scholarly journals Dilemmas in the Dosing of Heart Failure Drugs: Titrating Diuretics in Chronic Heart Failure

2017 ◽  
Vol 3 (2) ◽  
pp. 108 ◽  
Author(s):  
David Pham ◽  
Justin L Grodin ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Effective Dose ◽  
Medical Therapy ◽  
Ambulatory Setting ◽  
Diuretic Resistance ◽  
The Past ◽  
Treat Heart Failure ◽  
Heart Failure Hospitalisation

Despite advances in medical therapy over the past few decades, the incidence of heart failure hospitalisation continues to rise. Diuretics are the most common therapy used to treat heart failure as they relieve congestion. However, there is a lack of guidance on how to best use these medications. Guidelines support the use of diuretics at the lowest clinically effective dose but do not specify a diuretic strategy beyond that. Here we review the diuretics available for treatment, potential mechanisms of diuretic resistance and ways to address this in the ambulatory setting, and review tools that have been developed to help guide diuretic use in the treatment of chronic heart failure.

The RightSTEPS initiative: Continuing education impact on clinicians’ optimal medical therapy practices for chronic heart failure

2020 ◽  
pp. 1-8
Author(s):  
Priya Wanchoo ◽  
Ellen L. Cohen ◽  
Kathleen Donnelly-Bensalah ◽  
Katherine E. Stone ◽  
Margot Embree Fisher ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Continuing Education ◽  
Medical Therapy ◽  
Optimal Medical Therapy

Diuretic Resistance and Chronic Heart Failure

2019 ◽  
pp. 121-135
Author(s):  
Alice Ravera ◽  
Jozine M. ter Maaten ◽  
Marco Metra
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Diuretic Resistance

scholarly journals Clinical Characteristics of De Novo Heart Failure and Acute Decompensated Chronic Heart Failure: Are They Distinctive Phenotypes That Contribute to Different Outcomes?

2021 ◽  
Vol 7 ◽  
Author(s):  
Wilson Matthew Raffaello ◽  
Joshua Henrina ◽  
Ian Huang ◽  
Michael Anthonius Lim ◽  
Leonardo Paskah Suciadi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trials ◽  
Chronic Heart Failure ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
De Novo ◽  
Heart Failure Patients ◽  
Treat Heart Failure ◽  
Patients With Heart Failure ◽  
New Strategies

Heart failure is currently one of the leading causes of morbidity and mortality. Patients with heart failure often present with acute symptoms and may have a poor prognosis. Recent evidence shows differences in clinical characteristics and outcomes between de novo heart failure (DNHF) and acute decompensated chronic heart failure (ADCHF). Based on a better understanding of the distinct pathophysiology of these two conditions, new strategies may be considered to treat heart failure patients and improve outcomes. In this review, the authors elaborate distinctions regarding the clinical characteristics and outcomes of DNHF and ADCHF and their respective pathophysiology. Future clinical trials of therapies should address the potentially different phenotypes between DNHF and ADCHF if meaningful discoveries are to be made.

45 Ultrafiltration in decompensated chronic heart failure patients with diuretic resistance

2018 ◽  
Author(s):  
Keenan Saleh ◽  
Mayooran Shanmuganathan ◽  
Dahlia Abdulrahman ◽  
Noemi Findlay ◽  
Laura Greswell ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Diuretic Resistance ◽  
Heart Failure Patients

Emerging Therapies for Acute and Chronic Heart Failure

2016 ◽  
Vol 29 (1) ◽  
pp. 46-57 ◽  
Author(s):  
Sarah Hanigan ◽  
Robert J. DiDomenico
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiovascular Death ◽  
Phase 3 ◽  
Reduced Ejection Fraction ◽  
Emerging Therapies ◽  
Treat Heart Failure ◽  
Novel Drugs ◽  
The Us ◽  
History Of

Although the period from 1953 to 2001 resulted in the approval of more than 30 medications currently used to treat heart failure (HF), few novel drugs have been approved in the last decade. However, the investigational pipeline for HF medications once again appears promising. In patients with chronic heart failure with reduced ejection fraction (HFrEF), ivabradine and valsartan/sucubitril (LCZ696) were recently approved by the US Food and Drug Administration. Both agents have been shown to reduce the risk of cardiovascular death and HF hospitalization. In the treatment of acute HF, serelaxin and ularitide are the farthest along in development. Both agents have demonstrated favorable effects on surrogate end points and preliminary data suggest a possible mortality benefit with serelaxin. Consequently, phase 3 trials are ongoing to evaluate the effect of serelaxin and ularitide on clinical outcomes. Given the poor history of recent investigational acute HF drugs that have advanced to phase 3/4 studies, enthusiasm for both serelaxin and ularitide must be tempered until these trials are completed.

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