THERAPEUTIC APPROACH AND CLINICAL MANAGEMENT OF DECOMPENSATED HEART FAILURE

Abstract

Decompensated heart failure (HF) is the leading cause of hospitalization among the elderly, requiring a precise diagnostic approach and early intervention to mitigate the high risk of adverse events during the vulnerable post-discharge period (Voors et al., 2022; Morrow et al., 2024). Contemporary diagnosis integrates biomarkers (BNP/NT-proBNP) with lung ultrasound and artificial intelligence (AI) support (Wintrich et al., 2022). Pharmacological management has evolved toward rapid stabilization and the in-hospital initiation of disease-modifying therapy—notably SGLT2 inhibitors (empagliflozin) and the transition to sacubitril/valsartan—which have demonstrated significant reductions in mortality and rehospitalization rates (Voors et al., 2022; Morrow et al., 2024). Systematic identification of frailty and the implementation of multidisciplinary early cardiovascular rehabilitation programs are essential for restoring functional capacity and improving quality of life (Talha et al., 2023; Kamiya et al., 2025; Nakaya et al., 2021).