Disease monitoring of patient with chronic heart failure

Monitoring of patients with chronic heart failure requires recognition that "disease management programmes" for such patients need to be multifaceted with intensive patient education, optimisation of the therapeutic regimen and ongoing surveillance.2 6 20 In the absence of objective data, and since the various guidelines for managing patients with chronic heart failure do not provide uniform instructions, we have here given our personal view on what factors should be monitored, and how frequently. The vital question of optimisation of treatment is at present an uncertain goal wherein it is unclear whether drug doses should be directed according to completed trials or whether it is better to tailor treatment to some objective index of cardiac function in the individual patient. We declare our optimism regarding the place of BNP and NT-proBNP in individualising pharmacological treatment. The issue will become clear upon completion of several ongoing trials.