Abstract
The current ESC-guidelines for the diagnosis and treatment of heart failure state
clear-cut recommendations for the treatment of symptomatic patients with reduced LV-function:
A combination of three neuro-humoral antagonists, i. e., beta-blockers, ACE inhibitors
and aldosterone antagonists, all given in high doses, is the mainstay of therapy.
Driven by new data, ivabradine is now recommended if the patient is further symptomatic
and has a sinus tachycardia ≥ 70 /min. Cardiac resynchronization therapy (CRT) is
now recommended even in patients with milder symptoms (NYHA II) when in sinus rhythm.
In contrast, no evidence-based treatment exists for heart failure with preserved LV-function.
In those patients, optimal treatment of the co-morbidities (CHD, hypertension, diabetes,
sleep-disordered breathing, atrial fibrillation) is essential to prevent the progression
to/of heart failure. For the treatment of comorbidities a holistic approach is recommended.
