Acute heart failure syndromes and coronary perfusion.
Acute heart failure syndromes (AHFS), with a high post-discharge mortality and rehospitalization rate, represent a significant public health burden. The treatment of patients hospitalized with AHFS often includes the use of vasoactive medications such as inotropes and vasodilators. Although such agents are frequently used, their safety and efficacy remain controversial. A significant number of patients with heart failure have underlying coronary artery disease and may be at greater risk from hemodynamic alterations that can diminish coronary perfusion. In AHFS, the relationship among vasoactive medications, coronary perfusion, and potential myocardial injury needs further investigation. Newer techniques now available to evaluate coronary perfusion should provide guidance for the evaluation of existing and future vasoactive therapies for AHFS.
Beohar
Nirat
N
Bluhm Cardiovascular Institute, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois 60611, USA. n-beohar@northwestern.edu
Erdogan
Ata K
AK
Lee
Daniel C
DC
Sabbah
Hani N
HN
Kern
Morton J
MJ
Teerlink
John
J
Bonow
Robert O
RO
Gheorghiade
Mihai
M
D000208:Acute Disease; D003324:Coronary Artery Disease / Q000503:physiopathology*; D003326:Coronary Circulation; D053805:Fractional Flow Reserve, Myocardial; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008833:Microcirculation; D013577:Syndrome; D015899:Tomography, Emission-Computed, Single-Photon