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Differences between the left main and other bifurcations Ascending Aortic Length and Risk of Aortic Adverse Events: The Neglected Dimension Decline in Left Ventricular Ejection Fraction During Follow-Up in Patients With Severe Aortic Stenosis Infective Endocarditis After Transcatheter Aortic Valve Replacement New-onset atrial fibrillation after PCI and CABG for left main disease: insights from the EXCEL trial and additional studies Comparative effectiveness analysis of percutaneous coronary intervention versus coronary artery bypass grafting in patients with chronic kidney disease and unprotected left main coronary artery disease Surgical ineligibility and mortality among patients with unprotected left main or multivessel coronary artery disease undergoing percutaneous coronary intervention Serial intravascular ultrasound analysis of the main and side branches in bifurcation lesions treated with the T-stenting technique Active SB-P Versus Conventional Approach to the Protection of High-Risk Side Branches: The CIT-RESOLVE Trial EXCELling in Left Main Intervention
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Review ArticleVolume 75, Issue 10, March 2020

JOURNAL：J Am Coll Cardiol. Article Link

Diuretic Therapy for Patients With Heart Failure JACC State-of-the-Art Review

GM Felker, DH Ellison, W Mullens et al. Keywords: congestion; diuretics; heart failure; pharmacology

ABSTRACT

Expansion of extracellular fluid volume is central to the pathophysiology of heart failure. Increased extracellular fluid leads to elevated intracardiac filling pressures, resulting in a constellation of signs and symptoms of heart failure referred to as congestion. Loop diuretics are one of the cornerstones of treatments for heart failure, but in contrast to other therapies, robust clinical trial evidence to guide the use of diuretics is sparse. A nuanced understanding of renal physiology and diuretic pharmacokinetics is essential for skillful use of diuretics in the management of heart failure in both the inpatient and outpatient settings. Diuretic resistance, defined as an inadequate quantity of natriuresis despite an adequate diuretic regimen, is a major clinical challenge that generally portends a poor prognosis. In this review, the authors discuss the fundamental mechanisms and physiological principles that underlie the use of diuretic therapy and the available data on the optimal use of diuretics.
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