Related Experiment Videos
[Current status of treatment of chronic cardiac insufficiency]
C Théry1, P Asseman, J J Bauchart
1Service de soins intensifs, hôpital cardiologique, Lille, France.
Insights
Treating heart failure with digitalis, diuretics, and angiotensin-converting-enzyme inhibitors improves symptoms and survival. Early intervention with ACE inhibitors may slow disease progression in asymptomatic patients with reduced ejection fraction.
Area of Science:
- Cardiology
- Pharmacology
Abstract:
When there is no correctable cause, cardiac failure continues to progress and outcome is poor. However several controlled clinical trials have shown that several therapeutic agents relieve symptoms, improve exercise tolerance and, for some, reduce mortality. Patients in NYHA functional class II, III and IV, whose systolic function is impaired should be treated by digitalis, diuretics and angiotensin-converting-enzyme inhibitors. These therapeutic agents are complementary and each of them are required. Moreover a study has shown that the impairment of patients in NYHA functional class I (who are still asymptomatic but with a ventricular ejection fraction < 35%) could be slowed by angiotensin-converting-enzyme inhibitors. In each case, it is of paramount importance to exclude treatable causes of heart failure because the best the symptomatic treatment can do is slow the inevitable worsening of the disease.