THE IMPORTANCE OF CARDIOTONIC DRUGS IN MEDICAL PRACTICE, THE RANGE OF APPLICATIONS AND THE ADVANTAGES OF THEIR USE

Abstract

There are multiple evidence-based drug treatments for chronic heart failure (HF), both disease-modifying agents and those for symptom control. The majority of the evidence base supports drugs used in HF with reduced left ventricular ejection fraction. The mainstay of disease modification involves manipulation of neurohormonal activation that occurs in HF. In addition to established angiotensin-converting enzyme inhibitors, beta blockers and mineralocorticoid receptor antagonists (MRAs), newer agents are now available such as the angiotensin receptor neprilysin inhibitors. Achieving the optimal drug regimen is complex and best performed by a specialist heart failure team. We aim to provide a comprehensive overview of contemporary drug therapies in chronic heart failure, as well as practical guidance for their use. Treatment of patients with difficult comorbidities, including hypotension and chronic kidney disease (CKD), where a comprehensive knowledge of medication management is crucial, is the emphasis, and there are several current trials evaluating the advantages of novel treatments for heart failure, like intravenous iron. Predictive models for early intervention, risk assessment, and individualized therapy recommendations have also been made possible by the integration of AI and machine learning in the management of heart failure. By focusing on the disease's underlying mechanisms, these novel treatments for heart failure have the potential to completely transform the sector, as this narrative review highlights. By investigating these cutting-edge strategies, we seek to offer a thorough understanding of the changing paradigm of heart failure care, encouraging optimism in both patients and physicians.