Related Experiment Video
Updated: Apr 19, 2026
07:41
Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension
Published on: March 17, 2022
3.5K
Diuretic response in acute heart failure-pathophysiology, evaluation, and therapy
Jozine M ter Maaten1, Mattia A E Valente1, Kevin Damman1
1Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands.
Nature Reviews. Cardiology
|January 7, 2015
Summary
Loop diuretics are key for acute heart failure, but resistance is common. Understanding diuretic response better can improve treatment for patients with heart failure.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Loop diuretics are standard treatment for acute heart failure decongestion.
- Diuretic resistance is frequent in acute heart failure, linked to poor outcomes.
- Mechanisms of diuretic resistance involve cardiac/renal dysfunction and neurohormonal factors.
Purpose of the Study:
- To review the current understanding of diuretic response in acute heart failure.
- To highlight the need for a uniform definition of diuretic response.
- To discuss strategies for managing diuretic resistance.
Main Methods:
- Review of existing literature on loop diuretic therapy in acute heart failure.
- Analysis of proposed methods for evaluating diuretic response.
- Discussion of therapeutic strategies to overcome diuretic resistance.
Main Results:
- Impaired diuretic response is common and associated with adverse outcomes.
- Current understanding of diuretic resistance mechanisms is incomplete.
- Objective methods for evaluating diuretic response focus on dose-effect relationships.
Conclusions:
- A clearer understanding of diuretic response is needed for acute heart failure management.
- Standardized definitions and further prospective studies are required.
- Individualized treatment strategies are essential for optimizing diuretic efficacy.
More Related Videos
Related Concept Videos
01:22Heart Failure Drugs: Diuretics
1.2K
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...
1.2K
01:29Heart Failure II: Pathophysiology
1.6K
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
1.6K
01:30Heart Failure V: Medical Management
592
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...
592
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
1.5K
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...
1.5K
01:17Pathophysiology of Heart Failure
4.8K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
4.8K
01:22Heart Failure VI: Adjunct Therapies
614
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
614