Current Predictors of Survival and Methods of their Correction in Patients with Chronic Heart Failure in Medical Practice

Chronic heart failure (CHF) is an important problem of modern cardiology, a clinical syndrome, determines the course and prognosis of most cardiovascular disease is manifested by shortness of breath at rest or on exertion, fluid retention, structural or functional alteration of the heart. According to the national registers and epidemiological studies of various European countries, the prevalence of heart failure in the adult population ranges from 1,5 to 5,5% and increases with the age, and those over 70 years - is 15%. We know that informative clinical and demographic predictors of poor quality of life in patients with CHF is smoking, myocardial infarction, presence of chronic obstructive pulmonary disease, increased indices of left ventricular end-volume>155 ml / m², III-IV FC by NYHA, hypercreatynemia, hyponatriyemia, night apnea. Тo the recommendations of the Association of Cardiologists of Ukraine on the diagnosis, treatment and prevention of heart failure (2012), in the case of NT-proBNP in untreated patients 2000 pg / ml is a high probability of having heart failure and the risk of dangerous complications and death increases considerably at levels> 1000 pg / ml. It turned out that halektyn-3 is an independent predictor of worsening heart failure prognosis, increase its content of over 17.8 ng / mL, was associated with a higher risk of adverse events, including death and hospitalization. We study the role of nitric oxide, as the main pathogenetic factors of endothelial dysfunction in patients with CHF is to reduce the bioavailability of nitric oxide (NO) and increased endothelin-1, which has a strong vasoconstrictor action is inhibition of the expression of endothelial NO-synthase (eNOS) and changing the tumor necrosis factor α, which depends on the clinical severity of heart failure indicate patient prognosis. At present the algorithm of patients with heart failure and left ventricular systolic dysfunction, based on data from evidence-based medicine. Pharmacological agents can be divided into symptomatic and that improve the survival of patients. The first improves hemodynamics and clinical status of patients, although their ability to improve long-weather survival is not proven (thiazides, cardiac glycosides). The second block at different levels of neurohormonal activity of key systems responsible for the progression of CHF and help to increase the life expectancy of patients. Today, when all patients receive standard treatment to increase life expectancy, the problem remains acute improve their quality of life. Therefore, it is important to determine predictors of prognosis of CHF, because their modification gives the potential to increase the chances of life of these patients. Predictors of bold, be looking for further improvement algorithm individual prognosis and treatment policy in сhronic heart failure.