What's New in the Treatment of Acute Heart Failure?

被引:9
作者
Selby, Van N. [1 ]
Teerlink, John R. [2 ]
机构
[1] Univ Calif San Francisco, Div Cardiol, San Francisco, CA 94143 USA
[2] San Francisco VA Med Ctr, Cardiol Sect, San Francisco, CA 94121 USA
关键词
Acute heart failure; Drug therapy; Clinical trials; Vasodilators; Inotropes; Ultrafiltration; Diuretics; Nitroglycerin; Sodium nitroprusside; Nesiritide; Dobutamine; Milrinone; Levosimendan; Omecamtiv mecarbil; Serelaxin; Istaroxime; Ularitide; Cenderitide; Aliskiren; Rolofylline; Tezosentan; Cinaciguat; ACUTE MYOCARDIAL-INFARCTION; NATIONAL REGISTRY ADHERE; RANDOMIZED CONTROLLED-TRIALS; CARDIAC MYOSIN ACTIVATOR; SODIUM-NITROPRUSSIDE; NATRIURETIC PEPTIDE; INTRAVENOUS NESIRITIDE; OMECAMTIV MECARBIL; RENAL IMPAIRMENT; DOUBLE-BLIND;
D O I
10.1007/s11886-013-0393-z
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Acute heart failure is associated with substantial morbidity and mortality. Goals of treatment are decongestion, correction of hemodynamic abnormalities, symptom relief, and reducing long-term morbidity and mortality. Loop diuretics are a first-line agent for treatment of volume overload, with ultrafiltration reserved for those who do not respond to pharmacologic therapy. In patients with normal or elevated blood pressure, vasodilators are used to correct hemodynamics and reverse central volume redistribution, although no currently available agent has been shown to improve outcomes. Intravenous inotropes and inodilators are associated with frequent adverse effects and are reserved for patients with hypotension and evidence of inadequate perfusion. Novel drugs designed to maximize hemodynamic benefits while minimizing adverse effects are under investigation, with several agents showing promise in clinical studies.
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页数:9
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