STATE-OF-THE-ART PAPER
Acute Heart Failure Syndromes
Mihai Gheorghiade, MD, FACC*,* and
Peter S. Pang, MD
* Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Manuscript received July 2, 2008;
revised manuscript received October 21, 2008,
accepted October 26, 2008.
* Reprint requests and correspondence: Dr. Mihai Gheorghiade, Professor of Medicine and Surgery, Northwestern University Feinberg School of Medicine, Division of Cardiology, 676 N. St. Clair, Suite 600, Chicago, Illinois 60611 (Email: m-gheorghiade{at}northwestern.edu).
Heart failure resulting in hospitalization represents a significant and growing health care burden. Heterogeneity characterizes this group in terms of mode of presentation, pathophysiology, and prognosis. The vast majority of patients symptomatically improve during hospitalization; however, their early post-discharge rehospitalization and mortality rates continue to be high. Worsening signs and symptoms, neurohormonal, and renal abnormalities occurring soon after discharge may contribute to these high post-discharge event rates. Currently available assessment modalities combined with recent advances in cardiovascular therapies provide present-day opportunities to improve post-discharge outcomes. Further investigation into pathophysiologic targets and novel approaches to clinical trial design are needed. Improving post-discharge outcomes is the single most important goal in the management of acute heart failure syndromes.
Key Words: heart • failure • decompensated • acute • syndromes
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Abbreviations and Acronyms
| | ACE = angiotensin-converting enzyme | | AHFS = acute heart failure syndromes | | ARB = angiotensin receptor blocker | | BNP = B-type natriuretic peptide | | BP = blood pressure | | BW = body weight | | CAD = coronary artery disease | | CRT = chronic resynchronization therapy | | EF = ejection fraction | | HF = heart failure | | IV = intravenous | | LVFP = left ventricular filling pressure | | MI = myocardial infarction | | PCWP = pulmonary capillary wedge pressure | | PSF = preserved systolic function | | SBP = systolic blood pressure |
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