TITLE:
Management of acute heart failure-Is there a paradigm shift around the corner?
AUTHORS:
C. Pater, T. Severin
KEYWORDS:
Acute Heart Failure; Hemodynamic; Clinical and Residual Congestion; Vasodilators; Diuretics; Management Strategies
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.2A,
April
30,
2013
ABSTRACT: It has become increasingly apparent that the looming
epidemic of heart failure calls for systematic treatment approaches tailored
to the needs of individual patient phenotypes. Although chronic heart failure
(CHF) therapies are continuously evolving based on the increasing understanding
of the involved etiology, acute heart failure (AHF) therapies are still based
on hemodynamic improvements and symptom alleviation. Guidelines on AHF
management have highlighted that the currently administered AHF therapies
lack evidence and have raised concerns on the safety and efficacy of some of
the hitherto accepted treatment modalities. Additionally, the high mortality
and morbidity rates associated with the current AHF therapies also add to the
imperative need to revisit AHF management. The last decade has witnessed a
paradigm shift in the way we define and diagnose AHF. Apart from it being
recognized as a distinct clinical entity, research has also led to new data
on the pathophysiological changes associated
with AHF. These developments along with the limited short- and long-term
effects of currently used therapies may herald a paradigm shift in the way we
plan and deliver management strategies to treat the pathological progression
of heart failure.