CURRENT CONCEPTS IN THE TREATMENT OF CONGESTIVE-HEART-FAILURE

Heart failure is a complex syndrome; therapy should be aimed at the in dependent goals of prolonging life and of improving symptoms and quali ty of life. Some therapies are effective in achieving one goal but not the other. Shortterm symptomatic relief may relate to alleviation of haemodynamic abnormalities and of congestion, whereas slowing progress ion of the disease and reducing mortality involve neurohormonal mechan isms, left ventricular remodelling and arrhythmia generation. Current therapy is moderately effective on these end-points, but newer approac hes to management are necesssary to produce more profound improvements in morbidity and mortality.