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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

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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