Therapy for acute heart failure syndromes.

Curr Cardiol Rep. 2009 May;11(3):192-201

Authors: Donlan SM, Quattromani E, Pang PS, Gheorghiade M

The pharmacologic management of acute heart failure syndromes (AHFS) has changed little over the past 15 years. Traditional therapies, such as nitrates and loop diuretics, remain the mainstay of therapy, with inotropes reserved for patients who present in shock or an advanced low-output state. We review the use of these therapies in AHFS with added insights from recent clinical trials and registry data.

PMID: 19379639 [PubMed - indexed for MEDLINE]

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The cardiorenal connection in heart failure.

Curr Cardiol Rep. 2008 May;10(3):190-7

Authors: Rastogi A, Fonarow GC

Heart failure (HF) and renal dysfunction frequently coexist; this combination is commonly referred to as the “cardiorenal syndrome.” The intersection of cardiac and renal dysfunction has important therapeutic and prognostic implications in patients with HF. Approximately 60% to 80% of patients hospitalized for HF have at least stage III renal dysfunction; this comorbid renal insufficiency (RI) is associated with significantly increased morbidity and mortality risk. Comorbid RI can result from intrinsic renal disease and inadequate renal perfusion. HF and RI stimulate neurohormonal activation, increasing preload and afterload and reducing cardiac output. Inotropic agents augment this neurohormonal activation. Managing cardiorenal patients requires successful negotiation of the delicate balance between adequate volume reduction and adequate renal function. There is a compelling need for additional studies in this patient population.

PMID: 18489862 [PubMed - indexed for MEDLINE]

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