Current cardiology reports
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Acute heart failure is a public health issue with morbidity and mortality exceeding that of myocardial infarction. Novel compounds for the treatment of acute heart failure are clearly needed and fall into the general categories of inotropic, vasodilatory and other compounds in phase I to III of development. ⋯ Each compound has a unique set of assets and liabilities that will aid in the understanding of the syndrome and application to the right patients at the right time in this heterogeneous syndrome. This review will explore current and future novel pharmacologic therapies for the treatment of acute heart failure.
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Loop diuretics remain a mainstay in the pharmacologic treatment of acute decompensated heart failure (ADHF). Recent randomized trial results have challenged existing clinical dogma about the optimal manner of intravenous diuretic administration in hospitalized patients. ⋯ Venovenous ultrafiltration (UF) holds promise as an alternative approach to volume removal in ADHF, but significant work remains in characterizing the relative risks and benefits of this technique, as well as the degree to which it can be broadly utilized. This review highlights current approaches and future directions in mitigating congestion and volume overload in the ADHF population, with a particular focus on novel diuretic dosing strategies and on the emerging role of UF.