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Therapeutic novelties in acute heart failure and practical perspectives.
Anaesth Crit Care Pain Med
January 2025
City Cardiological Center, Almaty, Kazakhstan.
Acute Heart Failure (AHF) is a leading cause of death and represents the most frequent cause of unplanned hospital admission in patients older than 65 years. Since the past decade, several randomized clinical trials have highlighted the importance and pivotal role of certain therapeutics, including decongestion by the combination of loop diuretics, the need for rapid goal-directed medical therapies implementation before discharge, risk stratification, and early follow-up after discharge therapies. Cardiogenic shock, defined as sustained hypotension with tissue hypoperfusion due to low cardiac output and congestion, is the most severe form of AHF and mainly occurs after acute myocardial infarction, which can progress to multiple organ failure.
View Article and Find Full Text PDFNew and future heart failure drugs.
Nat Cardiovasc Res
December 2024
Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
In the past decade, our understanding of heart failure pathophysiology has advanced significantly, resulting in the development of new medications such as angiotensin-neprilysin inhibitors, sodium-glucose cotransporter-2 inhibitors and oral soluble guanylate cyclase stimulators. Backed by positive findings from large randomized controlled trials, recommendations for their use were recently included in the 2022 AHA/ACC/HFSA guidelines and 2023 ESC guidelines for management of heart failure. Promising drugs for future heart failure treatment include agents that modulate the neurohormonal system, vasodilators, anti-inflammatory drugs, mitotropes, which improve deranged energy metabolism of the failing heart, and myotropes, which increase cardiac contractility by affecting cardiac sarcomere function.
View Article and Find Full Text PDFThis document describes performance measures for heart failure that are appropriate for public reporting or pay-for-performance programs and is meant to serve as a focused update of the "2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures." The new performance measures are taken from the "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines" and are selected from the strongest recommendations (Class 1 or Class 3). In contrast, quality measures may not have as much evidence base and generally comprise metrics that might be useful for clinicians and health care organizations for quality improvement but are not yet appropriate for public reporting or pay-for-performance programs.
View Article and Find Full Text PDF2024 Update to the 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American Heart Association/American College of Cardiology Joint Committee on Performance Measures.
Circ Cardiovasc Qual Outcomes
September 2024
Heart Failure Society of America representative.
Article Synopsis
- - This document updates performance measures for heart failure, suitable for public reporting and pay-for-performance systems, based on the "2022 AHA/ACC/HFSA Guideline for Management of Heart Failure" and focusing on strong recommendations.
- - New performance measures include managing blood pressure in patients with preserved ejection fraction, using specific medications for those with reduced ejection fraction, and ensuring proper medical therapy for hospitalized patients.
- - The quality measures cover broader aspects, such as medication use, patient counseling on health risks related to heart failure, and the importance of screenings for related conditions, but aren't yet ready for public reporting.
How to Optimize Goal-Directed Medical Therapy (GDMT) in Patients with Heart Failure.
Curr Cardiol Rep
September 2024
Division of Cardiology, Thomas Jefferson University Hospital, 833 Chestnut Street, Suite 630, Philadelphia, PA, 19107, USA.
Purpose Of Review: Heart failure is a clinical syndrome with signs and symptoms from underlying cardiac abnormality and evidence of pulmonary or systemic congestion on laboratory testing or other objective findings (Bozkurt et al. in Eur J Heart Fail 23:352-380, 2021). Heart failure with reduced ejection fraction (HFrEF), when heart failure is due to underlying reduction in ejection fraction to 40.
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