Via practica 11/2007

CONGESTIVE HEART FAILURE TREATMENT

Congestive heart failure (CHF) is a complex clinical syndroma characterized by progressive deterioration of abnormal systolic and diastolic function of mainly left ventricle of the heart, affecting also skeletal muscles. Due to maladaptation, there is typical neurohumoral activity, mainly sympaticus, renin-angiotensin system (RAAS), cytokins (TNF-á, IL-1, IL-6) and activation of cardiorenal relations expressed by increased level of natriuretic peptids (ANP, BNP, CNP), where BNP fulfils criteria of a diagnostic marker for CHF. All clinical signs of CHF including dyspnoe, inadequatly increased fatigue, overall weakness and fluid retention are non-specific. CHF mainly affects elderly people with many comorbidities – CHF as an isolated heart condition practically doesn`t exist. Comorbidities modify the symptomatology, clinical course and therapeutic process of CHF. Treatment of CHF cannot be succesfull without synchronized treatment of comorbidities. It is not surprising, that most of the course of CHF is inapparent, fulfiling the criteria of an iceberg phenomenon.

Keywords: CHF, comorbidities, diet, lifestyle adjustments, physical activity, pharmacotherapy of CHF.