[Acute and chronic heart failure]

Herz. 2017 Nov;42(7):699-712. doi: 10.1007/s00059-017-4613-y.
[Article in German]

Abstract

The initial therapy of chronic heart failure is still based on diuretics, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and in specific cases mineralocorticoid receptor antagonists. The new European Society of Cardiology (ESC) guidelines published in 2016 introduced angiotensin-receptor-neprilysin inhibitors, such as sacubitril/valsartan (LCZ 696) as new therapeutic agents in patients with chronic and progressive heart failure. New subgroup analyses for LCZ 696 have been published showing a beneficial effect in the context of various comorbidities, such as renal insufficiency, diabetes and hypotension. Furthermore, new data are available on intravenous iron substitution in chronic heart failure and on the indications for implantable converter defibrillators, cardiac resynchronization therapy and other cardiac devices. Medicinal therapy of acute heart failure is still limited. For patients who cannot be treated with medicinal therapy, mechanical circulatory support, such as extracorporeal membrane oxygenation (ECMO) should be recommended.

Keywords: Angiotensin-receptor-neprilysin inhibitors; Heart failure treatment; Iron deficiency; Mechanical assist device; Primary prophylactic ICD indication.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adrenergic beta-Antagonists / therapeutic use
  • Aminobutyrates / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Biphenyl Compounds
  • Cardiac Resynchronization Therapy
  • Chronic Disease
  • Defibrillators, Implantable
  • Diuretics / therapeutic use
  • Drug Combinations
  • Extracorporeal Membrane Oxygenation
  • Guideline Adherence
  • Heart Failure / therapy*
  • Heart-Assist Devices
  • Infusions, Intravenous
  • Iron / therapeutic use
  • Tetrazoles / therapeutic use
  • Valsartan

Substances

  • Adrenergic beta-Antagonists
  • Aminobutyrates
  • Angiotensin-Converting Enzyme Inhibitors
  • Biphenyl Compounds
  • Diuretics
  • Drug Combinations
  • Tetrazoles
  • Valsartan
  • Iron
  • sacubitril and valsartan sodium hydrate drug combination