Publication details
Novinky v diagnostice a léčbě chronického srdečního selhání 2018
| Title in English | News in diagnosis and treatment of chronic heart failure 2018 |
|---|---|
| Authors | |
| Year of publication | 2018 |
| Type | Article in Periodical |
| Magazine / Source | Farmakoterapie |
| MU Faculty or unit | |
| Citation | |
| Keywords | heart failure; pharmacotherapy; ACE inhibitors; sacubitril/valsartan; SGLT2; omecamtiv mecarbil |
| Description | New classification of heart failure has 3 grades - heart failure with reduced ejection fraction (HFrEF}, heart failure with mid range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF). The main goal of the heart failure treatment is the decrease of mortality and morbidity, especially improvement of quality of life and decrease of hospitalisations. ACE inhibitors are the cornerstone of the treatment, MRA should be added to ACE-I. AHA are indicated in the case of ACE-I intolerance. Betablockers in maximal tolerated doses should be added to the renin angiotensin blockade. Diuretics are given to the symptoms relieve - dyspnoe or oedema. Digoxin is indicated in selected patients. The use of statins, anticoagulation or antiagregation drugs is recommended according to their basic indication (IHD, atrial fibrillation). Heart failure is not an indication for their use, but also not a contraindication. There are 3 new promising groups of drugs: 1. Sacubitril/valsartan can replace the ACE-I according to the results of the PARADIGM-HF trial. 2. SGLT2 inhibitors in patients with diabetes mellitus. 3. A huge clinical research is done with omecamtiv mecarbil. |