13. Treating Systolic Heart Failure

  1. Barry H. Greenberg2,
  2. Denise D. Barnard2,
  3. Sanjiv M. Narayan3 and
  4. John R. Teerlink4,5
  1. Vijay U. Rao MD, PhD1 and
  2. John R. Teerlink MD, FACC, FAHA, FESC4,5

Published Online: 14 SEP 2010

DOI: 10.1002/9780470669402.ch13

Management of Heart Failure

Management of Heart Failure

How to Cite

Rao, V. U. and Teerlink, J. R. (2010) Treating Systolic Heart Failure, in Management of Heart Failure (eds B. H. Greenberg, D. D. Barnard, S. M. Narayan and J. R. Teerlink), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470669402.ch13

Editor Information

  1. 2

    Division of Cardiology, University of California, San Diego, California, USA

  2. 3

    University of California and Veterans Affairs Medical Center, San Diego, California, USA

  3. 4

    Section of Cardiology, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

  4. 5

    School of Medicine, University of California, San Francisco, California, USA

Author Information

  1. 1

    Division of Cardiology, School of Medicine, University of California, San Francisco, California, USA

  2. 4

    Section of Cardiology, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

  3. 5

    School of Medicine, University of California, San Francisco, California, USA

Publication History

  1. Published Online: 14 SEP 2010
  2. Published Print: 8 OCT 2010

ISBN Information

Print ISBN: 9780470753798

Online ISBN: 9780470669402

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Keywords:

  • systolic heart failure treatment;
  • heart failure (HF), common problem in outpatient and inpatient settings;
  • symptoms and signs of HF - as edema, dyspnea and orthopnea, attributed to defects in myocardial pump function;
  • classification of heart failure by structural abnormality (ACC/AHA) - or by symptoms relating to functional capacity (NYHA);
  • stages in development of heart failure;
  • diabetes and the metabolic syndrome management;
  • modifiable risk factors - for cardiac injury;
  • diuretics, used for chronic heart failure;
  • beta-blockers (BB) - suppressing adrenergic system, up-regulated in HF patients;
  • supraventricular tachyarrhythmias (SVTs) - in HF population

Summary

This chapter contains sections titled:

  • Introduction

  • Etiology

  • Classification

  • Goals of therapy

  • At-risk for heart failure (stage A)

  • Patients with cardiac structural abnormalities or remodeling who have not developed HF symptoms (stage B)

  • Patients with current or prior symptoms of CHF with reduced left ventricular systolic function (stage C): Non-pharmacologic measures

  • Pharmacologic measures

  • Management of fluid status

  • Diuretics

  • Inhibition of the renin-angiotensin-aldosterone system

  • Ace-inhibitors

  • Angiotensin receptor blockers

  • Aldosterone antagonists

  • Beta-blockers

  • Digoxin

  • Vasoactive agents

  • Calcium-channel blockers

  • Drug treatment for supraventricular arrhythmias

  • Chronic resynchronization therapy and implantable cardioverter defibrillators

  • Anticoagulants (vitamin K antagonists)

  • HMG-CoA reductase inhibitors (statins)

  • Refractory HF requiring specialized interventions (stage D)

  • Future directions/new therapeutic targets

  • Summary

  • References