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Impact of Systemic Venous Congestion in Heart Failure

  • Prevention of Heart Failure after Myocardial Infarction (Martin St. John Sutton, Section Editor)
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Abstract

Systemic venous congestion is one of the hallmarks of the syndrome of heart failure that results from activation of different deleterious neurohormonal pathways. Apart from contributing to patients’ symptoms and hospital admissions, growing evidence suggests that congestion itself drives further heart failure progression. In addition, systemic venous congestion exerts detrimental effects on other organs (such as kidneys and liver) due to ineffective organ perfusion. Endothelial cell activation, altered ventricular geometry, and functional mitral insufficiency are among the proposed mechanisms. Diuretics and vasodilators remain the mainstay of treatment options, mostly because of poor understanding of the underlying cardiorenal mechanisms involved. Recently, ultrafiltration has emerged as an invasive treatment option in the setting of diuretic resistance. Congestion ideally should be prevented, often initially through water and salt restriction. Early detection, possibly with the help of novel implantable sensor technology, may allow for early detection and intervention long before overt congestion is established.

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Acknowledgements

Dr. Matthias Dupont is supported by a research grant from the Belgian American Educational Foundation (BAEF).

Disclosures

M. Dupont: none; W. Mullens: none. Dr. W. H. Wilson Tang is an employee of Cleveland Clinic; has served as a consultant for Medtronic, Inc. and St. Jude Medical; and has received grants from Abbott Laboratories.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Matthias Dupont & W. H. Wilson Tang

  2. Department of Cardiovascular Medicine, Ziekenhuis Oost Limburg, Genk, Belgium

    Wilfried Mullens

  3. School of Life Sciences, Transnational University Limburg, Diepenbeek, Belgium

    Wilfried Mullens

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  1. Matthias Dupont
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Correspondence to W. H. Wilson Tang.

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Dupont, M., Mullens, W. & Tang, W.H.W. Impact of Systemic Venous Congestion in Heart Failure. Curr Heart Fail Rep 8, 233–241 (2011). https://doi.org/10.1007/s11897-011-0071-7

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  • DOI: https://doi.org/10.1007/s11897-011-0071-7

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