Publication details
Prevence rozvoje pokročilého chronického srdečního selhání - možnosti farmakoterapie
| Title in English | Prevention of the development of advanced chronic heart failure - pharmacotherapy options |
|---|---|
| Authors | |
| Year of publication | 2024 |
| Type | Article in Periodical |
| Magazine / Source | Vnitřní lékařství |
| MU Faculty or unit | |
| Citation | |
| web | https://casopisvnitrnilekarstvi.cz/artkey/vnl-202402-0005_prevention-of-the-development-of-advanced-chronic-heart-failure-pharmacotherapy-options.php |
| Doi | https://doi.org/10.36290/vnl.2024.021 |
| Keywords | heart failure; inhibition RAAS (ACEi_ARNI_MRA); betablockers; SGLT2; vericiguat; omecamtiv mecarbil; ferric carboxymaltose; tafamidis |
| Description | The treatment of chronic heart failure is always complex and includes both pharmacological and non-pharmacological procedures. However, the disease progresses to the end-stage of advanced heart failure in many patients, which is characterized by the persistence of symptoms despite maximal therapy. The basis of the treatment of patients with heart failure with reduced ejection fraction (HFrEF) are 4 pillars of drug groups: Angiotensin Receptor-Neprilysin Inhibitor (ARNI)/ Angiotensin-Converting Enzyme Inhibitors (ACEi), Beta blockers (BB), Mineralocorticoid receptor antagonist (MRA) and Sodium-glucose cotransporter-2 inhibitors (SGLT2i), which have mortality data from large randomized clinical trials. Their early use and rapid uptitration to the maximum tolerated dose is recommended. In addition, Sodium-glucose cotransporter-2 inhibitors SGLT2i are suitable for all heart failure patients regardless of ejection fraction value, and are also recommended for the treatment of Heart failure with mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) patients. The treatment of comorbidities is also important, especially the treatment of anemia, where intravenous administration of iron carboxymaltose (FCM) already has its place. Patients with diabetes mellitus II. type and chronic kidney disease can benefit from treatment with finerenone. Tafamidis is recommended for patients with a genetically proven hereditary form of cardiac transthyretin amyloidosis and for patients with a wild-type form of cardiac transthyretin amyloidosis. |