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
. 2023 May;25(5):411-420.
doi: 10.1007/s11886-023-01865-y. Epub 2023 Apr 19.

Congestion and Use of Diuretics in Heart Failure and Cardiomyopathies: a Practical Guide

Javed Khan  1 , Fraser J Graham  2 , Gabriele Masini  3   4 , Antonio Iaconelli  2   4 , Jocelyn M Friday  2 , Chim C Lang  5   6 , Pierpaolo Pellicori  2
Affiliations
Review

Congestion and Use of Diuretics in Heart Failure and Cardiomyopathies: a Practical Guide

Javed Khan et al. Curr Cardiol Rep. 2023 May.

Erratum in

Abstract

Purpose of review: Heart failure is a highly prevalent condition caused by many different aetiologies and characterised by cardiac dysfunction and congestion. Once developed, congestion leads to signs (peripheral oedema) and symptoms (breathlessness on exertion), adverse cardiac remodelling, and an increased risk of hospitalisation and premature death. This review summarises strategies that could enable early identification and a more objective management of congestion in patients with heart failure.

Recent findings: For patients with suspected or diagnosed heart failure, combining an echocardiogram with assessment of great veins, lungs, and kidneys by ultrasound might facilitate recognition and quantification of congestion, the management of which is still difficult and highly subjective. Congestion is a one of the key drivers of morbidity and mortality in patients with heart failure and is often under-recognised. The use of ultrasound allows for a timely, simultaneous identification of cardiac dysfunction and multiorgan congestion; ongoing and future studies will clarify how to tailor diuretic treatments in those with or at risk of heart failure.

Keywords: Congestion; Diuretics; Heart failure; Management; Ultrasound.

PubMed Disclaimer

References

Papers of particular interest, published recently, have been highlighted as: •   Of importance
    1. • Cleland JGF, Pfeffer MA, Clark AL, et al. The struggle towards a universal definition of heart failure—how to proceed? Eur Heart J. 2021;42(24):2331–43. https://doi.org/10.1093/eurheartj/ehab082 . Authors propose a modern universal definition of heart failure, consisting of cardiac dysfunction and congestion. - DOI - PubMed
    1. Cleland JGF, Pellicori P, Clark AL. Prevention or procrastination for heart failure?: why we need a universal definition of heart failure∗. J Am Coll Cardiol. 2019;73(19):2398–400. https://doi.org/10.1016/j.jacc.2019.03.471 . - DOI - PubMed
    1. Pellicori P, Kaur K, Clark AL. Fluid management in patients with chronic heart failure. Card Fail Rev. 2015;1(2):90. https://doi.org/10.15420/cfr.2015.1.2.90 . - DOI - PubMed - PMC
    1. Skinner SL, McCubbin JW, Page IH. Renal baroreceptor control of acute renin release in normotensive. Circ Res. 1964;15:522–31. https://doi.org/10.1161/01.RES.15.6.522 . - DOI - PubMed
    1. Francis GS, Benedict C, Johnstone DE, et al. Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure: a substudy of the studies of left ventricular dysfunction (SOLVD). Circulation. 1990;82(5):1724–9. https://doi.org/10.1161/01.CIR.82.5.1724 . - DOI - PubMed

Publication types

LinkOut - more resources