[On the history of heart failure].

Abstract

The heart is by far the organ that is best known and has been identified for a long time. Myogenic weakness of the heart muscle pump with left-ventricular dysfunction remains the cardiac disease with the poorest prognosis while increasing in prevalence and incidence. Aside from all sorts of mystic treatment attempts and dubious herbal medicine, bloodletting was established early on as a superior remedy, which was applied in response to almost all cardiac illnesses. The first and perhaps most important cardiac drug was digitalis, the glycoside of the red and even more so of the white foxglove, described in 1552 by Leonhart Fuchs. In the 1980s, vasodilators and inotropic drugs supplemented the classical medications digitalis and diuretics. ACE inhibitors and beta-receptor blockers were added in the 1990s; at the turn of the millennium, the cardiac resynchronization therapy (CRT) and left-heart assist systems were developed; lately, there have been cellular and genetic approaches as well as xenotransplants. Preliminary results with stem cell technology are encouraging; however, it will be years until a clinical application-if it will happen at all.