Comment on ESC/CSC Guidelines
Heart failure pharmacotherapy

Czech version

Authors: J. Špinar
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno
Published in: Kardiol Rev Int Med 2016, 18(4): 235-240

Overview

The main goal of heart failure treatment is to reduce mortality and morbidity, improve the quality of life and reduce the number of hospitalisations. ACE inhibitors are the corner-stone of the treatment, complemented with MRA. AII agonists (AIIA) are indicated in the case of ACE-I intolerance. The results of the PARADIGM-HF trial indicate that ACE-I can be replaced with sacubitril/valsartan in symptomatic patients. ACE-I or AIIA are recommended in maximal tolerated doses. Beta blockers should be added to the renin angiotensin blockade in maximal tolerated doses. Diuretics are given to relieve symptoms such as dyspnoea or oedema. Adding digoxin is indicated in selected patients. The use of statins, anticoagulation or antiaggregation drugs is recommended according to their basic indication (IHD, atrial fibrillation). Heart failure is not a specific indication for their use, but neither is it a contraindication.

Keywords:
heart failure – pharmacotherapy – ACE inhibitors – sacubitril/valsartan

Sources

1. Ponikowski P, Voors AA, Anker SD et al. for the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016; 37(27): 2129– 2200. doi: 10.1093/ eurheartj/ ehw128.

2. Špinar J, Hradec J, Špinarová L et al. Summary of the 2016 ESC Guidelines on the diagnosis and treatment of acute and chronic heart failure. Prepared by the Czech Society of Cardiology. Cor Vasa 2016; 58(5): 597– 636. doi: 10.1016/ j.crvasa.2016.09.004.

3. Špinar J, Hradec J, Špinarová L et al. Souhrn doporučených postupů ESC pro diagnózu a léčbu akutního a chronického srdečního selhání z roku 2016. Připraven Českou kardiologickou společností 2016. Cor Vasa 2016; 58(4): 455– 494.