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[Prognosis of heart failure--value of drug therapy]
1Medizinische Klinik und Poliklinik I, Charité, Berlin.
Insights
Angiotensin-converting enzyme (ACE) inhibitors improve heart failure symptoms and survival. However, for severe congestive heart failure, cardiac transplantation is currently the only alternative to palliative medical treatment.
Area of Science:
- Cardiology
- Pharmacology
Context:
- Congestive heart failure (CHF) management has advanced.
- ACE-inhibitors show benefits in mild to severe CHF and left ventricular dysfunction.
Purpose:
- To evaluate the efficacy of ACE-inhibitors in congestive heart failure.
- To discuss treatment options for end-stage heart failure.
Summary:
- ACE-inhibitors improve symptoms and decrease mortality in CHF patients.
- Despite high-dose ACE-inhibitor therapy, 1-year mortality in severe CHF remains high at 36%.
Impact:
- ACE-inhibitors offer significant benefits but do not fully resolve severe CHF.
- Cardiac transplantation is the sole alternative for end-stage congestive heart failure patients.
Abstract:
During the last decade medical treatment of congestive heart failure has made impressive strides. Several studies have proven that ACE-inhibitors improve symptoms and decrease mortality in patients with severe heart failure. ACE-inhibitors have also been demonstrated to improve prognosis in patients with mild to moderate symptoms of heart failure as well as left ventricular dysfunction. However, long-term medical treatment of severe heart failure is only palliative. Despite treatment with high doses of ACE-inhibitors, 1-year mortality of patients with severe heart failure is as high as 36%. Therefore, at present, cardiac transplantation remains the only alternative treatment for patients with end-stage congestive heart failure.