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Vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications

AIMS: Acute heart failure (HF) is a frequent and life‐threatening syndrome with heterogeneous clinical, haemodynamic, and neurohormonal features. This article describes the vascular phenotypes associated with acute decompensated chronic HF (ADCHF), and new‐onset acute HF (NOAHF). DATA SYNTHESIS: Wor...

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Autor principal: Ferreira, Jorge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5695185/
https://www.ncbi.nlm.nih.gov/pubmed/28960929
http://dx.doi.org/10.1002/ehf2.12210
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author Ferreira, Jorge
author_facet Ferreira, Jorge
author_sort Ferreira, Jorge
collection PubMed
description AIMS: Acute heart failure (HF) is a frequent and life‐threatening syndrome with heterogeneous clinical, haemodynamic, and neurohormonal features. This article describes the vascular phenotypes associated with acute decompensated chronic HF (ADCHF), and new‐onset acute HF (NOAHF). DATA SYNTHESIS: Worsening of chronic HF occurs with full activation of adaptive mechanisms that maintain blood pressure (BP) and systemic perfusion. Rapid onset of HF in the setting of previous normal functioning heart not only does not allow full activation of adaptive mechanisms but also generates inappropriate responses from systemic endothelium leading to low BP/hypotension. Consequently, the treatment of ADCHF is based on diuretics and vasodilators, while in NOAHF, vasoconstrictors may be required to maintain BP to allow the correction of the acute cardiac disease. CONCLUSIONS: Patients with ADCHF and NOAHF present different vascular phenotypes with treatment implications.
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spelling pubmed-56951852018-02-14 Vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications Ferreira, Jorge ESC Heart Fail Perspective AIMS: Acute heart failure (HF) is a frequent and life‐threatening syndrome with heterogeneous clinical, haemodynamic, and neurohormonal features. This article describes the vascular phenotypes associated with acute decompensated chronic HF (ADCHF), and new‐onset acute HF (NOAHF). DATA SYNTHESIS: Worsening of chronic HF occurs with full activation of adaptive mechanisms that maintain blood pressure (BP) and systemic perfusion. Rapid onset of HF in the setting of previous normal functioning heart not only does not allow full activation of adaptive mechanisms but also generates inappropriate responses from systemic endothelium leading to low BP/hypotension. Consequently, the treatment of ADCHF is based on diuretics and vasodilators, while in NOAHF, vasoconstrictors may be required to maintain BP to allow the correction of the acute cardiac disease. CONCLUSIONS: Patients with ADCHF and NOAHF present different vascular phenotypes with treatment implications. John Wiley and Sons Inc. 2017-09-28 /pmc/articles/PMC5695185/ /pubmed/28960929 http://dx.doi.org/10.1002/ehf2.12210 Text en © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Perspective
Ferreira, Jorge
Vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications
title Vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications
title_full Vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications
title_fullStr Vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications
title_full_unstemmed Vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications
title_short Vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications
title_sort vascular phenotypes of acute decompensated vs. new‐onset heart failure: treatment implications
topic Perspective
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5695185/
https://www.ncbi.nlm.nih.gov/pubmed/28960929
http://dx.doi.org/10.1002/ehf2.12210
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