[Therapy of heart failure. I. Definition, pathophysiology, therapy of acute heart failure].

Acute cardiac insufficiency is often the result of acute or chronic overloading of the heart due to arterial hypertension, coronary heart disease and/or a reduction in ventricular muscle mass following myocardial infarction. Whenever possible, treatment should be causal (e.g. treatment of hypertension, operative correction of valvular disease). While the incidence of heart failure continues to increase, morbidity and mortality associated with the disease process have remained essentially unchanged. About 30% of the patients die within the first 12 months. The prognosis and outcome of heart failure patients strongly correlate with markers of neuroendocrine activation. While numerous drugs are capable of improving hemodynamics at rest or physical performance, they fall to prolong survival. It is hoped, that new pathophysiological information might lead to the development of new, effective therapeutic approaches.