title: What's new in the treatment of acute heart failure?
abstract: Acute heart failure is associated with substantial morbidity and mortality. Goals of treatment are decongestion, correction of hemodynamic abnormalities, symptom relief, and reducing long-term morbidity and mortality. Loop diuretics are a first-line agent for treatment of volume overload, with ultrafiltration reserved for those who do not respond to pharmacologic therapy. In patients with normal or elevated blood pressure, vasodilators are used to correct hemodynamics and reverse central volume redistribution, although no currently available agent has been shown to improve outcomes. Intravenous inotropes and inodilators are associated with frequent adverse effects and are reserved for patients with hypotension and evidence of inadequate perfusion. Novel drugs designed to maximize hemodynamic benefits while minimizing adverse effects are under investigation, with several agents showing promise in clinical studies.
authors.affiliation: Division of Cardiology, University of California, San Francisco, Box 0124, 505 Parnassus Ave, San Francisco, CA 94143-0124, USA. van.selby@ucsf.edu
authors.forename: Van N
authors.initials: VN
authors.lastname: Selby
authors.forename: John R
authors.initials: JR
authors.lastname: Teerlink
mesh_terms: D000208:Acute Disease; D065092:Antidiuretic Hormone Receptor Antagonists; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D014462:Ultrafiltration / Q000379:methods; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D002316:Cardiotonic Agents; D004232:Diuretics; D014665:Vasodilator Agents