Early in-hospital treatment of acute heart failure. Part 2 of the international expert opinion series on AHF management.

IF 3.7 2区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Anika S Naidu, Andrew P Ambrosy, Gad Cotter, Edimar A Bocchi, Javed Butler, Ovidiu Chioncel, Beth Davison, Anastase Dzudie, Yonathan Freund, Marat Fudim, Sivadasanpillai Harikrishnan, Ivna G Cunha, Alexandre Mebazaa, Robert J Mentz, Òscar Miró, Siti E Nauli, Mateo Pagnesi, Naoki Sato, Gianluigi Savarese, Karen Sliwa-Hahnle, Yuhui Zhang, Jingmin Zhou, Jan Biegus
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引用次数: 0

Abstract

Acute heart failure (AHF) remains a major global health challenge, contributing significantly to morbidity, mortality and healthcare resource utilization. It is one of the leading causes of hospitalization, with persistently high readmission rates underscoring the need for improved early management strategies. Despite its prevalence, clear and evidence-based guidance for the early evaluation and treatment of AHF is limited. Congestion is the primary reason for emergency admission, making rapid and effective decongestion a top priority, but diuretics are often underdosed in AHF patients. Medications proven to improve mortality are often not started. In this state-of-the-art review, we address this critical gap by outlining a practical, evidence-based framework for the early management of AHF. Key components include early identification of co-existing conditions, bedside haemodynamic profiling, a structured diagnostic approach incorporating both standard and individualized assessments, a stepwise pharmacologic diuretic strategy beginning with high-dose intravenous loop diuretics, and early in-hospital initiation of guideline-directed medical therapy.

急性心力衰竭的早期住院治疗。关于AHF管理的国际专家意见系列的第2部分。
急性心力衰竭(AHF)仍然是一项重大的全球健康挑战,对发病率、死亡率和医疗保健资源利用率有重大影响。它是住院的主要原因之一,再入院率居高不下,强调需要改进早期管理策略。尽管AHF很普遍,但早期评估和治疗AHF的明确和循证指导是有限的。充血是急诊入院的主要原因,快速有效地缓解充血是当务之急,但在AHF患者中,利尿剂往往剂量不足。经证实可降低死亡率的药物往往没有开始使用。在这篇最新的综述中,我们通过概述一个实用的、基于证据的AHF早期管理框架来解决这一关键差距。关键组成部分包括早期识别共存条件,床边血流动力学分析,结合标准和个性化评估的结构化诊断方法,从大剂量静脉循环利尿剂开始的逐步药物利尿剂策略,以及早期在医院开始指导药物治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ESC Heart Failure
ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine
CiteScore
7.00
自引率
7.90%
发文量
461
审稿时长
12 weeks
期刊介绍: ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.
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