Current Pharmacological Therapies in Heart Failure Patients
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REVIEW ARTICLE
Current Pharmacological Therapies in Heart Failure Patients Maria Lorenza Muiesan1,2 • Anna Paini1,2 • Claudia Agabiti Rosei1,2 Fabio Bertacchini1,2 • Deborah Stassaldi1,2 • Massimo Salvetti1,2
•
Received: 23 February 2017 / Accepted: 20 March 2017 Ó Springer International Publishing Switzerland 2017
Abstract Heart failure (HF) is a major problem of public health. More than 23 million patients worldwide are affected by heart failure. Despite incidence and prevalence of heart failure may vary according to real world or randomized trials database, advancing age is a major determinant of heart failure. Heart failure is also characterized by an elevated rate of morbidity and mortality and represents one of the leading causes of hospitalization. A major consequence of heart failure is the frequent hospital admissions and related costs. Guidelines have clearly indicated evidence-based treatments in patients with heart failure, and the adherence to these indications has translated in an improvement of patient’s prognosis. Nevertheless, the use of recommended treatments at the recommended dosages is still lower than expected. In the last year in Europe new guidelines on the diagnosis and treatment of heart failure and in USA an update on pharmacological treatment of heart failure were published, pointing the attention on the use of new available pharmacological and non-pharmacological treatments. HF syndrome reflects the interaction between hemodynamic dysregulation (alterations in myocardial preload, afterload, and contractility and a neurohormonal disarray those results in the development of symptoms and in the progression of the disease. Current treatment approaches target
& Maria Lorenza Muiesan [email protected] 1
Department of Clinical and Experimental Sciences, University of Brescia, c/o 2a Medicina, Spedali Civili, 25100 Brescia, Italy
2
Department of Medicine, ASST-Spedali Civili of Brescia, Brescia, Italy
both hemodynamic alterations and the neurohumoral elements to slow disease progression as well as to improve symptoms and outcomes. Keywords Heart failure Treatment Hypertension Sacubitril/valsartan Natriuretic peptides
1 Introduction Heart failure (HF) is a major problem of public health. More than 23 million patients worldwide are affected by heart failure [1]. Despite incidence and prevalence of heart failure may vary according to real world or randomized trials database, advancing age is a major determinant of heart failure [2]. Heart failure is also characterized by an elevated rate of morbidity and mortality and represents one of the leading causes of hospitalization. A major consequence of heart failure is the frequent hospital admissions [3–5], which are driven in about half of the cases by noncardiovascular reasons [5]. The global burden of hospitalization and related costs [3] is growing due to increasing age and comorbidities. Guidelines have clearly indicated evidence-based treatments in patients with heart failure, and the adherence to these indications h
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