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Related Experiment Videos

Chronic heart failure: developments and perspectives.

Michael A Crouch1

  • 1Virginia Commonwealth University, Richmond, Virginia 23298-0533, USA. macrouch@vcu.edu

The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
|March 22, 2006
PubMed
Summary

Chronic heart failure (CHF) management involves understanding systolic and diastolic dysfunction. Pharmacists play a crucial role in optimizing treatment and ensuring patient adherence to medications and lifestyle changes for better outcomes.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Chronic heart failure (CHF) is a prevalent condition, particularly affecting the elderly population.
  • Distinguishing between systolic and diastolic heart failure is critical for effective management.
  • Diastolic dysfunction, characterized by a normal to elevated ejection fraction, accounts for at least one-third of all CHF cases.

Purpose of the Study:

  • To outline the clinical presentation, diagnostic approaches, and current treatment strategies for chronic heart failure.
  • To highlight the significant role of pharmacists in managing patients with CHF.
  • To review contemporary pharmacotherapy and non-pharmacological interventions for both systolic and diastolic heart failure.

Main Methods:

  • A comprehensive review of English-language articles from MEDLINE focusing on chronic heart failure.

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  • Inclusion of diverse publications such as prospective trials, epidemiological studies, guidelines, reviews, and editorials.
  • Emphasis on primary literature published after major guideline releases from the Heart Failure Society of America (HFSA) and the European Society of Cardiology (ESC).

    • Main Results:

    • Systolic heart failure (ejection fraction < 40%) is commonly treated with ACE inhibitors, diuretics, beta-blockers, aldosterone antagonists, ARBs, and digoxin, with most prolonging survival except diuretics and digoxin.
    • Diastolic heart failure treatment is less evidence-based, focusing on managing blood pressure, heart rate, fluid overload, and ischemia.
    • Additional options for systolic dysfunction include hydralazine/isosorbide dinitrate and devices like biventricular pacemakers or implantable cardioverter-defibrillators.

    Conclusions:

    • Managing chronic heart failure presents ongoing therapeutic challenges.
    • Pharmacists are essential in CHF care by preventing exacerbations, optimizing medication regimens, and ensuring patient compliance.
    • Effective CHF management requires a multidisciplinary approach, with pharmacists playing a key role in pharmacotherapy and patient education.