Therapeutic management of acute and chronic heart failure

Hearth failure is a common disease affecting millions of people around the world. Its morbi-mortality remains high. In its chronic form, heart failure (HF) with preserved left ventricular function (HFpEF) is distinguished from that with reduced left ventricular function (HFrEF). HFrEF has a better prognosis than HFpEF. Management of acute HF is based on prompt decongestion with medication (combined with non-invasive ventilation in the event of respiratory distress), combined with initiation/reintroduction of heart failure treatments at optimal doses in the days following the event. Close clinico-biological follow-up is essential from the time of hospital discharge. The management of chronic HF depends on its type: hydrosodium depletion, beta-blockers and modulators of the renin angiotensin aldosterone system have proved effective in HFrEF. Studies are underway in HFpEF. Sodium-glucose co-transporter 2 inhibitors have shown promising results (on prognosis and cardiovascular events) in heart failure patients (HFpEF and HFrEF), with or without diabetes. Trials are currently underway to confirm these results. Long-term follow-up of HF patients from hospital discharge is necessary to improve prognosis, enhance quality of life, reduce mortality and limit the risk of rehospitalization.