without shortness of breath or fatigue.
This end-stage cardiovascular disease is called heart failure.
In the past, doctors could not offer heart failure patients much solace. But physicians in CPMC's comprehensive cardiovascular care program have enhanced the quality of lives of 70 percent of heart failure patients, removed 40 percent of patients from the transplant list, and reduced mortality by 25 percent.
To further CPMC's success with heart failure patients, Dr. Milton Packer brought together 15 physicians and researchers from P&S and throughout the world in January 1993 to launch CPMC's Heart Failure Center, the nation's first clinical and research facility dedicated to heart failure, the nation's No. 1 cardiovascular health problem. His leadership of the center is a natural: When Dr. Myron Weisfeldt, chairman of medicine, recruited Dr. Packer in July 1992 from Mount Sinai, Dr. Weisfeldt described him as the world's leader in heart failure clinical research.
"There have been enormous strides in treating and preventing other cardiovascular problems, such as stroke and heart attack, but there has been little work in understanding or treating heart failure, until now," says Dr. Packer, the Dickinson W. Richards Jr. Professor of Medicine, chief of the division of circulatory physiology, and Irving Clinical Research Scholar.
Compared to other cardiovascular disorders, heart failure is the only one increasing in frequency. The risk of hospitalization for heart failure has increased 400 percent over the past 15 years. About 3.5 million Americans, including 6 percent to 10 percent of people age 65 or older, have heart failure, and each year about 200,000 Americans die from it. In the New York metropolitan area alone, some 400,000 people suffer from heart failure. "When patients fail conventional treatment," says MaryAnn Kral, the center's clinical program director, "they come to us." The center offers unique diagnostic procedures, such as the cardiopulmonary stress test, transplants, and some 20 investigational treatment protocols that use standard and new drugs and heart-assist devices. Each physician and scientist in the center also conducts research to better understand heart failure and to devise better strategies to prevent and treat it.
The center's administrative offices are located on the fifth floor of Milstein Hospital, but its diagnostic and basic and clinical research facilities cover 15,000 square feet throughout CPMC. The center has more than $7 million in support, including a $1.7 million NIH grant and other funding from Presbyterian Hospital, Columbia University, industry, and private gifts. Since the center opened, about 1,500 patients have been treated, and Dr. Packer hopes to accommodate two to three times that many patients in the future.

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