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Title: | The use of diuretics in heart failure with congestion - a position statement from the Heart Failure Association of the European Society of Cardiology | Authors: | MULLENS, Wilfried Damman, Kevin Harjola, Veli-Pekka Mebazaa, Alexandre Brunner-La Rocca, Hans-Peter MARTENS, Pieter Testani, Jeffrey M. Tang, W. H. Wilson Orso, Francesco Rossignol, Patrick Metra, Marco Filippatos, Gerasimos Seferovic, Petar M. Ruschitzka, Frank Coats, Andrew J. |
Issue Date: | 2019 | Publisher: | WILEY | Source: | EUROPEAN JOURNAL OF HEART FAILURE, 21(2), p. 137-155 | Abstract: | The vast majority of acute heart failure episodes are characterized by increasing symptoms and signs of congestion with volume overload. The goal of therapy in those patients is the relief of congestion through achieving a state of euvolaemia, mainly through the use of diuretic therapy. The appropriate use of diuretics however remains challenging, especially when worsening renal function, diuretic resistance and electrolyte disturbances occur. This position paper focuses on the use of diuretics in heart failure with congestion. The manuscript addresses frequently encountered challenges, such as (i) evaluation of congestion and clinical euvolaemia, (ii) assessment of diuretic response/resistance in the treatment of acute heart failure, (iii) an approach towards stepped pharmacologic diuretic strategies, based upon diuretic response, and (iv) management of common electrolyte disturbances. Recommendations are made in line with available guidelines, evidence and expert opinion. | Notes: | [Mullens, Wilfried; Martens, Pieter] Ziekenhuis Oost Limburg, Genk, Belgium. [Mullens, Wilfried; Martens, Pieter] Univ Hasselt, Hasselt, Belgium. [Damman, Kevin] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands. [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland. [Mebazaa, Alexandre] Univ Paris Diderot, Hop Univ St Louis Lariboisiere, AP HP, FCRIN INI CRCT,INSERM,U942, Paris, France. [Brunner-La Rocca, Hans-Peter] Maastricht Univ, Med Ctr, Maastricht, Netherlands. [Testani, Jeffrey M.] Yale Univ, New Haven, CT USA. [Tang, W. H. Wilson] Cleveland Clin, Cleveland, OH 44106 USA. [Orso, Francesco] Univ Florence, Florence, Italy. [Rossignol, Patrick] Univ Lorraine, INSERM, Ctr Invest Clin 1433, Nancy, France. [Rossignol, Patrick] INSERM, U1116, Nancy, France. [Rossignol, Patrick] CHRU Nancy, Nancy, France. [Rossignol, Patrick] F CRIN INI CRCT, Nancy, France. [Metra, Marco] Univ Brescia, Brescia, Italy. [Filippatos, Gerasimos] Univ Athens, Athens, Greece. [Filippatos, Gerasimos] Univ Cyprus, Nicosia, Cyprus. [Seferovic, Petar M.] Univ Belgrade, Fac Med, Belgrade, Serbia. [Ruschitzka, Frank] Univ Zurich, Zurich, Switzerland. [Coats, Andrew J.] IRCCS San Raffaele Pisana, Rome, Italy. | Keywords: | Diuretics; Heart failure; Acute heart failure; Pharmacotherapy; Loop diuretics;Diuretics; Heart failure; Acute heart failure; Pharmacotherapy; Loop diuretics | Document URI: | http://hdl.handle.net/1942/29041 | ISSN: | 1388-9842 | e-ISSN: | 1879-0844 | DOI: | 10.1002/ejhf.1369 | ISI #: | 000458652400002 | Rights: | 2018 European Society of Cardiology | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2020 |
Appears in Collections: | Research publications |
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mullens 1.pdf Restricted Access | Published version | 5.5 MB | Adobe PDF | View/Open Request a copy |
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