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Diuretic Strategies in Acute Decompensated Heart Failure

  • Pharmacologic Therapy (W H W Tang, Section Editor)
  • Published:
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Abstract

Purpose of Review

The burden of heart failure in the United States is growing rapidly to epic proportions with serious clinical implications for patients and economic strain for healthcare systems. One of the most common reasons for hospitalization in acute decompensated heart failure (ADHF) is excess volume accumulation which leads to untoward symptoms including dyspnea,orthopnea, and edema.

Recent Findings

Over the past several decades, there has been great interest in exploring various decongestive strategies in order to achieve symptomatic improvement and favorable clinical outcomes. These include different modalities of loop diuretic administration, the adjunctive use of non-loop diuretics, and other diuretic sparing strategies.

Summary

Herein, we provide an appraisal of these decongestive strategies and discuss novel concepts predicting clinical outcomes based on diuretic response and decongestive adequacy while discussing commonly encountered problems such as worsening renal function in ADHF.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9047, USA

    E. Ashley Hardin & Justin L. Grodin

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  1. E. Ashley Hardin
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  2. Justin L. Grodin
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Correspondence to Justin L. Grodin.

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E. Ashley Hardin and Justin L. Grodin declare that they have no conflict of interest

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Hardin, E.A., Grodin, J.L. Diuretic Strategies in Acute Decompensated Heart Failure. Curr Heart Fail Rep 14, 127–133 (2017). https://doi.org/10.1007/s11897-017-0319-y

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