Management of chronic heart failure therapy in the setting of acute heart failure

Abstract

Clinical research on the treatment of chronic heart failure (CHF) has developed significantly over the last 20 years, leading to substantial changes in therapeutic practices and notable improvements in patients' outcome. Research on the treatment of acute heart failure (AHF) has not developed in parallel, and only in the last few years have researchers turned their interest toward this important public health problem. This shift in interest has been predominantly caused by the development of new drugs for use in cardiology and the consequent resources made available by the pharmaceutical industry. However, the two areas of interest remain distinct. Neither research nor the medical literature has so far dealt with the link between ongoing treatments in patients with CHF and acute clinical destabilization or with the therapeutic changes induced by the event in survivors. In reality, patients with CHF typically fluctuate between periods of clinical stability and other periods of instability, and the diagnostic-therapeutic strategy in these patients is continuously reshaped by the occurrence of acute events. © 2008 Springer-Verlag London.