The Recent Advances In Diagnosis And Therapy Of Chronic Heart Failure

Studies in recent years have revealed that chronic heart failure (CHF ) is not only the change of hermodynamics, but also has neuro-endocrine system dysfunction. The foundation on which develops is myocardial remodeling, so the key treatment of chronic heart failure is to block the excessive activation of rinin-angiotension-aldosterone system (RAAS) and myocardial remodeling. Some of the large-scale clinical trials have confirmed that angiotensin converting enzyme inhibitor (ACEI), β-blockers and aldosterone antagonist can reverse myocardial remodeling and improve the prognosis of the CHF patients. At present, ACEI and β-blockers have become a in the treatment of CHF. But there still exist disputes about the appropriate doses and methods of the medicine. Some investigators think that the target dose or the highest tolerated dose is necessary, but there some others who consider that small doses with few adverse effect are adequate with similar improvement in the symptoms and prognosis. Those patients with unstable hermodynamics who are not suitable for using P-blockers, and patients with renal dysfunction are not suitable for using ACEI. Therefore in the last a few years some new neuro-endocrine system antagonists have been developed, such as endothelia receptor antagonist, vaso pressure receptor antagonist, etc. Only few of these medicines have been used clinically, without definite conclusion. But at the same time these drugs have brought new hopes for the patients.