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[Recommendations for the treatment of heart failure : What's new?]

G Hasenfuß1, F Edelmann, R Wachter

  • 1Klinik für Kardiologie und Pneumologie, Herzzentrum, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland. hasenfus@med.uni-goettingen.de

Der Internist
|July 18, 2013
PubMed

Insights

Treatment escalation for chronic systolic heart failure in symptomatic patients with reduced ejection fraction (≤30%) involves ACE inhibitors, beta-blockers, and other therapies. Device-based treatments like ICDs and CRT are also key considerations.

Area of Science:

  • Cardiology
  • Internal Medicine

Context:

  • Chronic systolic heart failure management requires tailored treatment escalation based on patient status.
  • Severely reduced left ventricular function (ejection fraction ≤30%) necessitates a multi-faceted therapeutic approach.

Purpose:

  • To outline recommended treatment escalation strategies for symptomatic patients with severely reduced left ventricular function.
  • To provide a comprehensive overview of pharmacological and device-based interventions.

Summary:

  • Recommended therapies include ACE inhibitors (or ARBs), beta-blockers, mineralocorticoid receptor antagonists, and diuretics for congestion.
  • Further options include digitalis, ivabradine, implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy (CRT).
  • Intravenous iron for deficiency and exercise training for stable patients are also advised.

Impact:

  • Optimizing treatment strategies can improve outcomes for patients with advanced systolic heart failure.
  • This guideline aids clinicians in selecting appropriate interventions for complex heart failure cases.
  • Highlights the importance of a personalized and comprehensive approach to heart failure management.

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