PATHOPHYSIOLOGY OF ACUTE HEART FAILURE. WHAT’S NEW?

By the date, acute heart failure (AHf) is of the most significant problems in whole world healthcare, as it is one of the main causes for hospitalization to specialized units and intensive care units. About 80% of AHf cases are due to acute decompensation (AD) of heart failure (Hf), and if formerly AHf was regarded as a condition actual only for elderly (older than 70), now these are the patients “younger” — economically active (50-65 y.o.), what makes AHf not just medical but social, economical problem, demanding special attention from policies and healthcare. It is crucial to diagnose on-time for risk stratification and correct assessment. Also, mechanisms of AHf are complicated and are not studied completely, that is why till now there is no single strategy for that sort of patients management. Understanding of pathophysiological mechanisms of Hf development has been changed significantly recent decades, from simple hemodynamic model to a conception of systemic multifactorial process, with involved multiple mechanisms of various organs and systems interaction. Hemodynamic overloads, venous congestion, neuro-humoral systems activation, natri-uretic peptides, inflammation, endothelial dysfunction, oxidative stress and its influence on the heart and vessels remodeling, as mechanisms of cellular adaptation are currently the main in AHf pathogenesis reasons.