© 2007 European Society of Cardiology
Filling the gap between guidelines and clinical practice in heart failure treatment — Still a far cry from reality
Sticares Cardiovascular Research Institute Rhoon, P.O. Box 882, 3160 AB Rhoon, The Netherlands Tel.: +31 10 485 51 77; fax: +31 10 485 48 33. E-mail address: w.j.remme@sticares.org
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Heart failure (HF) treatment has progressed considerably over the last two decades. Whereas before that time only a symptomatic approach was possible, subsequent large controlled studies with angiotensin converting enzyme (ACE) inhibitors, beta-blockers, aldosterone inhibitors and angiotensin receptor blockers (ARBs) (in that order) have clearly demonstrated the potential of these neurohormonal antagonists to improve survival and clinical wellbeing of HF patients and to retard HF progression [1-9]. Moreover, when administered at an earlier, asymptomatic stage, some of these agents may prevent or delay the occurrence of symptomatic HF [10]. These beneficial effects are apparent with mono-therapy, but increase significantly in size when different types of agents are combined. Of importance, each of the neurohormonal antagonists mentioned above has a positive effect on aspects of cardiac remodelling, which is pivotal to the occurrence and progression of heart failure. This helps to explain why these agents beneficially affect the clinical
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  A. M. Clark, L. A. Savard, and D. R. Thompson What is the strength of evidence for heart failure disease-management programs? J. Am. Coll. Cardiol., July 28, 2009; 54(5): 397 - 401. [Abstract] [Full Text] [PDF]
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