Thesis Statement
The innovative strategies both in medical and surgical aspects of congestive heart failure treatment have more advanced opportunities to improve the life expectancy diagnosed with this disease.
Diagnosis with Supporting Details
Congestive heart failure is associated with decreased heart function. During this illness, the heart muscle cannot generate the energy needed to circulate the necessary amount of blood in the body. In almost all cases, ischemic heart disease is the leading cause of heart failure (Clark et al., 2019). Taking into consideration this fact, clinicians focus on choosing approaches to myocardial revascularization in chronic heart failure. Another leading cause of this problem is myocardial injury leading to abnormal ventricular remodeling due to chamber dilatation and impaired contractility (Clark et al., 2019). These changes result in a decrease in cardiac output, a decline in organ perfusion, and activation of compensatory neurohormonal systems. The relevance of the problem of this disease for health care is conditioned by the prevalence of pathology and the high economic costs of its treatment. These problems are due to the severe progressive course of the disease, multiple hospitalizations, early disability, expensive cardiac surgery and long-term drug treatment, complex program rehabilitation and high mortality.
Treatments with Supporting Details
Approaches to the treatment of heart failure have changed repeatedly. In the 50-the 60s of the 20th century, inotropic heart stimulation was considered the primary therapy (Alvarez et al., 2018). In the 70s, emphasis was placed on combating fluid retention, while in the 80s, clinicians focused on decreasing the load on the heart through vasodilators (Alvarez et al., 2018). Later, in the 80s, a phosphodiesterase inhibitor III (PDE III) was synthesized for the dual effect – inotropic and vasodilating indicators. Since the 1990s, the mainstay of treatment has been the suppression of excessive activation of neurohumoral systems (Alvarez et al., 2018). ACE inhibitors, beta-blockers, and diuretics have traditionally been used to treat chronic heart failure. Medicines are used to prevent complications and improve quality of life.
In the case of severe heart failure, a defibrillator is frequently implanted as part of a pacemaker to prevent hazardous irregular cardiac rhythms (Alvarez et al., 2018). Resynchronization therapy is another name for this treatment (Alvarez et al., 2018). Physiotherapy is an essential part of successful treatment. In emergency cases, surgery is performed, which is especially necessary when disorders of the heart valves cause insufficiency. Sometimes, a heart transplant is the only way to save a patient’s life.
New Treatments/Medicines – And Benefits with Supporting Details
At the end of the last century, the neurohormonal theory of the pathogenesis of heart failure became generally accepted, based on the idea of ​​excessive activation of the neurohumoral systems – renin-angiotensin-aldosterone (RAAS) and sympathetic-adrenal (SAS). Biologically active substances produced by these systems, as well as vasopressin and endothelins, which increase during this illness, are responsible for vasoconstriction and retention of sodium and water in the body, steady hyperplasia and proliferation of cardiomyocytes. As a result, myocardial and vascular remodeling occurs. Against this background, systolic and diastolic dysfunction of the left ventricle is aggravated, which potentiates an increase in the activity of neurohumoral systems, closing the pathological circuit and maintaining a high potential for myocardial damage and fatal arrhythmias (Alvarez et al., 2018). Recent studies have shown the importance of cytokines in the development and progression of heart failure. Pro-inflammatory cytokines stimulate the production of endothelin and nitric oxide synthase, which contribute to the development of oxidative stress and apoptosis, causing the progression of myocardial dysfunction.
The development of new angiotensin (AT)-converting enzyme (ACE) inhibitors is in the direction of finding drugs with optimal efficacy and safety profiles. Imidapril hydrochloride, a long-acting ACE inhibitor, is in the clinical trial phase (Alvarez et al., 2018). Compared with other group drugs, dry cough rarely develops against its background. Using inotropic detection agents leads to reduced myocardial contractility and the possibility of its detection. It was found that using digoxin helps reduce the severity of symptoms of congestive heart failure and is especially indicated in patients with concomitant supraventricular tachycardia. Recently, new classes of drugs have been used to treat heart failure, such as vasodilators. These drugs primarily affect the peripheral arteries, stimulating their expansion. As a result, by facilitating blood flow through the vessels, the work of the heart improves. Vasodilators include nitrates, angiotensin-converting enzyme blockers, and calcium channel blockers.
An implantable cardioverter-defibrillator (ICD) is a device that detects and treats most cardiac tachyarrhythmias, such as ventricular tachycardia (VT) and ventricular fibrillation, automatically (Maron et al., 2021). ICD practically stimulates the heart when it beats incorrectly or atypically. This technology is adapted to estimating the heart’s electrical activity based on which the pacemaker evaluates the necessity to send the electric signals for supporting a normal heartbeat. When the defibrillator is implanted, it allows to monitor of the atypical heartbeats and rhythms and supports the normal functioning of the heart simultaneously. In cases where tachyarrhythmias disturb the average heart rate, ICD defines the problem and restores the right rapidly, which helps to prevent many life-threatening conditions. Moreover, this technology includes the function to alert the user to visit for an assessment when the heart condition cannot be restored only by the ICD alone. For emergency medical situations, the ICD can be configured to generate 30-second beeps (Maron et al., 2021). The ICD has two different signals, which may indicate various problems. The combination of sounds may represent the distortions in a heartbeat or indicate that ICD cannot support the heart and currently requires an urgent visit to the doctor. Such signals are repeated in varied periods, which are chosen based on the severity of the problem. For example, when ICD needs adjusting, the signals are repeated every twenty-four hours.
Closing
Based on the analyzed materials, such innovations in heart failure treatment as the development of new types of inhibitors and the implantable cardioverter-defibrillator are beneficial. The innovations mentioned are vital for improving healthcare quality and increasing the life expectancy of patients with congestive heart failure. New inhibitors are designed to minimize the negative impacts of the treatment on the patient’s lives. Despite the significant risks of surgical interventions, this technology can be efficiently used in monitoring heart failure-related problems preventing many deaths.
Future directions in improving treatment opportunities for people with heart failure are primarily related to medications. The development and implementation of new substances and inhibitors should be efficiently analyzed. A comparative analysis of the traditional and innovative inhibitors can be conducted to highlight the practical essence of the new elaboration. Therefore, this sphere requires more prescience attention from the scientists, especially to state the reliability and repeatability of gained results in different conditions.
References
Alvarez, B., Abou-Jokh, C., Brion, M., Gonzalez-Juanatey, R., Grigorian-Shamagian, L., & Rodrigez-Manero, M. (2018). Innovative strategies in heart failure: Present and future.Archives of Medical Research, 49(8), 558–567. Web.
Clark, AL, Kalra, PR, Mark, O., Petrie, M, Tomlinson. L., & Tomson, C. (2019). Change in renal function associated with drug treatment in heart failure: National guidance. Heart, 105(12), 904–910.
Maron, B., Maron, B., & Rowin, E. (2021). Evolution of risk stratification and sudden death prevention in hypertrophic cardiomyopathy: Twenty years with the implantable cardioverter-defibrillator.Heart Rhythm, 18(6), 1012–1023. Web.