Conceptos epidemiológicos, manejo diagnóstico y farmacológico de la insuficiencia cardiaca congestiva crónica

  • Christian Osmar Chávez Alfonso Universidad Nacional de Asunción
  • Osmar Antonio Centurión Universidad Nacional de Asunción
Palabras clave: insuficiencia cardiaca, terapéutica, cardiomiopatías, volumen sistólico, epidemiología

Resumen

La insuficiencia cardiaca (IC) es un síndrome clínico complejo que resulta de cualquier deterioro estructural o funcional del llenado ventricular o gasto cardiaco. Las manifestaciones clínicas típicas de la insuficiencia cardiaca son disnea y fatiga, que pueden limitar la tolerancia al ejercicio, y retención de líquidos, lo que pueden conducir a la congestión pulmonar y esplácnica, y  edema periférico. La prevalencia de la IC se sitúa aproximadamente en el 1-2% de la población adulta en países desarrollados, y aumenta a más del 10% entre personas de 70 o más años de edad. El riesgo de IC a los 55 años es del 33% para los varones y el 28% para las mujeres. Es categórico el hecho de la existencia de una tendencia demográfica hacia el aumento de la longevidad de la población en general, lo cual implica a su vez un aumento en la incidencia de la insuficiencia cardiaca. Por lo tanto, las investigaciones científicas se deben dirigir al estudio del manejo diagnóstico y terapéutico de esta población con edad avanzada. Normalmente, la miocardiopatía es la causa de la disfunción ventricular sistólica o diastólica. No obstante, las anomalías de válvulas, pericardio, endocardio, ritmo cardiaco y conducción también pueden causar IC, en algunas ocasiones se puede deber a la combinación de más de una de ellas. Los objetivos del tratamiento para los pacientes con IC son mejorar el estado clínico, la capacidad funcional y la calidad de vida, prevenir las hospitalizaciones y reducir la mortalidad. Los estudios experimentales y clínicos deben enfocarse a seguir aportando datos sobre la fisiopatología, la influencia de la edad, los criterios diagnósticos, la caracterización de subgrupos especiales, y la identificación de nuevos agentes farmacológicos para mejorar la estrategia terapéutica preventiva y curativa en pacientes con insuficiencia cardiaca congestiva crónica.

Citas

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Publicado
2019-03-01
Sección
ARTÍCULOS DE REVISIÓN