Summary

The analysis of the heart failure therapeutic allows us to conclude that for many patients it will be necessary the prescription of different drugs to control all the multiple active mechanism in the progression of heart failure. Digitalis, diuretics and angiotensin-converting-enzyme inhibitors in patients with ventricular dysfunction results in clinical and hemodynamic beneficits and reduces mortality in this population. Recently, a new specific renin-angiotensin-aldosterone system blockade has been used with angiotensin II receptor blockers, with similar benefits and less side effects. Betablockers may lead to: upregulation of beta adrenergic receptors, block of action of high blood vessels of norepinephrine, inhibition of renin-angiotensin- aldosterone system reducing angiotensin II effects. The authors evaluated the effects of betablockers in the heart failure patients and reached a morbidity and mortality reduction in patients with ventricular dysfunction. Aldosterone has an important role in the pathophysiology of heart failure: Aldosterone promotes the retention of sodium, the loss of magnesium and potassium, sympathetic activation, parasympathetic inhibition, myocardial and vascular fibrosis, baroreceptor dysfunction. Blockade of aldosterone receptors by spironolactone, reduces the risk of both morbidity and death among patient with severe heart failure.