Abstract：
:Acute heart failure hospitalizations complicated by diuretic resistance are associated with worse outcomes. Yet, quantification of the frequency and accompanying risk from loop diuretic resistance is limited by the absence of a comprehensive definition with universal clinical application. Herein, we outline limitations of the current metrics used to identify and define diuretic resistance. We discuss the best available methods to identify and prognosticate outcomes in diuretic resistance. We propose a mechanism-based classification system of diuretic resistance by anatomical location as follows: pre-nephron resistance, pre-loop of Henle resistance, loop of Henle resistance, and post-loop of Henle resistance. Within this paradigm, we compare and contrast historical beliefs of resistance mechanisms with current literature specific to patients with heart failure. We recommend a treatment pathway to restore diuretic efficacy with a literature review of the various combination diuretic strategies and ongoing clinical trials that may impact current best practices.
journal_name
Heart Fail Revjournal_title
Heart failure reviewsauthors
Cox ZL,Testani JMdoi
10.1007/s10741-019-09851-9subject
Has Abstractpub_date
2020-01-01 00:00:00pages
133-145issue
1eissn
1382-4147issn
1573-7322pii
10.1007/s10741-019-09851-9journal_volume
25pub_type
杂志文章,评审abstract：:The evolving paradigm of heart failure has now been expanded to include the favorable neurohormonal, structural and hemodynamic profile of B-type natriuretic peptide [BNP]. As a marker of left ventricular dysfunction, BNP is a practical tool that facilitates diagnosis, contributes to prognostic evaluations and tracks ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1023/a:1026107701983
更新日期：2003-10-01 00:00:00
abstract：:The pathophysiology of heart failure (HF) is characterized by an abnormal activation of neurohumoral systems, including the sympathetic nervous and the renin-angiotensin-aldosterone systems, which have long-term deleterious effects on the disease progression. Perpetuation of this neurohumoral activation is partially d...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-014-9427-x
更新日期：2014-11-01 00:00:00
abstract：:Heart failure (HF) is a chronic, systemic disorder that presents a serious and growing public health problem due to its high prevalence, mortality, and cost of care. Due to the aging of the population and medical advances that prolong the life of HF patients, more effective, widespread strategies for improved HF manag...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-019-09781-6
更新日期：2019-07-01 00:00:00
abstract：:Physiologic endurance exercise performance is primarily limited by cardiac function. In patients with heart failure, there is dissociation between cardiac performance and exercise capacity, suggesting a distinct role of abnormal peripheral organ function, including skeletal muscle function. The impact of heart failure...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-012-9353-8
更新日期：2013-09-01 00:00:00
abstract：:The development of a diabetic cardiomyopathy is a multifactorial process, and evidence is accumulating that defects in intracellular free calcium concentration [Ca2+]i or its homeostasis are related to impaired mechanical performance of the diabetic heart leading to a reduction in contractile dysfunction. Defects in r...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-017-9663-y
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Whether mechanical restraint of the left ventricle (LV) can influence remodeling following myocardial infarction (MI) remains poorly understood. The following discussion details three studies examining the effects of surgically placing a cardiac support device (CSD) over the entire epicardial surface, on inf...
journal_title：Heart failure reviews
pub_type： 杂志文章
doi：10.1007/s10741-005-4640-2
更新日期：2005-06-01 00:00:00
abstract：:Cell transplantation is emerging as a new treatment designed tot improve the poor outcome of patients with cardiac failure. Its rationale is that implantation of contractile cells into postinfarction scars can functionally rejuvenate these areas. Primarily for practical reasons, autologous skeletal myoblasts have been...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1023/a:1024705214292
更新日期：2003-07-01 00:00:00
abstract：:From previous systematic reviews and meta-analyses, there is consensus about the positive effect of exercise training on exercise capacity for systolic heart failure (HF); however, the effect on actual prognostic markers such as NTproBNP and minute ventilation/carbon dioxide production (VE/VCO2) slope has not been eva...
journal_title：Heart failure reviews
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s10741-013-9407-6
更新日期：2014-09-01 00:00:00
abstract：:It is over 4 years since the Prospective Comparison of angiotensin receptor/neprilysin inhibitor (ARNI) with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial was published in New England Journal of Medicine. The PARADIGM-HF trial was the one that contributed to the offici...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-019-09879-x
更新日期：2020-05-01 00:00:00
abstract：:Diabetes mellitus is one of the leading causes of death, and the majority of these deaths are associated with cardiovascular diseases. Development and progression of myocardial infarction leading to heart failure is much more complex and multifactorial in diabetics compared with non-diabetics. Despite significant adva...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-010-9172-8
更新日期：2010-11-01 00:00:00
abstract：:Cardiac hypertrophy is promoted by adrenergic over-activation and represents an independent risk factor for cardiovascular morbidity and mortality. The basic knowledge about mechanisms by which sustained adrenergic activation promotes myocardial growth, as well as understanding how structural changes in hypertrophied ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-007-9007-4
更新日期：2007-03-01 00:00:00
abstract：:The prevalence of heart failure (HF) is increasing. A distinction is made between diastolic HF (preserved left ventricular ejection fraction (LVEF)) and systolic HF (reduced LVEF). Advanced glycation end-products (AGEs) are crystallized proteins that accumulate during ageing, but are particularly increased in patients...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-010-9225-z
更新日期：2012-03-01 00:00:00
abstract：:Recent cardiovascular outcome trials have highlighted the propensity of the antidiabetic agents, SGLT2 inhibitors (SGLT2is or -flozin drugs), to exert positive clinical outcomes in patients with cardiovascular disease at risk for major adverse cardiovascular events (MACEs). Of interest in cardiac diabetology is the ph...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-020-09996-y
更新日期：2020-06-24 00:00:00
abstract：:The spectrum of ischemic heart diseases, encompassing acute myocardial infarction to heart failure, represents the leading cause of death worldwide. Although extensive progress in cardiovascular diagnoses and therapy has been made, the prevalence of the disease continues to increase. Cardiac regeneration has a promisi...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-020-09953-9
更新日期：2020-04-18 00:00:00
abstract：:Heart failure (HF) is a common complication in patients with type 2 diabetes and it is closely associated with high morbidity and mortality rate. The incidence of cardiovascular events in patients with diabetes is related to high levels of glycemia, expressed by increase of HbA1c levels. However, there is little evide...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-018-9669-0
更新日期：2018-05-01 00:00:00
abstract：:In response to a prolonged pressure- or volume-overload, alterations occur in myocardial fatty acid, glucose, and glycogen metabolism. Oxidation of long chain fatty acids has been found to be reduced in hypertrophied hearts compared to non-hypertrophied hearts. However, this observation depends upon the degree of card...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1023/a:1015380609464
更新日期：2002-04-01 00:00:00
abstract：:Rheumatic heart disease (RHD) is a major cause of cardiovascular morbidity and mortality in low- and middle-income countries, where living conditions promote spread of group A β-haemolytic streptococcus. Autoimmune reactions due to molecular mimicry of bacterial epitopes by host proteins cause acute rheumatic fever (A...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-020-09993-1
更新日期：2020-07-11 00:00:00
abstract：:End-stage systolic heart failure is an increasingly common problem in elderly patients and is associated with high cost, poor quality of life, and poor outcomes. Mechanical circulatory support is a promising therapy as both a bridge to transplantation and destination therapy. Elderly patients are frequently ineligible...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-012-9298-y
更新日期：2012-09-01 00:00:00
abstract：:Heart failure with preserved ejection fraction (HFpEF) is a common disorder generating high mortality and important morbidity prevalence, with a very limited medical treatment available. Studies have shown that the pathophysiological hallmark of this condition is an elevated left intra-atrial pressure (LAP), exertiona...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-019-09787-0
更新日期：2019-09-01 00:00:00
abstract：:Stem cell therapy is a promising approach to the treatment of ischemic heart disease via replenishing cell loss after myocardial infarction. Both preclinical studies and clinical trials have indicated that cardiac function improved consistently, but very modestly after cell-based therapy. This mainly attributed to low...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-016-9576-1
更新日期：2016-11-01 00:00:00
abstract：:Since its discovery in 1988, there has been increasing evidence that endothelin-1 (ET-1) plays an important role in the pathophysiology of hypertension and its related end-organ damages. First studies, using ET-1 administration in animals or in humans suspected this role by demonstrating the hypertensive properties of...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1023/a:1011419223152
更新日期：2001-12-01 00:00:00
abstract：:Uric acid, the metabolic mediator of gout and urate renal stones, is associated with increased cardiovascular risk burden. Hyperuricemia is an old emerging metabolic disorder, and interaction among uric acid and cardiovascular diseases has been clearly described. Several illness including hypertension, myocardial infa...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-019-09869-z
更新日期：2020-01-01 00:00:00
abstract：:Heart failure (HF) is characterized by the elaboration of a portfolio of pro-inflammatory cytokines and inflammatory mediators that are considered to contribute to disease progression by virtue of the deleterious effects that these molecules exert on the heart and circulation. Recent studies have suggested that these ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-009-9140-3
更新日期：2010-07-01 00:00:00
abstract：:Although mineralocorticoid antagonists (MRAs) have been proposed as effective fourth-line blood pressure (BP) lowering agents in resistant hypertension, this effect in heart failure is undetermined. In this synthesis of heart failure randomized controlled trials (RCTs), we evaluated the extent of BP lowering following...
journal_title：Heart failure reviews
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s10741-018-9689-9
更新日期：2018-07-01 00:00:00
abstract：:β-Adrenergic receptors (βARs) belong to a large family of cell surface receptors known as G protein-coupled receptors (GPCRs). They are coupled to Gs protein (Gαs) for the activation of adenylyl cyclase (AC) yielding cyclic AMP (CAMP), and this provides valuable responses, which can affect the cardiac function such as...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-019-09825-x
更新日期：2020-03-01 00:00:00
abstract：:Treatment of patients with heart failure with reduced ejection fraction (HFrEF) with currently available therapies reduces morbidity and mortality. However, implementation of these therapies is a problem with only few patients achieving guideline-recommended maximal doses of therapy. In an effort to improve guideline ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-020-10004-6
更新日期：2021-01-01 00:00:00
abstract：:Heart failure is a complex clinical syndrome associated with a significant morbidity and mortality burden. Reductions in left ventricular (LV) function trigger adaptive mechanisms, leading to structural changes within the LV and the potential development of dyssynchronous ventricular activation. This is the substrate ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-018-9734-8
更新日期：2019-01-01 00:00:00
abstract：:Diabetes mellitus is a chronic disease requiring lifelong control with hypoglycemic agents that must demonstrate excellent efficacy and safety profiles. In patients taking glucose-lowering drugs, hypoglycemia is a common cause of death associated with arrhythmias, increased thrombus formation, and specific effects of ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-017-9647-y
更新日期：2018-05-01 00:00:00
abstract：:Heart failure is a complex disease process, the manifestation of various cardiac and noncardiac abnormalities. General treatment approaches for heart failure have remained the same over the past decades despite the advent of novel therapies and monitoring modalities. In the same vein, the readmission rates for heart f...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-018-9697-9
更新日期：2018-07-01 00:00:00
abstract：:Despite remarkable progress in the therapeutic approach of patients with chronic heart failure (CHF), exercise intolerance remains one of the hallmarks of the disease. During the past two decades, evidence has accumulated to underscore the key role of both endothelial dysfunction and skeletal muscle wasting in the pro...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-012-9324-0
更新日期：2013-01-01 00:00:00
