CHRONIC HEART FAILURE: CAUSE OR RESULT?

Abstract

Heart failure syndrome was first recognized as a new epidemic about 30 years ago. Given that currently the aging of the population is progressively increasing, the total number of patients with heart failure is also increasing. Despite the constant improvement of diagnostic and therapeutic algorithms, the number of patients with this diagnosis is constantly growing. Chronic heart failure is one of the main causes of both primary and secondary hospitalizations in people of all ages, resulting in an increase in the share of national spending for the health care system. The prevalence of heart failure is influenced by both specific and nonspecific risk factors and the number of comorbidity that patients may have. Recent national and international studies suggest that the number of patients with heart failure in low-income countries is much higher due to the prevalence of infectious diseases and low sociocultural status. There is a growing tendency to diagnose chronic heart failure in relatively young people that can be attributed to the pernicious impact of a sedentary lifestyle, an increase in obesity among the population and a decrease in the number of periodic preventive checkups. The ability to diagnose and, last but not least, to predict the risk of developing chronic heart failure will allow healthcare workers to influence one or another mechanism of the development different in patients of different ages, geographical location, sex and concomitant pathology. It has been already known that young patients are more likely to have heart failure with a preserved ejection fraction, but this does not mean that this group of patients does not need a proper diagnostic search and therapeutic approach. All the recommendations of the European Association of Cardiologists on the management of patients with chronic heart failure, including the Recommendations of 2021 are based on evidence-based medicine, the main message of which is the integrated approach and timeliness of medical services. This literature review reveals a structural analysis of literature sources, which demonstrate the need for a holistic understanding of the consistent adaptive changes in systems and individual organs of the human body that occur in certain diseases and become both causes and consequences of chronic heart failure.