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Related Concept Videos

Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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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...
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Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension07:41

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We present a protocol to induce and phenotype an acute right heart failure in a large animal model with chronic pulmonary hypertension. This model can be used to test therapeutic interventions, to develop right heart metrics or to improve the understanding of acute right heart failure...
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In this protocol, we explain how to obtain and interpret phase angle values and bioelectrical impedance vectorial analysis (BIVA) Z-score obtained by bioelectrical impedance in patients with acute heart failure admitted to the Emergency Department and their clinical applicability as a predictive marker for the prognosis of a 90-day...
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This protocol presents R codes for performing restricted cubic spline multivariable Cox regression analysis to determine the cutoff value of the phase angle for prognosis in acute heart failure as well as codes for calculating statistics that measure the discriminatory ability of each model and evaluate its goodness of fit.
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Related Experiment Video

Updated: Jan 19, 2026

Heart Failure Drugs: Diuretics
01:22

Heart Failure Drugs: Diuretics

816

Loop diuretic resistance complicating acute heart failure.

Zachary L Cox1,2, Jeffrey M Testani3

  • 1Department of Pharmacy Practice, Burton Health Science Center, Lipscomb University College of Pharmacy, One University Park Drive, Nashville, TN, 37204, USA. Zachary.l.cox@vumc.org.

Heart Failure Reviews
|September 15, 2019
PubMed
Summary

Diuretic resistance in acute heart failure leads to poor outcomes. This study proposes a new classification system for diuretic resistance to improve patient prognostication and treatment strategies.

Keywords:
Acute heart failureCombination diuretic therapyCombination nephron blockadeDiureticDiuretic resistanceHeart failureLoop diuretic

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Related Experiment Videos

Last Updated: Jan 19, 2026

Heart Failure Drugs: Diuretics
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Heart Failure Drugs: Diuretics

816
Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension
07:41

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Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
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Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis

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Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Diuretic resistance complicates acute heart failure hospitalizations, worsening patient outcomes.
  • Current definitions and quantification of diuretic resistance lack universal clinical application, limiting risk assessment.

Purpose of the Study:

  • To address limitations in current metrics for identifying and defining diuretic resistance.
  • To propose a mechanism-based classification system for diuretic resistance.
  • To recommend treatment pathways for restoring diuretic efficacy in heart failure patients.

Main Methods:

  • Review of current metrics for diuretic resistance.
  • Proposal of a mechanism-based classification system by anatomical location (pre-nephron, pre-loop of Henle, loop of Henle, post-loop of Henle).
  • Comparison of historical and current literature on resistance mechanisms in heart failure.

Main Results:

  • Identified limitations in existing methods for defining and quantifying diuretic resistance.
  • Proposed a novel classification system to categorize diuretic resistance based on anatomical location.
  • Reviewed combination diuretic strategies and ongoing trials for heart failure management.

Conclusions:

  • A standardized, mechanism-based classification of diuretic resistance is needed for improved clinical application.
  • The proposed system offers a framework for better understanding and managing diuretic resistance in acute heart failure.
  • Further research and clinical trials are essential to refine treatment strategies for diuretic resistance.