CHRONIC HEART FAILURE: MODERN DIAGNOSTIC AND THERAPEUTIC APPROACHES
Keywords:
Chronic heart failure, pathophysiology, echocardiography, natriuretic peptides, ARNI, SGLT2 inhibitors, beta-blockers, implantable cardioverter-defibrillator, cardiac resynchronization therapy, gene therapy, cell therapy, cardiac rehabilitation.Abstract
Chronic heart failure (CHF) is a complex clinical syndrome characterized by the heart's persistent inability to pump blood adequately to meet the body's demands or to receive blood effectively. This article provides a comprehensive scientific overview of CHF's pathophysiology, modern diagnostic methods, and treatment strategies. The pathogenesis of CHF involves myocardial systolic or diastolic dysfunction, neurohormonal activation, inflammatory processes, and oxidative stress. Diagnostic approaches emphasize the role of echocardiography, natriuretic peptides (BNP, NT-proBNP), and cardiac magnetic resonance imaging (MRI) in accurate assessment. Treatment strategies include pharmacological interventions such as angiotensin receptor-neprilysin inhibitors (ARNI), sodium-glucose cotransporter-2 inhibitors (SGLT2i), beta-blockers, and mineralocorticoid receptor antagonists, alongside device-based therapies like implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy (CRT). Lifestyle modifications and cardiac rehabilitation are integral to improving patients' functional status. Emerging research on gene and cell therapies, as well as artificial intelligence-based models, offers promising future directions. The article underscores the importance of early diagnosis and individualized treatment to enhance patient outcomes and quality of life.
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References
1. Xamrayeva, N. X., & Raximov, M. R. (2020). Fundamentals of Diagnosis and Treatment of Cardiovascular Diseases. Tashkent: Medical Publishing House.
2. Abdullayeva, G. K. (2018). Modern Approaches in Cardiology. Tashkent: Ministry of Health of Uzbekistan.
3. Mirzayev, A. B., & Saidov, T. S. (2022). Clinical Diagnosis and Treatment Methods of Heart Failure. Medical Journal, 4(2), 45–52.
4. Usmonov, Sh. M. (2019). Propedeutics of Internal Diseases: Cardiovascular System. Samarkand: SamMI Publishing House.
5. Ponikowski, P., Voors, A. A., Anker, S. D., et al. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37(27), 2129–2200.
6. McMurray, J. J. V., Solomon, S. D., Inzucchi, S. E., et al. (2019). Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction (DAPA-HF Trial). New England Journal of Medicine, 381(21), 1995–2008.
7. Packer, M., Anker, S. D., Butler, J., et al. (2020). Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure (EMPEROR-Reduced Trial). New England Journal of Medicine, 383(15), 1413–1424.
