Pharmacotherapy of Chronic Heart Failure

Abstract

The aspects of chronic heart failure treatment in age-related risk group are described in the present article. It is established that the optimal treatment duration is 6-12 months. The authors focused on pharmacotherapeutic part only, excluding active application of invasive treatment and diagnostics methods. The analysis of long-term therapy in three parallel groups defined the role of both blood pressure control and pharmacodynamics specifics of the drugs in clinical positive dynamics of the disease development and reverse heart and vessels remodeling. Indication of spironolactone along with the basic blood pressure control therapy increased tolerance to physical loads, improved quality of life in patients with chronic heart failure (CHF), accelerated recovery rate of the disturbed circadian rhythm of blood pressure, significantly reduced left ventricle dimensions and left atrium dilation reversion, decreased systolic blood pressure in pulmonary artery due to significant improvement of left ventricle diastolic function. Indication of trimetazidine in combination with spironolactone lowered functional class of the disease by New York Heart Association (NYHA) functional classification in 66.7% of cases and increased glomerular filtration rate. Nephroprotective activity of trimetazidine confirmed the fact that 80% of patients were rediagnosed with lower stage of chronic kidney disease after the therapy.