CHRONIC HEART FAILURE. MODERN POSSIBILITIES OF DIURETIC THERAPY

Abstract

Today, cardiovascular diseases remain the leading cause of morbidity and mortality. Advances in modern medicine have led to increased life expectancy and, concurrently, to a growing number of patients with chronic heart failure (CHF).

Aim. The aim of the article was to evaluate the mechanisms of development of heart failure and to analyze the possibility of current use of drugs with a diuretic effect in patients with CHF.

Material and methods. The article discusses the importance of diuretic therapy in patients with CHF and its influence not only on natriuresis, but also on organ protection, and also reflects modern ideas about the place of diuretics in the treatment of CHF, and provides a theoretical and evidence base.

Results. Heart failure is a syndrome characterized by the activation of various neurohumoral systems, primarily the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS), as well as the natriuretic peptide (NP) system. In this review article, along with a brief assessment of the general aspects of CHF physiopathology, the cross-talk between RAAS and NP, which has been shown to be crucial in both hemodynamic and tissue remodeling of the cardiovascular system and the development of CHF, is discussed. Diuretics are the mainstay of heart failure therapy and are used to reduce its symptoms, improve exercise tolerance, and reduce the risk of hospitalization. They should be considered as an element in a complex of measures aimed at preventing and treating patients with CHF.

Conclusion. Optimization of diuretic therapy in patients with heart failure remains a complex task, requires further research, as well as an individual approach to patients, and should be aimed at maintaining a balance between the various mechanisms of heart failure development.