Avtor/Urednik		Kenda, Miran F; Šebeštjen, Miran
Naslov		Pharmacological approach for the prevention of sudden death in patients with congestive heart failure
Tip		članek
Vir		Ital Heart J
Vol. in št.		Letnik 5, št. suppl 1
Leto izdaje		2004
Obseg		str. 83S-7S
Jezik		eng
Abstrakt		Patients with heart failure (HF) are at increased risk of sudden cardiac death (SCD). This fact is not only a medical but also a great socio-economic problem. Despite of the significant progress in treatment and prevention of cardiovascular diseases, the incidence and prevalence of HF have been increasing especially in elderiy. The most common cause of chronic HF as well as SCD is coronary artery disease (CAD) in about 70% of patients. The most frequent cause of SCD in HF are malignant ventricular arrhythmias, especially ventricular tachycardia caused by acute coronary event coupled with previous myocardial damage and pump failure. The degree of functional impairment classified by NYHA classification is the simplest variable to predict overall mortality. Left ventricular dysfunction in terms of ejection fraction has been established as a major predictor of outcome in studies evaluating CAD, secondary prevention of SCD as well as in multiple HF studies. Neurohormonal activity has also been related to prognosis. The signal-averaged ECG may have value in predicting SCD in post-myocardial infarction patients. Heart rate variability is reduced in patients with congestive HF and could be a useful predictor of death. Electrophysiologic studies have identified patients at higher risk for SCD in CAD groups. Unfortunately, there are not until now undisputedly accepted markers to identify the patients with HF who are most prone to die suddenly. Concerning therapeutic strategies in HF to prevent SCD, data about ACE-inhibitors, beta-blockers and amiodarone are well documented; ACEinhibitors for preventing the progression of CAD and HF, betablockers with relief of ischemia, reduction of heart rate and maintenance of favorable autonomic balance, and amiodarone with its unique complex antiarrhythmic action, and also combination of amiodarone and beta-blockers. (Abstract truncated at 2000 characters).
Deskriptorji		HEART FAILURE, CONGESTIVE DEATH, SUDDEN, CARDIAC ANGIOTENSIN-CONVERTING ENZYME INHIBITORS ADRENERGIC BETA-ANTAGONISTS AMIODARONE CORONARY DISEASE TACHYCARDIA, VENTRICULAR VENTRICULAR DYSFUNCTION, LEFT ELECTROCARDIOGRAPHY DEFIBRILLATORS, IMPLANTABLE RISK FACTORS