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Title: Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)
Authors: Harjola, Veli-Pekka
Mullens, Wilfried 
Banaszewski, Marek
Bauersachs, Johann
Brunner-La Rocca, Hans-Peter
Chioncel, Ovidiu
Collins, Sean P.
Doehner, Wolfram
Filippatos, Gerasimos S.
Flammer, Andreas J.
Fuhrmann, Valentin
Lainscak, Mitja
Lassus, Johan
Legrand, Matthieu
Masip, Josep
Mueller, Christian
Papp, Zoltan
Parissis, John
Platz, Elke
Rudiger, Alain
Ruschitzka, Frank
Schaefer, Andreas
Seferovic, Petar M.
Skouri, Hadi
Yilmaz, Mehmet Birhan
Mebazaa, Alexandre
Issue Date: 2017
Publisher: WILEY
Source: EUROPEAN JOURNAL OF HEART FAILURE, 19(7), p. 821-836
Abstract: Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field.
Notes: [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland. [Mullens, Wilfried] Ziekenhuis Oost Limburg, Dept Cardiol, Genk, Belgium. [Mullens, Wilfried] Hasselt Univ, Biomed Res Inst, Fac Med & Life Sci, Diepenbeek, Belgium. [Banaszewski, Marek] Intens Cardiac Therapy Clin, Inst Cardiol, Warsaw, Poland. [Bauersachs, Johann; Schaefer, Andreas] Med Sch Hannover, Dept Cardiol & Angiol, Hannover, Germany. [Brunner-La Rocca, Hans-Peter] Maastricht Univ, Dept Cardiol, Med Ctr, Maastricht, Netherlands. [Chioncel, Ovidiu] Univ Med & Pharm Carol Davila, Inst Emergency Cardiovasc Dis, Bucharest, Romania. [Collins, Sean P.] Vanderbilt Univ, Med Ctr, Dept Emergency Med, Nashville, TN USA. [Doehner, Wolfram] Ctr Stroke Res, Berlin, Germany. [Doehner, Wolfram] Charite Med Univ, Dept Cardiol, Berlin, Germany. [Filippatos, Gerasimos S.; Parissis, John] Univ Athens, Athens Univ Hosp Attikon, Sch Med, Athens, Greece. [Flammer, Andreas J.; Ruschitzka, Frank] Univ Zurich Hosp, Univ Heart Ctr, Zurich, Switzerland. [Fuhrmann, Valentin] Med Univ Vienna, Div Gastroenterol & Hepatol, Vienna, Austria. [Fuhrmann, Valentin] Univ Med Ctr Hamburg Eppendorf, Dept Intens Care Med, Hamburg, Germany. [Lainscak, Mitja] Gen Hosp Murska Sobota, Dept Internal Med, Murska Sobota, Slovenia. [Lainscak, Mitja] Gen Hosp Murska Sobota, Dept Res & Educ, Murska Sobota, Slovenia. [Lainscak, Mitja] Univ Ljubljana, Fac Med, Ljubljana, Slovenia. [Lassus, Johan] Univ Helsinki, Helsinki Univ Hosp, Cardiol, Helsinki, Finland. [Legrand, Matthieu; Mebazaa, Alexandre] AP HP, INSERM, U942, Paris, France. [Legrand, Matthieu; Mebazaa, Alexandre] INI CRCT, Nancy, France. [Legrand, Matthieu] Univ Paris Denis Diderot, St Louis Hosp, Dept Anaesthesiol, Crit Care & Burn Unit, Paris, France. [Masip, Josep] Univ Barcelona, Consorci Sanitari Integral Publ Hlth Consortium, Barcelona, Spain. [Masip, Josep] Hosp Sanitas CIMA, Dept Cardiol, Barcelona, Spain. [Mueller, Christian] Univ Hosp Basel, Dept Cardiol, Basel, Switzerland. [Mueller, Christian] Univ Hosp Basel, CRIB, Basel, Switzerland. [Papp, Zoltan] Univ Debrecen, Div Clin Physiol, Dept Cardiol, Res Ctr Mol Med,Fac Med, Debrecen, Hungary. [Platz, Elke] Harvard Med Sch, Brigham & Womens Hosp, Dept Emergency Med, Boston, MA USA. [Rudiger, Alain] Univ Zurich, Univ Zurich Hosp, Cardiosurg Intens Care Unit, Zurich, Switzerland. [Seferovic, Petar M.] Univ Belgrade, Dept Internal Med, Sch Med, Belgrade, Serbia. [Seferovic, Petar M.] Univ Belgrade, Heart Failure Ctr, Med Ctr, Belgrade, Serbia. [Skouri, Hadi] Amer Univ, Div Cardiol, Dept Internal Med, Beirut Med Ctr, Beirut, Lebanon. [Yilmaz, Mehmet Birhan] Cumhuriyet Univ, Dept Cardiol, Fac Med, Sivas, Turkey. [Mebazaa, Alexandre] Univ Paris Diderot, Paris, France. [Mebazaa, Alexandre] Univ Hosp St Louis Lariboisiere, Dept Anaesthesia & Crit Care, Paris, France.
Keywords: Heart failure; Multiple organ failure; Venous congestion;heart failure; multiple organ failure; venous congestion
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ISSN: 1388-9842
e-ISSN: 1879-0844
DOI: 10.1002/ejhf.872
ISI #: 000405571400002
Rights: © 2017 The Authors European Journal of Heart Failure © 2017 European Society of Cardiology
Category: A1
Type: Journal Contribution
Validations: ecoom 2018
Appears in Collections:Research publications

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