TY - JOUR
T1 - Acute decompensated heart failure
T2 - Update on new and emerging evidence and directions for future research
AU - Givertz, Michael M.
AU - Teerlink, John R.
AU - Albert, Nancy M.
AU - Westlake Canary, Cheryl A.
AU - Collins, Sean P.
AU - Colvin-Adams, Monica
AU - Ezekowitz, Justin A.
AU - Fang, James C.
AU - Hernandez, Adrian F.
AU - Katz, Stuart D.
AU - Krishnamani, Rajan
AU - Stough, Wendy Gattis
AU - Walsh, Mary N.
AU - Butler, Javed
AU - Carson, Peter E.
AU - Dimarco, John P.
AU - Hershberger, Ray E.
AU - Rogers, Joseph G.
AU - Spertus, John A.
AU - Stevenson, William G.
AU - Sweitzer, Nancy K.
AU - Wilson Tang, W. H.
AU - Starling, Randall C.
N1 - Funding Information:
Michael M. Givertz: consultant or advisory board: Merck, Cardioxyl. John R. Teerlink: consultant or advisory board: Amgen, Corthera, Cytokinetics, Novartis, Gambro; research grants: Amgen , Corthera , Cytokinetics , Novartis , Affymax , St Jude . Randall C. Starling: sponsored research: Johnson & Johnson, Scios; stock options: CardioMEMS; steering committee: Biocontrol INOVATE-HF, NHLBI Heart Failure Network; advisory board: Medtronic; all details posted on Cleveland Clinic website. Nancy M. Albert: honoraria or speaker's bureau: BG Medicine, Medtronic; consultant or advisory board: BG Medicine, Gambro. Sean P. Collins: consultant or advisory board: The Medicines Company, Novartis, Radiometer, Trevena; research grants: Medtronic . Justin A. Ezekowitz: research grants: Amgen, Johnson & Johnson , Alere . James C. Fang: consultant or advisory board: Medtronic; research grants: Medtronic. Adrian F. Hernandez: honoraria or speaker's bureau: Corthera, BMS; research grants: Amylin , Portola , Janssen . Wendy Gattis Stough: consultant: Medtronic. Mary N. Walsh: consultant or advisory board: United Healthcare, Eli Lilly; officer, trustee, or director: American College of Cardiology. Javed Butler: consultant of advisory board: Stemira, Medtronic, Trevena, Gambro, Ono, Bayer, Harvest; research grants: NIH, HRSA, European Union; ethical trial: Medtronic, Otsuka; DSMB or steering committee: Amgen, Celladon, Corthera, Novatis, BG Medicine. John P. Dimarco: consultant: Medtronic, St Jude; speaker: Boston Scientific. John A. Spertus: consultant or advisory board: Genentech, United Healthcare, Janssen, Amgen; equity interests or stock options: Health Outcomes; royalties or intellectual property rights: KCCQ, SAQ, PAQ; research grants: Genentech , Lilly , EvaHeart , Amorcyte , ACCF . W. H. Wilson Tang: research grants: NIH , Abbott Laboratories .
PY - 2013/6
Y1 - 2013/6
N2 - Acute decompensated heart failure (ADHF) is a complex clinical event associated with excess morbidity and mortality. Managing ADHF patients is challenging because of the lack of effective treatments that both reduce symptoms and improve clinical outcomes. Existing guideline recommendations are largely based on expert opinion, but several recently published trials have yielded important data to inform both current clinical practice and future research directions. New insight has been gained regarding volume management, including dosing strategies for intravenous loop diuretics and the role of ultrafiltration in patients with heart failure and renal dysfunction. Although the largest ADHF trial to date (ASCEND-HF, using nesiritide) was neutral, promising results with other investigational agents have been reported. If these findings are confirmed in phase III trials, novel compounds, such as relaxin, omecamtiv mecarbil, and ularitide, among others, may become therapeutic options. Translation of research findings into quality clinical care can not be overemphasized. Although many gaps in knowledge exist, ongoing studies will address issues around delivery of evidence-based care to achieve the goal of improving the health status and clinical outcomes of patients with ADHF.
AB - Acute decompensated heart failure (ADHF) is a complex clinical event associated with excess morbidity and mortality. Managing ADHF patients is challenging because of the lack of effective treatments that both reduce symptoms and improve clinical outcomes. Existing guideline recommendations are largely based on expert opinion, but several recently published trials have yielded important data to inform both current clinical practice and future research directions. New insight has been gained regarding volume management, including dosing strategies for intravenous loop diuretics and the role of ultrafiltration in patients with heart failure and renal dysfunction. Although the largest ADHF trial to date (ASCEND-HF, using nesiritide) was neutral, promising results with other investigational agents have been reported. If these findings are confirmed in phase III trials, novel compounds, such as relaxin, omecamtiv mecarbil, and ularitide, among others, may become therapeutic options. Translation of research findings into quality clinical care can not be overemphasized. Although many gaps in knowledge exist, ongoing studies will address issues around delivery of evidence-based care to achieve the goal of improving the health status and clinical outcomes of patients with ADHF.
KW - biomarkers
KW - clinical trials
KW - diuretics
KW - Heart failure
KW - quality of care
KW - ultrafiltration
KW - vasodilators
UR - http://www.scopus.com/inward/record.url?scp=84878588169&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2013.04.002
DO - 10.1016/j.cardfail.2013.04.002
M3 - Review article
AN - SCOPUS:84878588169
SN - 1071-9164
VL - 19
SP - 371
EP - 389
JO - Journal of cardiac failure
JF - Journal of cardiac failure
IS - 6
ER -