Diagnostic and classification criteria of heart failure in the practice of doctors at the prehospital stage

Abstract

The article deals with an overview of heart failure with an emphasis on identification criteria and models of its classification based on literary sources from the MEDLINE database on the PubMed, Web of Science, Scopus, and Google Scholar platforms. The subjective and objective signs of chronic heart failure accor­ding to the Framingham Heart Study using the methods of clinical epidemiology and presented with modern data in the international guidelines are shown. Clinical manifestations of acute heart failure in patients with myocardial infarction are outlined. In chronological order, the hemodynamic classification of heart failure is reproduced with the definition of systolic and diastolic dysfunction as markers for ranking patients in practical work. Based on the materials of international guidelines developed by the experts of the American College of Cardiology, American Heart Association, Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, the diagnostic indicators of cardiac decompensation are summarized. Given the modern perception, the diagnostic value of the left ventricular ejection fraction has been proven for determining heart failure phenotypes. The classification of heart failure of the New York Heart Association plays a significant role in determining the functional class; this was reflected in the article. Based on the provisions of international guidelines, the importance of natriuretic peptides as potential biomarkers of acute and chronic heart failure is proved. The advantages of assessing the structural and functional parameters of the heart in patients for detecting the preclinical stage of heart failure, association with clinical events and control of treatment are described. An update version of heart failure classification is presented with the identification of four stages and highlighting their characteristics. According to this classification, a relevant preventive measure is to shift the therapeutic focus to the initial stages of diseases that trigger heart failure.