[Therapeutic strategy of chronic heart failure]

Considerable advances have been made in the management of heart failure during the past decade, with the development of new pharmacological agents. Now the therapeutic goals are not only to reduce symptoms but also to decrease the occurrence of acute heart failure, hospitalizations and to delay death. Prevention plays a key role: by correcting predisposing factors, and by slowing the process which leads from asymptomatic left ventricular dysfunction to overt heart failure. The range for therapeutic action is broad: general and dietetic advices, pharmacological agents, surgical procedures which are reserved for the end-stage patient. Angiotensin converting enzyme inhibitors remain the cornerstone of treatment at almost all stages of the disease.