Intravenous treatment of acute heart failure
Spinar, J.; Vítovec, J.
Vnitrni Lekarstvi 53(4): 412-419
2007
ISSN/ISBN: 0042-773X PMID: 17578177 Document Number: 610680
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.