Current Aspects of Drug Therapy of Chronic Heart Failure Syndrome

Abstract

Chronic heart failure (CHF) is an important problem for the country, which has both medical and socio-economic aspects. The presence of the syndrome not only significantly increases the risks of an unfavorable course of diseases underlying its etiological basis, but in itself, through the development of decompensation, causes a high frequency of deaths. Despite all the advances in pharmacotherapy, the prognosis of heart failure remains poor. More than 40% of patients die within 4 years after the diagnosis of heart failure, and the one-year mortality rate for patients with severe CHF (NYHA class IV) exceeds 50%. The foregoing determines the need and importance of using all possible drug and non-drug therapy technologies aimed at reducing mortality, increasing the duration and quality of life of patients with CHF, as well as reducing the number and likelihood of decompensation and related hospitalizations, and makes this direction one of the priorities in medicine. The article describes current approaches to the treatment of patients with CHF syndrome from the perspective of evidence-based medicine and taking into account the recommendations of leading international organizations for the treatment and prevention of cardiovascular diseases. The drugs used were analyzed in terms of their influence on clinical symptoms, quality of life of patients, the risk of hospitalization due to decompensation of CHF, and mortality rates. The emphasis is made on the possibilities, mechanism of action and further prospects for the use of a new class of drugs in the treatment of CHF, acting at the level of the renin-angiotensin-aldosterone system and the system of neutral endopeptidases - inhibitors of angiotensin-neprilisin receptors.