[Management of advanced chronic heart failure].
Because of the progressive ageing of the population and the extensive use of recommended drugs, the number of patients with advanced chronic heart failure constantly increases. Several studies showed the efficacy of neurohormonal antagonists and electric devices in NYHA class III-IV patients; however, there is no agreement on the management of refractory heart failure, especially for patients who are not candidates for heart transplantation, because of age or comorbidity. The treatment with intravenous inotropic agents is considered a palliative care. The growing experience with implant of left ventricular assist devices, on the other hand, is encouraging and suggests more extensive use of these devices, both as bridge to transplant and as destination therapy.
Oliva
Fabrizio
F
Cardiologia 2-Insufficienza Cardiaca e Trapianto Cardiaco, Dipartimento Cardiologico "A. De Gasperis", A.O. Niguarda Ca' Granda, Milano. fabri.oliva@gmail.com
Macera
Francesca
F
Verde
Alessandro
A
Frigerio
Maria
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial; D002908:Chronic Disease; D017147:Defibrillators, Implantable; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D010166:Palliative Care
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists