In the 2nd part of their work, dealing with the modern treatment of chronic heart failure, the authors explain the role of myocardial damage and dysfunction in the maladaptive compensatory mechanism. They stress the significance of predominance of vasoconstrictor, positive inotropic and growth promoting autocrine and paracrine effects in the progression of heart failure i. e. the predominance of angiotensin, endothelin and peptide growth factor effects over the opposite ones of EDFR, ANP and prostacyclin. They emphasize the significance of abnormal cell growth and that of the low stress tolerability and shorter than normal life span of the hypertrophied myocytes with altered protein composition. They deal with the diastolic heart failure and its treatment possibilities differing from the treatment of systolic heart failure. Some practical problems of treatment of heart failure are discussed in the work as well; the authors suggest treatment strategies allowing higher doses of vasodilators, first of all of ACE inhibitors. At last the authors give proposals to the drug treatment of chronic heart failure taking into account not only its clinical severity but the underlying hemodynamic abnormalities as well. They think that the noninvasive methods are suitable for the estimation of those abnormalities.
|Number of pages||13|
|Publication status||Published - Jan 1 1994|
ASJC Scopus subject areas