Stage C structural heart disease with symptoms. Stage D: refractory hf and need interventions. Stage D heart failure is a refractory type of heart failure to optimal medical treatment with ACEI,beta blockers, diuretics and angiotensin antagonist. There are half of millions of end stage heart failure with reduced EF ( HfrEF) and the average survival is less than 6 months (5) The treatment options for stage D acute decompensate heart failure include: inotropes, mechanical circulatory support (including: IABP, LVD (intermediate and long term, Cardiopulmonary assist devices), heart transplantation (3). Inotropes can be used for multiple purposes in heart failure: as a bridge to the heart transplantation for patients who meet criteria for the transplantations (depending on the heart transplant center). Inotropes can also be used as a bridge to the mechanical circulatory support (LVAD, impella, IABP). For patients who are not candidate for the heart transplantation or mechanical support or those who refuse the invasive treatment (the transplantation or the mechanical support devices), inotropes can be used as a palliative treatment (3). In some patients, inotropes can be weaned
Stage C structural heart disease with symptoms. Stage D: refractory hf and need interventions. Stage D heart failure is a refractory type of heart failure to optimal medical treatment with ACEI,beta blockers, diuretics and angiotensin antagonist. There are half of millions of end stage heart failure with reduced EF ( HfrEF) and the average survival is less than 6 months (5) The treatment options for stage D acute decompensate heart failure include: inotropes, mechanical circulatory support (including: IABP, LVD (intermediate and long term, Cardiopulmonary assist devices), heart transplantation (3). Inotropes can be used for multiple purposes in heart failure: as a bridge to the heart transplantation for patients who meet criteria for the transplantations (depending on the heart transplant center). Inotropes can also be used as a bridge to the mechanical circulatory support (LVAD, impella, IABP). For patients who are not candidate for the heart transplantation or mechanical support or those who refuse the invasive treatment (the transplantation or the mechanical support devices), inotropes can be used as a palliative treatment (3). In some patients, inotropes can be weaned