Article

Diagnóstico y tratamiento de la insuficiencia cardíaca diastólica

Servicio de Cardiología. Hospital Universitario Reina Sofía. Córdoba. España
Revista española de cardiología, ISSN 0300-8932, Vol. 57, Nº. 6, 2004, pags. 570-575 DOI: 10.1016/S0300-8932(04)77147-X
Source: OAI

ABSTRACT La insuficiencia cardíaca diastólica, o con función sistólica conservada, representa entre el 30 y el 50% de todos los casos de insuficiencia cardíaca, y su pronóstico es casi tan desfavorable como el de los pacientes con insuficiencia cardíaca crónica (ICC) con función sistólica deprimida. En la actualidad sólo se exige para su diagnóstico la presencia de criterios clínicos estrictos de insuficiencia cardíaca y una fracción de eyección del ventrículo izquierdo (FEVI) conservada (mayor del 40-50%), aunque la determinación de los valores de péptido natriurético cerebral puede tener interés para el diagnóstico en el futuro. Puesto que no hay evidencia derivada de ensayos clínicos importantes, salvo el ligero beneficio obtenido con candesartán en el estudio CHARM en la reducción de los reingresos, su tratamiento se basa en la identificación y el tratamiento de su etiología (hipertensión arterial, cardiopatía isquémica), el control de la frecuencia cardíaca y el alivio de la congestión, por lo que la combinación de diuréticos a dosis bajas, antihipertensivos bradicardizantes (bloqueadores beta, antagonistas del calcio) y antagonistas de la angiotensina en la actualidad parece ser la mejor estrategia terapéutica.

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