Worsening Heart Failure

The deterioration of chronic heart failure – so-called worsening heart failure (WHF) – is no longer solely an acute event, but an expression of complex, often repetitive pathophysiological dynamics. Despite improved pharmacotherapy, earlier diagnosis and more sophisticated monitoring, the hospitalization rate remains high and mortality within the first year after discharge is a cause for concern. New data show that WHF is not only the final stage of advanced heart failure, but is often triggered by treatable mechanisms: Volume shifts, inadequate neurohormone blockade, inflammatory or metabolic triggers and inadequate adherence to therapy.