Full decongestion in acute heart failure therapy

Incomplete decongestion is the main cause of readmission in the early post-discharge period of a hospitalization for acute heart failure. Recent heart failure guidelines have highlighted initiation and rapid up-titration of quadruple therapy with angiotensin receptor neprilysin inhibitor, beta adren...

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Bibliographic Details
Published in:The American journal of the medical sciences 2024-09, Vol.368 (3), p.182-189
Main Authors: Buttar, Chandan, Alai, Hamid, Matanes, Faris N., Cassidy, Mark M., Stencel, Jason, Le Jemtel, Thierry H.
Format: Article
Language:English
Subjects:
Acute decompensated heart failure
Acute Disease
Adrenergic beta-Antagonists - therapeutic use
Angiotensin Receptor Antagonists - therapeutic use
Decongestion
Diuretics
Diuretics - therapeutic use
Heart Failure - drug therapy
Heart failure with reduced ejection fraction
Humans
Mineralocorticoid Receptor Antagonists - therapeutic use
Sodium-Glucose Transporter 2 Inhibitors - therapeutic use
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Summary:Incomplete decongestion is the main cause of readmission in the early post-discharge period of a hospitalization for acute heart failure. Recent heart failure guidelines have highlighted initiation and rapid up-titration of quadruple therapy with angiotensin receptor neprilysin inhibitor, beta adrenergic receptor blocker, mineralocorticoid receptor antagonist, and sodium glucose cotransporter 2 inhibitor to prevent hospitalizations for heart failure with reduced ejection fraction. However, full decongestion remains the foremost therapeutic goal of hospitalization for heart failure. While early addition of sodium glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists may be helpful, the value of the other therapeutics comes after decongestion is complete.
ISSN:0002-9629
1538-2990
1538-2990
DOI:10.1016/j.amjms.2024.06.002