Ambulatory Management of Worsening Heart Failure: Current Strategies and Future Directions

Wand, Alison L.; Russell, Stuart D.; Gilotra, Nisha A.

doi:10.17925/hi.2021.15.1.49

Cited by 6 publications

(3 citation statements)

References 78 publications

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“…Symptom monitoring, along with medication adherence and preventive behaviors (such as sodium restriction), is the foundation of HF self-care maintenance [91]. The burden of daily assessment for signs and symptoms of worsening HF falls largely on the patient and the ambulatory care provider [91]. Early detection of a deterioration in HF symptoms is important in order to prevent hospital admission and increased mortality [6].…”

Section: Congestion-self-care and Ambulatory Care Of Heart Failure Pa...mentioning

confidence: 99%

The Importance of Optimal Hydration in Patients with Heart Failure—Not Always Too Much Fluid

Wittczak,

Ślot,

Bielecka-Dabrowa

2023

Biomedicines

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Heart failure (HF) is a leading cause of morbidity and mortality and a major public health problem. Both overhydration and dehydration are non-physiological states of the body that can adversely affect human health. Congestion and residual congestion are common in patients hospitalized for HF and are associated with poor prognosis and high rates of rehospitalization. However, the clinical problem of dehydration is also prevalent in healthcare and community settings and is associated with increased morbidity and mortality. This article provides a comprehensive review of the issue of congestion and dehydration in HF, including HF guidelines, possible causes of dehydration in HF, confirmed and potential new diagnostic methods. In particular, a full database search on the relationship between dehydration and HF was performed and all available evidence in the literature was reviewed. The novel hypothesis of chronic subclinical hypohydration as a modifiable risk factor for HF is also discussed. It is concluded that maintaining euvolemia is the cornerstone of HF management. Physicians have to find a balance between decongestion therapy and the risk of dehydration.

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Section: Congestion-self-care and Ambulatory Care Of Heart Failure Pa...mentioning

confidence: 99%

The Importance of Optimal Hydration in Patients with Heart Failure—Not Always Too Much Fluid

Wittczak,

Ślot,

Bielecka-Dabrowa

2023

Biomedicines

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“…Risk scoring based on comorbidities, labwork, and patient profile can help suggest who is at risk for WHF. [25][26][27]. In a 2020 review, Wierda et al [27] summarized evidence to support innovative outpatient management instead of inpatient admission.…”

Section: Key Pointsmentioning

confidence: 99%

“…Specialized outpatient decongestion centers may prevent patients from requiring inpatient treatment [25–27]. In a 2020 review, Wierda et al [27] summarized evidence to support innovative outpatient management instead of inpatient admission.…”

Section: Outpatient Worsening Heart Failure Centersmentioning

confidence: 99%

Worsening heart failure: a concept in evolution

Puthenpura,

Wilcox,

Tang

2023

Current Opinion in Cardiology

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Purpose of review Worsening heart failure (WHF) has developed as a unique definition within heart failure (HF) in recent years. It captures the disease as a dynamic process. This review describes what is currently known about WHF, why it should be considered a discrete scientific endpoint, and future directions for research. Recent findings There is no single agreed upon definition for WHF. It can be identified as being due to treatment side-effects, related to concomitant comorbidity, or true disease progression. Risk scores based on criteria like those already developed for HF can be created to stratify risk for WHF. Conclusions WHF is an emerging entity within HF that defines itself as a unique point of interest. Understanding it as a clinical measure of where a patient's HF is evolving allows for identifying patients that require a refreshed approach to their care. Keeping this in mind will help redefine more patient-centric outcome measures in research to come.

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