Intravenous treatment of acute heart failure

Czech version

Authors: J. Špinar ¹; J. Vítovec ²
Authors‘ workplace: Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC ¹; I. interní kardioangiologická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta prof. MUDr. Jiří Vítovec, CSc., FESC ²
Published in: Vnitř Lék 2007; 53(4): 412-419
Category: Reviews

Overview

Acute heart failure is a disease with various etiologies that is difficult to treat and has a poor prognosis. If causal treatment – revascularization, treatment of a hypertensive crisis – is not possible, symptomatic treatment takes over, based primarily on intravenous treatment with diuretics, vasodilators and/or positive inotropes. Despite undoubted progress in this form of treatment, large, randomised clinical studies have never proved the success of this treatment or confirmed an improvement in prognosis. For this reason most recommendations are based only on clinical experience and surrogate targets such as a reduction in BNP or shortening of the hospitalisation period. Great attention is directed in particular to natriuretic peptides (nesiritide, ularitide) and to levosimendan, which is a calcium sensitizer with a vasodilatory and positive inotropic effect. Nevertheless, even this medicine has not yet been shown to reduce mortality in large studies.

Key words:
acute heart failure – diuretics – natriuretic peptides – levosimendan

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