Heart failure is a condition in which the heart is too weak to pump enough blood to the body’s tissues and organs. It can affect the left or right side of the heart. In left-sided heart failure, the main pumping chamber of the heart is weak and doesn’t have adequate force to push oxygenated blood into circulation. Blood coming into the heart from the lungs backs up, causing fluid to leak into the lung tissues. In addition, blood flowing through the body slows, causing excess fluid to back up in the tissues (edema).

Right-sided heart failure affects the half of the heart that pumps deoxygenated blood into the lungs. That causes blood coming into the heart to back up in the veins, leading to swelling in the ankles and legs.

Initially, a weak heart tries to compensate for weakness by increasing its muscle mass and pumping faster. These efforts may work for awhile, but eventually, the heart becomes too weak. Patients may develop fatigue, shortness of breath, persistent coughing or wheezing, swelling in the tissues, loss of appetite, nausea and confusion or memory loss.

According to the American Heart Association, about 5.3 million people in the U.S. have heart failure. One in five Americans 40 and older will develop heart failure at some point in their lives. Cost of care for heart failure patients will be about $34.8 billion in 2008. About 300,000 men and women die from the condition each year.

Treating Heart Failure: The HeartNet™ Study

Initially, doctors may treat heart failure patients with diet, exercise and medications. If the symptoms become life-threatening, a heart transplant may be needed.

Researchers around the country are testing a new treatment for patients with moderate heart failure, called the HeartNet™. The HeartNet is an elastic mesh that is wrapped around the heart. The goal is to provide enough pressure to slow down or halt the growth of the enlarging heart muscle and help the heart work more efficiently.

The HeartNet mesh is made of Nitinol, a super-elastic alloy of nickel and titanium. To place the device, a small incision in made between the ribs. Then a preloaded delivery device is placed into the chest and onto the tip at the bottom of the heart. The device releases the mesh and stretches it up and around the ventricles, or lower chambers. Once it’s properly positioned, the mesh is released from the delivery mechanism. The HeartNet snaps back to its normal (relaxed) shape, creating a gentle squeeze around the heart muscle. X-rays are used to confirm the placement of the HeartNet and to ensure it remains in place as the heart is beating.

Researchers say it takes about 90 minutes to place the HeartNet. Patients remain in the hospital for about 5 to 6 days. Leway Chen, M.D., M.P.H., Transplant Cardiologist with the University of Rochester Medical Center, says recovery is a slow process and it can take 6 to 12 months until patients have visible signs of improvement.

Currently, the HeartNet is in clinical trials at more than 20 sites in the U.S. The study is called the Prospective Evaluation of Elastic Restraint to LESSen the Effects of Heart Failure (PEERLES-HF) Trial. The device comes in different sizes to enable doctors to make the best fit. Experts say the HeartNet is a permanent device, but doesn’t interfere with imaging and is safe for MRI scans. PEERLESS-HF Trial sites:

University of Alabama Birmingham, Birmingham, AL

USC Keck School of Medicine, Los Angeles, CA

University of Florida, Gainesville, FL

Emory University, Atlanta, GA

Midwest Heart Foundation, Lombard, IL

Genesis Medical Center, Davenport IA

University of Maryland, Division of Cardiology, Baltimore, MD

Caritas St. Elizabeth’s Medical Center, Boston, MA

St. Paul Heart Clinic, St. Paul, MN

Mid America Health Institute, Kansas City, MO

BryanLGH Heart Improvement Program, Lincoln, NE

Morristown Memorial Hospital, Morristown, NJ

Montefiore Medical Center, Bronx, NY

University of Rochester Medical Center, Rochester, NY

The Lindner, Clinical Trial Center, Cincinnati, OH

The Ohio State University Medical Center, Columbus, OH

Oklahoma Heart Hospital, Oklahoma City, OK

Penn State Milton S. Hershey Medical Center, Hershey, PA

Allegheny General Hospital, Pittsburgh, PA

Tennessee Cardiovascular Research Institute, Nashville, TN

The Stern Cardiovascular Center, Germantown, TN

Intermountain Medical Center, Murray, UT

For information about HeartNet™, go to http://www.paracormedical.com.

For information about the trial, or to locate the nearest study site, go to http://www.clinicaltrials.gov. Then type the trial ID number in the search box: NCT00382863. Information can also be found at http://www.peerless-hf.com/clinical_research_study_HF.html.

For information about heart failure:

American Heart Association

Heart Failure Online

National Heart, Lung and Blood Institute