Pharmacotherapeutic principles of fluid management in heart failure
- 9 February 2021
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Opinion on Pharmacotherapy
- Vol. 22 (5), 595-610
- https://doi.org/10.1080/14656566.2020.1850694
Abstract
Introduction: Heart failure is a major public health concern that is expected to increase over the decades to come. Despite significant advances, fluid overload and congestion remain a major therapeutic challenge. Vascular congestion and neurohormonal activation are intricately linked and the goal of therapy fundamentally aims to reduce both. Areas covered: The authors briefly review a number of core concepts that elucidate the link between fluid overload and neuro-hormonal activation. This is followed by a review of heart–kidney interactions and the impact of diuresis in this setting. Following an in-depth review of currently available pharmacological agents, the rationale and evidence behind their use, the authors end with a brief note on novel agents/approaches to aid volume management in HF. Expert opinion: A number of non-pharmacological advances in the management of volume overload in heart failure, though promising – are associated with a number of shortcomings. Pharmacological therapy remains the cornerstone of volume management. A number of novel approaches, utilizing existing therapies as well as the emergence of new agents over the past decade bode well for the vulnerable HF population.Keywords
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