Key points of heart failure in some special situations

Abstract

Introduction: Heart failure (HF) is a highly prevalent pathology worldwide, its proper diagnosis and management is essential to reduce and/or control its morbidity, however, its treatment not only goes hand in hand with the pathology itself, as the optimization of some of the diseases that usually surround this pathology directly impacts on the course of the disease.

Methods: A Narrative review of the literature was carried out.

Results: In patients with HF with preserved ejection fraction, iSGLT-2 are the only drugs that have shown to be useful in this subpopulation regardless of their comorbid state with diabetes; moreover, in patients with HF with reduced fraction with or without diabetes, their initiation can be performed early after discharge, generating an impact on the outcomes of major cardiovascular disease (MACE), hospitalization and mortality. As for chronic kidney disease, the drugs used in HF are no longer considered nephrotoxic, since their use, although it produces a reduction of the Glomerular Filtration Rate (GFR) in the long term, delays deterioration and improves prognosis. In addition, the adequate management of iron deficiency and atrial fibrillation reduces adverse outcomes and improves quality of life.

Conclusions: timely management of type 2 diabetes mellitus and chronic renal disease is essential to control the progression of heart failure, as well as therapeutics such as the use of iron carboxymaltose and the adequate therapeutic approach to atrial fibrillation are determinant to reduce adverse outcomes and improve quality of life.