Abstract
The failing heart is a challenge to clinicians, scientists, and those who grapple with the problems of economics and equity in the provision of medical services. Numerically, the problem is enormous: 400,000 new cases and $10.2 billion in direct medical costs in the United States annually. Current forms of treatment are reasonable but have a limited impact on the overall human and monetary costs of this condition. Cardiac transplantation provides definitive therapy with acceptable risks, but the costs are high and donor hearts are available for only a tiny fraction of the patients in need. Medical therapy for heart failure . . .
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