Modern view on chronic heart failure therapy: guidelines‑2020 key messages and adjuvant therapy

Abstract

Objective. Data analysis on modern therapy strategies of chronic heart failure (CHF) and the possibilities of adjuvant therapy with phosphocreatine. Methods. Analysis and systematization of the positions of the year 2020 Russian Ministry of Health clinical guidelines on CHF and modern local and international literature data.Results. Currently, for the treatment of CHF, a wide range of drugs are used that can improve the prognosis and reduce mortality in patients, including β-blockers, blockers of the renin-angiotensin-aldosterone system, diuretics, aldosterone antagonists and neprilisin inhibitors. At the same time, based on the peculiarities of the pathogenesis of CHF and the characteristics of the myocardial energy metabolism in heart failure conditions, a promising direction is the use of additional (adjuvant) drugs in this category of patients. Here, a special place is occupied by phosphocreatine, which is essential in maintaining the energy balance of cardiomyocytes and has been widely studied in a large number of studies that have confirmed its ability not only to increase exercise tolerance in patients with CHF, but also to improve heart systolic function and prognosis, improving patient survival. Conclusion. Based on the reviewed body of evidence, a rational approach in the management of patients with CHF is to add adjuvant phosphocreatine therapy to the standard treatment strategy according to the current clinical guidelines, which provides an additional improvement in prognosis and a decrease in mortality rates in patients.