J Neurocrit Care.  2018 Jun;11(1):13-22. 10.18700/jnc.180047.

Acute Heart Failure and Its Management

• Choi S

• KMID: 2426209
• DOI: http://doi.org/10.18700/jnc.180047

Abstract

The prevalence of heart failure (HF) is rapidly increasing throughout the world, and is closely associated with serious morbidity and mortality. In particular, acute HF is one of the main causes of hospitalization and mortality, especially in elderly individuals. In Korea, the socioeconomic burden of HF is substantial. Because of this, the Korean HF society developed chronic and acute HF management guidelines in 2017, adapted process while including as much data from Korean studies as possible. The scope of the current review, which is based on the Korean HF guidelines, includes the definition, diagnosis, and treatment of acute HF with reduced or preserved ejection fractions of various etiologies.

Keyword

Heart failure; Guideline; Medication therapy management

MeSH Terms

Aged
Diagnosis
Heart Failure*
Heart*
Hospitalization
Humans
Korea
Medication Therapy Management
Mortality
Prevalence

Figure

• 

  Figure 1. Clinical assessment of acute decompensated heart failure

• 

  Figure 2. Diagnostic approach in patient suspicious acute heart failure. ECG, electrocardiogram; BNP, B-type natriuretic peptide.

Reference

1. Lee JH, Lim NK, Cho MC, Park HY. Epidemiology of heart failure in Korea: present and future. Korean Circ J. 2016; 46:658–64.

2. Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, Manolio T, et al. Heart disease and stroke statistics--2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006; 113:e85–151.

3. Fang J, Mensah GA, Croft JB, Keenan NL. Heart failure-related hospitalization in the U.S., 1979 to 2004. J Am Coll Cardiol. 2008; 52:428–34.

4. Youn JC, Han SW, Ryu KH. Temporal trends of hospitalized patients with heart failure in Korea. Korean Circ J. 2017; 47:16–24.

5. Choi DJ, Han S, Jeon ES, Cho MC, Kim JJ, Yoo BS, et al. Characteristics, outcomes and predictors of long-term mortality for patients hospitalized for acute heart failure: a report from the Korean heart failure registry. Korean Circ J. 2011; 41:363–71.

6. Nohria A, Tsang SW, Fang JC, Lewis EF, Jarcho JA, Mudge GH, et al. Clinical assessment identifies hemodynamic profiles that predict outcomes in patients admitted with heart failure. J Am Coll Cardiol. 2003; 41:1797–804.

7. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016; 18:891–975.

8. Fuat A, Murphy JJ, Hungin AP, Curry J, Mehrzad AA, Hetherington A, et al. The diagnostic accuracy and utility of a B-type natriuretic peptide test in a community population of patients with suspected heart failure. Br J Gen Pract. 2006; 56:327–33.

9. Yamamoto K, Burnett JC Jr, Bermudez EA, Jougasaki M, Bailey KR, Redfield MM. Clinical criteria and biochemical markers for the detection of systolic dysfunction. J Card Fail. 2000; 6:194–200.

10. Cowie MR, Struthers AD, Wood DA, Coats AJ, Thompson SG, Poole-Wilson PA, et al. Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care. Lancet. 1997; 350:1349–53.

11. Krishnaswamy P, Lubien E, Clopton P, Koon J, Kazanegra R, Wanner E, et al. Utility of B-natriuretic peptide levels in identifying patients with left ventricular systolic or diastolic dysfunction. Am J Med. 2001; 111:274–9.

12. Kelder JC, Cramer MJ, Verweij WM, Grobbee DE, Hoes AW. Clinical utility of three B-type natriuretic peptide assays for the initial diagnostic assessment of new slow-onset heart failure. J Card Fail. 2011; 17:729–34.

13. Gustafsson F, Steensgaard-Hansen F, Badskjaer J, Poulsen AH, Corell P, Hildebrandt P. Diagnostic and prognostic performance of N-terminal ProBNP in primary care patients with suspected heart failure. J Card Fail. 2005; 11(5 Suppl):S15–20.

14. Nielsen OW, Rasmussen V, Christensen NJ, Hansen JF. Neuroendocrine testing in community patients with heart disease: plasma N-terminal proatrial natriuretic peptide predicts morbidity and mortality stronger than catecholamines and heart rate variability. Scand J Clin Lab Invest. 2004; 64:619–28.

15. Kelder JC, Cowie MR, McDonagh TA, Hardman SM, Grobbee DE, Cost B, et al. Quantifying the added value of BNP in suspected heart failure in general practice: an individual patient data meta-analysis. Heart. 2011; 97:959–63.

16. Gupta DK, Wang TJ. Natriuretic peptides and cardiometabolic health. Circ J. 2015; 79:1647–55.

17. Zois NE, Bartels ED, Hunter I, Kousholt BS, Olsen LH, Goetze JP. Natriuretic peptides in cardiometabolic regulation and disease. Nat Rev Cardiol. 2014; 11:403–12.

18. Nishikimi T, Kuwahara K, Nakao K. Current biochemistry, molecular biology, and clinical relevance of natriuretic peptides. J Cardiol. 2011; 57:131–40.

19. Peacock WF 4th, De Marco T, Fonarow GC, Diercks D, Wynne J, Apple FS, et al. Cardiac troponin and outcome in acute heart failure. N Engl J Med. 2008; 358:2117–26.

20. Januzzi JL Jr, Peacock WF, Maisel AS, Chae CU, Jesse RL, Baggish AL, et al. Measurement of the interleukin family member ST2 in patients with acute dyspnea: results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study. J Am Coll Cardiol. 2007; 50:607–13.

21. Fermann GJ, Lindsell CJ, Storrow AB, Hart K, Sperling M, Roll S, et al. Galectin 3 complements BNP in risk stratification in acute heart failure. Biomarkers. 2012; 17:706–13.

22. Cox ZL, Lenihan DJ. Loop diuretic resistance in heart failure: resistance etiology-based strategies to restoring diuretic efficacy. J Card Fail. 2014; 20:611–22.

23. Mentz RJ, Kjeldsen K, Rossi GP, Voors AA, Cleland JG, Anker SD, Gheorghiade M, et al. Decongestion in acute heart failure. Eur J Heart Fail. 2014; 16:471–82.

24. Felker GM, Lee KL, Bull DA, Redfield MM, Stevenson LW, Goldsmith SR, et al. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med. 2011; 364:797–805.

25. Ezekowitz JA, Hernandez AF, Starling RC, Yancy CW, Massie B, Hill JA, et al. Standardizing care for acute decompensated heart failure in a large megatrial: the approach for the Acute Studies of Clinical Effectiveness of Nesiritide in Subjects with Decompensated Heart Failure (ASCEND-HF). Am Heart J. 2009; 157:219–28.

26. Mebazaa A, Nieminen MS, Filippatos GS, Cleland JG, Salon JE, Thakkar R, et al. Levosimendan vs. dobutamine: outcomes for acute heart failure patients on beta-blockers in SURVIVE. Eur J Heart Fail. 2009; 11:304–11.

27. Pathak A, Lebrin M, Vaccaro A, Senard JM, Despas F. Pharmacology of levosimendan: inotropic, vasodilatory and cardioprotective effects. J Clin Pharm Ther. 2013; 38:341–9.

28. Tang X, Liu P, Li R, Jing Q, Lv J, Liu L, et al. Milrinone for the treatment of acute heart failure after acute myocardial infarction: a systematic review and meta-analysis. Basic Clin Pharmacol Toxicol. 2015; 117:186–94.

29. Cuffe M, Califf R, Adams K, Benza R, Bourge R, Colucci WS, et al. Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Investigators. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002; 287:1541–7.

30. O’Connor C, Gattis W, Uretsky B, Adams K, McNulty S, Grossman S, et al. Continuous intravenous dobutamine is associated with an increased risk of death in patients with advanced heart failure: insights from the Flolan International Randomized Survival Trial (FIRST). Am Heart J. 1999; 138:78–86.

31. Clemo H, Wood M, Gilligan D, Ellenbogen K. Intravenous amiodarone for acute heart rate control in the critically ill patient with atrial tachyarrhythmias. Am J Cardiol. 1998; 81:594–8.

32. Hou Z, Chang M, Chen C, Tu M, Lin S, Chiang H, et al. Acute treatment of recent-onset atrial fibrillation and flutter with a tailored dosing regimen of intravenous amiodarone. A randomized, digoxin-controlled study. Eur Heart J. 1995; 16:521–8.

33. Konstam M, Gheorghiade M, Burnett J Jr, et al. Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST outcome trial. JAMA. 2007; 297:1319–1331.

34. Bart B, Goldsmith S, Lee K, Givertz M, O’Connor C, Bull D, et al. Ultrafiltration in decompensated heart failure with cardiorenal syndrome. N Engl J Med. 2012; 367:2296–304.

35. Costanzo M, Guglin M, Saltzberg M, Jessup M, Bart B, Teerlink J, et al. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am Coll Cardiol. 2007; 49:675–83.

36. Costanzo M, Saltzberg M, Jessup M, Teerlink J, Sobotka P. Ultrafiltration is associated with fewer rehospitalizations than continuous diuretic infusion in patients with decompensated heart failure: results from UNLOAD. J Card Fail. 2010; 16:277–84.

37. Thiele H, Zeymer U, Neumann F, Ferenc M, Olbrich H, Hausleiter J, et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med. 2012; 367:1287–96.

38. Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, et al. Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. Lancet. 2013; 382:1638–45.

39. Bartlett RH, Roloff DW, Custer JR, Younger JG, Hirschl RB. Extracorporeal life support: the University of Michigan experience. JAMA. 2000; 283:904–8.

40. Chen YS, Chao A, Yu HY, et al. Analysis and results of prolonged resuscitation in cardiac arrest patients rescued by extracorporeal membrane oxygenation. J Am Coll Cardiol. 2003; 41:197–203.

41. Cheng JM, den Uil CA, Hoeks SE, van der Ent M, Jewbali LS, van Domburg RT, et al. Percutaneous left ventricular assist devices vs. intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock: a meta-analysis of controlled trials. Eur Heart J. 2009; 30:2102–8.

42. O’Neill WW, Kleiman NS, Moses J, Henriques JP, Dixon S, Massaro J, et al. A prospective, randomized clinical trial of hemodynamic support with impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. Circulation. 2012; 126:1717–27.

43. Youn YJ, Yoo BS, Lee JW, Kim JY, Han SW, Jeon ES, et al. Treatment performance measures affect clinical outcomes in patients with acute systolic heart failure: report from the Korean Heart Failure Registry. Circ J. 2012; 76:1151–8.