Abstract Pharmacological treatment of heart failure with reduced ejection fraction (HFREF) has undergone changes over the years as discoveries have been made related to new systems involved in its pathophysiology and, consequently, of new therapeutic targets. For this treatment, certain drug classes have become essential and should be used in combinations with the objective of reducing the disease’s high rates of morbidity and mortality. They are therefore considered the pillars of treatment for patients with HFREF. These drug classes act […]

Angiotensin-converting enzyme inhibitors (ACEI) […]

Abstract Heart failure with preserved ejection fraction (HFpEF) is a syndrome in which there is clinical evidence of heart failure (HF), left ventricle ejection fraction (LVEF) ≥50%, and evidence of diastolic dysfunction and/or structural cardiac changes. The pathophysiology of HF with preserved LVEF is related to the primary morbidities responsible for cardiac and vascular aggression via a chronic proinflammatory state involving the endothelium. Currently, the foundation of management of HFpEF rests on 5 pillars: control of circulatory congestion, management of […]

Abstract Heart failure is the leading cause of hospitalization in patients over 65 years of age, and, in most cases, patients present with signs and symptoms of congestion. Thus, diuretics play a prominent role and are among the most used drugs in heart failure. Although they have been used for decades, the lack of large controlled studies in the literature to support their use more adequately and the eventual development of resistance/tolerance are among the factors that make management of […]

Heart failure (HF) is one of the leading causes of death, hospitalization, and rehospitalization worldwide. In spite of advances in treatment with new medications, devices, and heart transplantation, the condition is still associated with significant morbidity and mortality.1 One factor that likely contributes to this fact is the difficulty in titrating doses of drugs targeted at treating HF.2 […]

Abstract Heart failure is a highly prevalent condition, and a series of new therapies have emerged over the past years, improving patients’ survival and quality of life, simultaneously making its management more complex. When treating patients with advanced heart failure, that is, with persistent limiting symptoms and recurrent hospitalizations, it is usually even more challenging to manage cases, given that, in addition to frequently having characteristics that would exclude them from most clinical studies, they pose a series of difficulties […]

Introduction Advances in oncology, such as better access to health care system, earlier cancer diagnosis, and new chemotherapies, have led to longer survival of oncologic patients over the last decades. However, this population is vulnerable to cardiovascular drug-related adverse events like cardiomyopathy, which leads to heart failure and impairs survival and quality of life. , Among different classes of chemotherapeutic agents, anthracyclines (ANT) stand out as the most related to cardiomyopathy, which may affect cancer survivors in 9% of all […]

Abstract Aortic stenosis is the most prevalent valve disease in clinical practice. The wild form of transthyretin amyloidosis has an increased incidence in elderly individuals, usually over 70 years of age. Amyloidosis and aortic stenosis are 2 diseases that affect similar populations; therefore, they may coexist in the same patient. Patients with amyloidosis and aortic stenosis have disproportionately higher serum levels of troponin and NT-proBNP compared to patients with pure severe aortic stenosis in addition to greater ventricular hypertrophy. Therapeutic […]

Abstract Amyloidosis is a multisystem disease characterized by deposition of fibrillar proteins in different tissues, the heart being one of the sites of amyloid deposition. Cardiac amyloidosis may present as a restrictive syndrome with symptoms of heart failure (HF). Treatment includes prognosis-modifying medications in HF; their optimization, however, is a challenge due to the frequent adverse effects in this population. Renin-angiotensin-aldosterone system blockade should be carried out using low doses because, due to autonomic dysfunction, these drugs may cause hypotension […]

Abstract Heart failure with preserved ejection fraction (HFpEF) is a syndrome with multiple etiologies and varied phenotypic manifestations. Amyloidosis is a systemic disease that frequently affects the myocardium, and it may represent a specific etiology of HFpEF. The treatment of HFpEF associated with amyloidosis is not based on specific evidence, and the risk of hypotension as an adverse effect of pharmacological management is always a concern. In this context, this review addresses some strategies for controlling circulatory congestion, arrhythmias, cardiac […]