Overview of current noninodilator therapies for acute heart failure syndromes.
Several treatment strategies exist for patients hospitalized with acute heart failure syndromes (AHFS). These therapies traditionally focus on improving hemodynamics and relieving congestion. This review focuses on noninodilator therapies, including diuretics, nitrovasodilators (nitroprusside and nitroglycerin), vasodilators (nesiritide), digoxin, and intravenous angiotensin-converting enzyme inhibitors. These agents are used based on their associated symptomatic improvements alone. In the hospitalized setting, none of these agents have demonstrated benefits on long-term outcomes. Future work in AHFS should strive to understand the influence of conventional and new pharmacologic therapies on the underlying pathophysiology of AHFS, the processes that lead to myocardial injury and progressive heart failure, and measurable clinical outcomes.
Stough
Wendy Gattis
WG
Duke University Medical Center, Durham, North Carolina, USA. wendy.gattis@duke.edu
O'Connor
Christopher M
CM
Gheorghiade
Mihai
M
D000208:Acute Disease; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use; D005996:Nitroglycerin / Q000627:therapeutic use; D009599:Nitroprusside / Q000627:therapeutic use; D012720:Severity of Illness Index; D013577:Syndrome; D014665:Vasodilator Agents / Q000627:therapeutic use
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D009599:Nitroprusside; D004077:Digoxin; D005996:Nitroglycerin