Congestion and Diuretic Resistance in Acute or Worsening Heart Failure

Hospitalisation for acute heart failure (AHF) is associated with high mortality and high rehospitalisation rates. In the absence of evidence-based therapy, treatment is aimed at stabilisation and symptom relief. The majority of AHF patients have signs and symptoms of fluid overload, and, therefore,...

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Main Authors: Ingibjörg Kristjánsdóttir, Tonje Thorvaldsen, Lars H Lund
Format: Article
Language:English
Published: Radcliffe Medical Media 2020-09-01
Series:Cardiac Failure Review
Online Access:https://www.cfrjournal.com/articles/congestion-and-diuretic-resistance
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author Ingibjörg Kristjánsdóttir
Tonje Thorvaldsen
Lars H Lund
author_facet Ingibjörg Kristjánsdóttir
Tonje Thorvaldsen
Lars H Lund
author_sort Ingibjörg Kristjánsdóttir
collection DOAJ
description Hospitalisation for acute heart failure (AHF) is associated with high mortality and high rehospitalisation rates. In the absence of evidence-based therapy, treatment is aimed at stabilisation and symptom relief. The majority of AHF patients have signs and symptoms of fluid overload, and, therefore, decongestion is the number one treatment goal. Diuretics are the cornerstone of therapy in AHF, but the treatment effect is challenged by diuretic resistance and poor diuretic response throughout the spectrum of chronic to worsening to acute to post-worsening HF. Adequate dosing and monitoring and evaluation of diuretic effect are important for treatment success. Residual congestion at discharge is a strong predictor of worse outcomes. Therefore, achieving euvolaemia is crucial despite transient worsening renal function.
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series Cardiac Failure Review
spelling doaj-art-bd035d6b11864aefbe57fc70c6d15d672025-08-20T02:37:48ZengRadcliffe Medical MediaCardiac Failure Review2057-75402057-75592020-09-01610.15420/cfr.2019.18Congestion and Diuretic Resistance in Acute or Worsening Heart FailureIngibjörg Kristjánsdóttir0Tonje Thorvaldsen1Lars H Lund2Karolinska Institutet, Department of Medicine, Stockholm, Sweden; and Karolinska University Hospital, Heart and Vascular Theme, Stockholm, SwedenKarolinska Institutet, Department of Medicine, Stockholm, Sweden; and Karolinska University Hospital, Heart and Vascular Theme, Stockholm, SwedenKarolinska Institutet, Department of Medicine, Stockholm, Sweden; and Karolinska University Hospital, Heart and Vascular Theme, Stockholm, SwedenHospitalisation for acute heart failure (AHF) is associated with high mortality and high rehospitalisation rates. In the absence of evidence-based therapy, treatment is aimed at stabilisation and symptom relief. The majority of AHF patients have signs and symptoms of fluid overload, and, therefore, decongestion is the number one treatment goal. Diuretics are the cornerstone of therapy in AHF, but the treatment effect is challenged by diuretic resistance and poor diuretic response throughout the spectrum of chronic to worsening to acute to post-worsening HF. Adequate dosing and monitoring and evaluation of diuretic effect are important for treatment success. Residual congestion at discharge is a strong predictor of worse outcomes. Therefore, achieving euvolaemia is crucial despite transient worsening renal function.https://www.cfrjournal.com/articles/congestion-and-diuretic-resistance
spellingShingle Ingibjörg Kristjánsdóttir
Tonje Thorvaldsen
Lars H Lund
Congestion and Diuretic Resistance in Acute or Worsening Heart Failure
Cardiac Failure Review
title Congestion and Diuretic Resistance in Acute or Worsening Heart Failure
title_full Congestion and Diuretic Resistance in Acute or Worsening Heart Failure
title_fullStr Congestion and Diuretic Resistance in Acute or Worsening Heart Failure
title_full_unstemmed Congestion and Diuretic Resistance in Acute or Worsening Heart Failure
title_short Congestion and Diuretic Resistance in Acute or Worsening Heart Failure
title_sort congestion and diuretic resistance in acute or worsening heart failure
url https://www.cfrjournal.com/articles/congestion-and-diuretic-resistance
work_keys_str_mv AT ingibjorgkristjansdottir congestionanddiureticresistanceinacuteorworseningheartfailure
AT tonjethorvaldsen congestionanddiureticresistanceinacuteorworseningheartfailure
AT larshlund congestionanddiureticresistanceinacuteorworseningheartfailure