Clinical and demographic characteristics of an outpatient Russian population with chronic heart failure at the time of enrollment in the QUALIFY registry for evaluating consistency with clinical guidelines on drug therapy

The presented clinical case describes the development of diffuse myocarditis in a 31-year-old man with the outcome of dilated cardiomyopathy and terminal chronic heart failure, resistant to drug therapy that required heart transplantation. Discussed aspects of diagnosis, clinical manifestations, tactics of patient management and indications for heart transplantation.

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Chronic heart failure: actual aspects of treatment in real clinical practice

Medical Council ◽

10.21518/2079-701x-2019-16-50-58 ◽

2019 ◽

pp. 50-58

Author(s):

D. I. Trukhan ◽

E. L. Davydov

Keyword(s):

Heart Failure ◽

Clinical Practice ◽

Drug Therapy ◽

Chronic Heart Failure ◽

Sinus Node ◽

Public Health Problem ◽

Point Of View ◽

Primary Health ◽

Long Time ◽

Real Clinical Practice

An urgent public health problem is the optimization of drug therapy in patients with chronic heart failure.A large number of works devoted to the treatment of chronic heart failure form the point of view that about the treatment of chronic heart failure «all is well known for a long time.» However, in real clinical practice, especially at the stage of primary health care, for various reasons, possible pitfalls, reefs and shallows are not taken into account, the underestimation of which can introduce certain difficulties and cause the treatment of patients with chronic heart failure to be ineffective.The review article examined a number of important aspects of the treatment of chronic heart failure, which, for various reasons, are underestimated in the supervision of patients. First of all, this refers to antagonists of mineralocorticoid receptors, in particular to spironolactone, and an inhibitor of If - channels of the sinus node ivabradine.The results of foreign and Russian studies, modern recommendations for the supervision of patients with chronic heart failure, indicate that the presence of spironolactone and ivabradine in the arsenal of a practical doctor allows optimizing drug therapy in patients with chronic heart failure and increasing its effectiveness.

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The role of compliance in the treatment of chronic heart failure and the ways to improve it

Курский научно-практический вестник «Человек и его здоровье» ◽

10.21626/vestnik/2021-3/01 ◽

2021 ◽

Vol 24 (3) ◽

pp. 4-13

Author(s):

Natalia S. Meshcherina ◽

Elena M. Khardikova ◽

Nina K. Gorshunova ◽

Natalia V. Abrosimova ◽

Tatyana S. Leontieva

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Guidelines ◽

Large Scale ◽

Positive Impact ◽

Treatment Compliance ◽

Good Clinical Practice ◽

Patient Registries ◽

Physician Compliance ◽

Scientific Practical

Despite the development and implementation of clinical guidelines, emergence of modern effective drugs for the treatment of chronic heart failure (CHF), this pathology is characterized by stable progression, directly worsening the quality of life and decreasing the life expectancy. With that, treatment efficacy directly depends on high treatment compliance in patients with CHF both at the treatment start and upon its subsequent correction. One should also not underestimate the value of patient readiness to modify their lifestyle. Besides, the complete physician compliance with clinical guidelines also plays a significant role. The absence of correspondence between principles defined in the guidelines and really administered drugs excludes the possibility of achieving control over CHF symptoms and positive impact on the prognosis. This review is aimed at evaluating treatment compliance among both patients with CHF and their physicians with a focus on Russian studies and good clinical practice (GCP) compared to studies of foreign authors. Unfortunately, the problem of compliance in CHF in the Russian Federation has not been sufficiently analyzed in large-scale studies up to the present time: CHF patient registries mainly allow to detect clinical and epidemiological disease features, while almost not covering compliance issues. It should also be noted that the problem of compliance in both physicians and patients is undoubtedly up-to-date, as it often defines further prognosis in patients with CHF, which explains the scientific practical value of large trials with subsequent thorough analysis and searches regarding increasing its efficiency.

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