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Pharmaco-refractory chronic heart failure - The need for drug level tailored management.
MedLine Citation:
PMID:  22889615     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Pharmacorefractory chronic heart failure is a serious world-wide problem of systolic dysfunction not improving despite evidence based chronic heart failure pharmacotherapy. With the aim to reverse the poor pharmacorefractory chronic heart failure prognosis, severe sophisticated technical therapeutic approaches (from cardiac resynchronization usually with implantable cardioverter-defibrillator to heart transplantation) have been clinically adopted and detached at least for the most eligible pharmacorefractory chronic heart failure patients. However, both significant limitations of these highly specialised therapeutic techniques (cost, uncertain individual effect, complication, adverse effect, waiting list) and the pharmacorefractory chronic heart failure hopelessness for unfit patients make the effort to stop the pharmacorefractory chronic heart failure genesis never ending longing. Regarding growing knowledge on differences in pharmacokinetics, authors assume that the relative undertreatment despite fixed doses may explain the pharmacorefractory chronic heart failure genesis. If this hypothesis proves to be correct, the evidence based chronic heart failure pharmacotherapy innovatively personalized according to steady state drug serum level may reduce the pharmacorefractory chronic heart failure epidemiology with the lower need for cost-consuming techniques and be the promising strategy for patients left on individually ineffective evidence based chronic heart failure pharmacotherapy.
Authors:
Radka Hazuková; Rudolf Praus; Eva Cermáková; Vilma Fűrmanová; Jan Vojáček; Miloslav Pleskot
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-10
Journal Detail:
Title:  Medical hypotheses     Volume:  -     ISSN:  1532-2777     ISO Abbreviation:  Med. Hypotheses     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505668     Medline TA:  Med Hypotheses     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Cardiovascular Medicine I, University Hospital, Faculty of Medicine in Hradec Králové, Charles University in Prague, Sokolská 581, 500 05 Hradec Králové, Czech Republic.
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