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.
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.