[The beneficial effects of treatment with betablockers in patients with chronic heart failure have been demonstrated in several large, prospective, randomised, placebo-controlled clinical trials. In large trials with mortality as the endpoint, the long-term use of bisoprolol, carvedilol, nevibolol and metoprolol succinate have been associated with a reduction in total mortality, cardiovascular mortality, sudden cardiac death and death due to progression of heart failure in patients of functional classes II-IV. These favorable clinical experiences warrant a recommendation that beta-blockers should be used in all haemodynamically stable heart failure patients with reduced left ventricular systolic function who are on standard treatment, unless contraindicated. In this review, the most important data of clinical trials and practical considerations of therapy with beta-blockers in heart failure are summarized.]

[Diuretics are an integral part of the management of chronic heart failure. Although there are no large, randomized, placebo-controlled, multicentric studies available to show that loop- and thiazid diuretics improve survival, the efficacy of these drugs in relieving heart failure symptoms and fluid retention is indisputable. The third class of diuretics used in heart failure is aldosterone antagonists, whose beneficial effects on mortality and morbidity were demonstrated in the RALES and EPHESUS trials. In this paper, the effects and side effects of the various diuretics, as well as the indications and recommendations on their use are reviewed. New options in diuretic treatment, including adenosine receptor blockers, vasopressin antagonists, atrial natriuretic peptide analogues and ultrafiltration are also presented.]

[The past decade has seen a considerable change in the approach to manage heart failure. In chronic heart failure, physical training primarily improves peripheral circulation rather than the function of the left ventricle. Regular training of patients with stable NYHA II-III stages improves physical stress tolerance and respiratory function, and also reduces the over-activated sympathetic tone. It has beneficial effects on the biochemical processes of the skeletal muscles. The duration, intensity and frequency of the training are individually set and can be changed according to the clinical state of the patient. The recommended intensity of the training is 60 to 70% of the peak oxygen use. The duration and frequency of the training depends on the clinical state of the patient and it can be raised to 3 to 6 occasions and the duration can vary between 30 to 60 minutes. For safety reasons the patient should be monitored before, during and after physical training. Cardiological rehabilitation should be a team work, with the physician as the co-ordinator, but the physiotherapist, the dietician, the psychologist and the social worker all have important, indispensable roles in achieving the optimal state of the patient.]

[The six-part summary presents the epidemiology, diagnosis, pathogenesis, and treatment of hyperkalaemia.]