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Title: | Decongestion strategies in patients presenting with acutely decompensated heart failure: A worldwide survey among physicians | Authors: | Vazir, Ali Kapelios, Chris J. Agaoglu, Elif Metra, Marco Lopatin, Yury Seferovic, Petar MULLENS, Wilfried Filippatos, Gerasimos Rosano, Giuseppe Coats, Andrew J. S. Chioncel, Ovidiu |
Issue Date: | 2023 | Publisher: | WILEY | Source: | EUROPEAN JOURNAL OF HEART FAILURE, 25 (9) , p. 1555 -1570 | Abstract: | Aims Decongestion strategies for acute decompensated heart failure (ADHF) characterized by volume overload differ widely. The aim of this independent international academic web-based survey was to capture the therapeutic strategies that physicians use to treat ADHF and to assess differences in therapeutic approaches between cardiologists versus non-cardiologists. Methods and results Physicians were invited to complete a web-based questionnaire, capturing anonymized data on physicians' characteristics and treatment preferences based on a hypothetical clinical scenario of a patient hospitalized with ADHF. A total of 641 physicians from 60 countries participated. A wide variation in the management of the patient was observed. There was conservative use of diuretics, i.e. only 7% started intravenous furosemide at a dose >= 2 times the baseline oral dose, and infrequent use of ultrasound in assessing congestion (20.4%). Spot urinary sodium was infrequently or never measured by >= 85% of physicians. A third considered a patient with ongoing oedema as being stabilized. There were significant differences between cardiologists and non-cardiologists in the management of ADHF, the targets for daily body weight loss and urine output, diuretic escalation strategies (66.3% vs. 40.7% would escalate diuresis by adding a thiazide) and assessment of response to treatment (27.0% vs. 52.9% considered patients with minimal congestion as stabilized). Conclusions There is substantial variability amongst physicians and between cardiologists and non-cardiologists in the management of patients with ADHF, with regard to clinical parameters used to tailor treatment, treatment goals, diuretic dosing and escalation strategies. | Notes: | Vazir, A (corresponding author), Imperial Coll London, Royal Brompton Hosp, NHLI, Sydney St, London SW3 6NP, England. a.vazir@imperial.ac.uk |
Keywords: | Acute heart failure;Diuretics | Document URI: | http://hdl.handle.net/1942/41730 | ISSN: | 1388-9842 | e-ISSN: | 1879-0844 | DOI: | 10.1002/ejhf.2985 | ISI #: | 001070018400001 | Rights: | 2023 European Society of Cardiology | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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