Toward equitable utilization of durable left ventricular assist device therapy in advanced heart failure-Raising the veil of health disparities.

Abstract

Heart failure (HF) is a progressive disease with high attendant morbidity and mortality. Contemporary guideline-directed medical therapies have led to remarkable improvements in HF outcomes. However, in a subset of patients, progression to advanced HF stages requiring durable left ventricular assist device (LVAD) and or heart transplantation is inevitable. LVADs improve survival and quality of life in eligible patients with advanced HF. However, access to LVAD therapy is marked by disparities, attributable to race and ethnicity, social-economic status, geography, and sex and gender categories. This commentary addresses the findings by Jones and colleagues on "The Impact of Race on Utilization of Durable Left Ventricular Assist Device Therapy in Patients with Advanced Heart Failure" and also highlights the importance of social determinants of health in defining health disparities as well as the urgent work needed to improve HF clinical outcomes by dismantling these disparities.