Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026).

Global heart·2026
Same author

A Validated, Modifiable Proteomic Score from the EXSCEL Trial Predicts Cardiovascular Events in Diabetes.

JCI insight·2026
Same author

AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026).

European heart journal·2026
Same author

AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026).

Circulation·2026
Same author

AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026).

Journal of the American College of Cardiology·2026
Same author

A Contemporary Perspective on Acute Decompensated Heart Failure Classification: A State-of-the-art Review from an International Expert Group.

Cardiac failure review·2026
Same journal

Mavacamten in adolescent obstructive hypertrophic cardiomyopathy: SCOUTing a way forward.

Heart failure reviews·2026
Same journal

Overcoming barriers to early diagnosis and treatment of p.Val142Ile amyloid transthyretin (ATTR) cardiomyopathy.

Heart failure reviews·2026
Same journal

Beyond vasodilation: sotatercept and the remodeling hypothesis in hfpef-associated pulmonary hypertension.

Heart failure reviews·2026
Same journal

Beyond the right ventricle: left heart involvement in pulmonary arterial hypertension.

Heart failure reviews·2026
Same journal

Left ventricular non-compaction in heart failure: contemporary perspective on diagnostic challenges and treatment opportunities.

Heart failure reviews·2026
Same journal

Correction to: Left atrial shunting devices: why, what, how, and… when?

Heart failure reviews·2026
See all related articles

Related Experiment Videos

Loop diuretics in heart failure.

G Michael Felker1

  • 1Division of Cardiology, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St, Room 0311 Terrace Level, Durham, NC 27705, USA. michael.felker@duke.edu

Heart Failure Reviews
|April 26, 2011
PubMed
Summary
This summary is machine-generated.

Loop diuretics are essential for managing heart failure congestion. Recent randomized trials suggest higher doses may be more effective for symptom relief, despite previous concerns about potential harm.

Related Experiment Videos

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Congestion is a primary clinical manifestation of heart failure.
  • Diuretic therapy, particularly loop diuretics, is the standard treatment for managing fluid overload in heart failure patients.
  • Current clinical practice for prescribing and adjusting diuretic doses lacks robust evidence from prospective randomized studies.

Purpose of the Study:

  • To review the pharmacology of loop diuretics.
  • To evaluate the evidence guiding the optimal use and dosing of loop diuretics in heart failure.
  • To discuss recent findings from randomized trials regarding loop diuretic efficacy and safety.

Main Methods:

  • Literature review of observational studies and randomized controlled trials.
  • Analysis of pharmacological properties of loop diuretics.
  • Synthesis of data from recent clinical trials on diuretic therapy in heart failure.

Main Results:

  • Limited high-quality evidence exists to guide diuretic prescription and titration in heart failure.
  • Observational studies suggesting harm from high-dose diuretics are confounded by patient severity and comorbidities.
  • Recent randomized trial data indicate higher loop diuretic doses may be more effective for congestion relief with transient renal function changes.

Conclusions:

  • Optimal use of loop diuretics in heart failure requires a strong understanding of their pharmacology.
  • Higher doses of loop diuretics may offer superior congestion relief in heart failure.
  • Ongoing research and trials are crucial for defining the definitive role of loop diuretics in heart failure management.