Acute decompensation of heart failure: current issues of epidemiology, diagnostics, therapy

Abstract

The relevance and importance of the problem of acute decompensation of heart failure (ADHF) for the healthcare system worldwide is due to significant increase in the number of hospitalizations with associated increase in material costs and extremely unfavorable prognosis. The article covers the issues of epidemiology, modern approaches to the diagnosis and treatment of ADHF. The article touches upon the still unsolved problem of differentiation between the terms «acute heart failure» (AHF) and «acute decompensation of chronic heart failure». Particular attention is given to the risk factors and causes of ADHF, the clinical phenotypes of patients, the peculiarities of diagnosis in elderly and «fragile» patients are discussed. In approaches to drug therapy, the emphasis is placed on the tactics of using loop diuretics; doses and methods of their administration are analyzed in terms of effectiveness, influence on prognosis, and methods of achieving and controlling euvolemia are discussed. The importance of prescribing basic therapy for CHF after stabilization of the condition is emphasized, factors that worsen the prognosis are highlighted.