Chronic heart failure: from pathogenesis to personalized therapy and digital technologies

Objective . To systematize and critically analyze current approaches to the diagnosis and treatment of chronic heart failure (CHF), with a focus on personalized therapeutic strategies and the integration of digital technologies into clinical practice. Material and methods . A systematic search was conducted in PubMed, Scopus, Web of Science, and eLibrary databases for the period 2019–2024. Keywords included: “chronic heart failure”, “CHF pathogenesis”, “personalized CHF therapy”, and “digital technologies in cardiology”. A total of 145 sources meeting the inclusion criteria were selected and analyzed. Results . The review describes the most recent pathophysiological mechanisms of CHF development and examines current pharmacological and device-based therapies, including SGLT2 inhibitors, sacubitril/valsartan, cardiac resynchronization therapy, implantable cardioverterdefibrillators, and mechanical circulatory support devices. Special attention is given to the role of digital technologies, including telemedicine, remote monitoring, and artificial intelligence, in managing patients with CHF. Conclusions . A personalized approach, incorporating pharmacogenetics and the implementation of digital solutions, represents a promising direction for improving the effectiveness of CHF treatment and patient outcomes. Further integration of innovative technologies into clinical practice and addressing the accessibility of novel therapeutic methods are required.