Cardiac Decompensation

Ramirez, Alberto; Abelmann, Walter H.

doi:10.1056/nejm197402282900906

Cited by 53 publications

(31 citation statements)

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“…Unfortunately, the same success has not been seen in the treatment of acute decompensated heart failure. Consequently, therapy for acute decompensated heart failure has not changed significantly over the past 30 years (Table 1), 28 and neither has the risk of death among patients admitted to hospital with the condition (30-day mortality 12% and 1-year mortality 28% during 1950-1969, and 11% and 28% respectively during 1990-1999).…”

Section: Treatmentmentioning

confidence: 99%

Management of acute decompensated heart failure

Allen¹,

O’Connor²

2007

Canadian Medical Association Journal

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Management of acute decompensated heart failure ReviewAcute decompensated heart failure represents a heterogeneous group of disorders that typically present as dyspnea, edema and fatigue. Despite the high prevalence of this condition and its associated major morbidity and mortality, diagnosis can be difficult, and optimal treatment remains poorly defined. Identification of the acute triggers for the decompensation as well as noninvasive characterization of cardiac filling pressures and output is central to management. Diuretics, vasodilators, continuous positive airway pressure and inotropes can be used to alleviate symptoms. However, few agents currently available for the treatment of acute decompensated heart failure have been definitively shown in large prospective randomized clinical trials to provide meaningful improvements in intermediate-term clinical outcomes. Multiple novel therapies are being developed, but previous treatment failures indicate that progress in the management of acute decompensated heart failure is likely to be slow. CMAJ 2007;176(6):797-805 negative likelihood ratio 0.66, 95% CI 0.57-0.77), although measurement of jugular venous pressure by clinicians is notoriously inaccurate. Abstract

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Section: Treatmentmentioning

confidence: 99%

Management of acute decompensated heart failure

Allen¹,

O’Connor²

2007

Canadian Medical Association Journal

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“…Se ha demostrado que un abordaje ené rgico y apropiado del tratamiento de la ICA resulta ú til para mejorar la evolució n clínica de los pacientes 5,6 . Actualmente, el tratamiento farmacoló gico tradicional se caracteriza por el uso de diuré ticos, oxigenoterapia y vasodilatadores, que siguen siendo la piedra angular del tratamiento inmediato de la ICA 7,8 .…”

Section: Introducció Nunclassified

Tratamiento farmacológico en la insuficiencia cardiaca aguda

Somma¹,

Magrini²

2015

Revista Española de Cardiología

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“…Diuretics and vasodilators are used to alleviate symptomatic congestion; however, strong evidence-based trial results are still in progress. The most significant side effects of these therapeutic modalities include hemodynamic compromise, electrolyte disturbances, impaired renal function, and arrythmias [14].…”

Section: Introductionmentioning

confidence: 99%

Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure: Nesiritide Redux

Pleister

Baliga

Haas

2011

Curr Heart Fail Rep

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Nesiritide, a synthetic drug form of human B-type natriuretic peptide, is approved for the early treatment of dyspnea in acute decompensated heart failure. Meta-analyses suggested a risk of worsening renal insufficiency and mortality with its use. Therefore, the Acute Study of Clinical Effectiveness in Decompensated Heart Failure (ASCEND-HF) was designed as a prospective, multicenter, double-blind, randomized trial to examine the use of nesiritide in this common, morbid, and often lethal clinical condition. Two coprimary end points, dyspnea and 30-day hospital readmission or death, were chosen to examine symptomatic response and objective outcomes, respectively. Preliminary reports from ASCEND-HF investigators suggest no significant improvement in symptoms or clinical outcomes, although no adverse effect on mortality or renal function was noted. We recommend the continued use of nesiritide in acute decompensated heart failure as an individualized case-based therapy to those patients who meet criteria for treatment and are expected to receive benefit from its use.

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Cardiac Decompensation

Cited by 53 publications

References 0 publications

Management of acute decompensated heart failure

Management of acute decompensated heart failure

Tratamiento farmacológico en la insuficiencia cardiaca aguda

Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure: Nesiritide Redux

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