Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Feb 11;12(2):e6952.
doi: 10.7759/cureus.6952.

Pharmacological and Non-pharmacological Strategies for Volume Overload in Acute Decompensated Congestive Heart Failure: A Review Article

Meer R Zafar  1 , Timothy W Miller  2 , Syed Farrukh Mustafa  3 , Nawfal Al-Khafaji  4
Affiliations
Review

Pharmacological and Non-pharmacological Strategies for Volume Overload in Acute Decompensated Congestive Heart Failure: A Review Article

Meer R Zafar et al. Cureus. .

Abstract

The epithet of acute decompensated heart failure (ADHF) is volume overload. ADHF is associated with a rising number of hospital admission for volume overload. Medication non-compliance, excessive salt intake, comorbidities, and/or disease progression can attribute to volume overload. Heart failure (HF) therapy has innovated during the past few decades, but diuretics have been the mainstay of treatment. Diuretics are vital even though these drugs stimulate the renin-angiotensin-aldosterone system (RAAS) and lead to adaptive responses like diuretic resistance, neurohormonal activation, and worsening renal function that may be inimical. There has been a thriving interest in cutting-edge strategies to manage volume overload in ADHF. The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) guidelines advocate pharmacological and non-pharmacological interventions to treat volume overload in ADHF patients. Ultrafiltration (UF) is, therefore, an emerging stand-in therapy of interest for treating volume overload in ADHF patients. This review article epitomizes available clinical data on the use of diuretics and UF in ADHF patients and identifies challenges for each approach.

Keywords: acute decompensated heart failure; diuretic resistance; diuretics; heart failure; renin-angiotensin-aldosterone system; ultrafiltration; volume overload.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to update the 2001 guidelines for the evaluation and management of heart failure) Hunt SA. J Am Coll Cardiol. 2005;46:1–82. - PubMed
    1. Acute heart failure syndromes: current state and framework for future research. Gheorghiade M, Zannad F, Sopko G, et al. Circulation. 2005;112:3958–3968. - PubMed
    1. Long-term trends in the incidence of and survival with heart failure. Levy D, Kenchaiah S, Larson MG, et al. N Engl J Med. 2002;347:1397–1402. - PubMed
    1. 2009 focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Jessup M, Abraham WT, Casey DE, et al. J Am Coll Cardiol. 2009;119:1977–2016. - PubMed
    1. Epidemiology and risk profile of heart failure. Bui AL, Horwich TB, Fonarow GC. Nat Rev Cardiol. 2011;8:30–41. - PMC - PubMed

LinkOut - more resources