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Association Between Functional Impairment and Medication Burden in Adults with Heart Failure Permanent pacemaker use among patients with heart failure and preserved ejection fraction: Findings from the Acute Decompensated Heart Failure National Registry (ADHERE) National Registry Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies From Subclinical Atherosclerosis to Plaque Progression and Acute Coronary Events Sex- and Race-Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction Intravascular Ultrasound-Guided Versus Angiography-Guided Implantation of Drug-Eluting Stent in All-Comers: The ULTIMATE trial Nocturnal thoracic volume overload and post-discharge outcomes in patients hospitalized for acute heart failure In patients with stable coronary heart disease, low-density lipoprotein-cholesterol levels < 70 mg/dL and glycosylated hemoglobin A1c < 7% are associated with lower major cardiovascular events Aliskiren, Enalapril, or Aliskiren and Enalapril in Heart Failure Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized Controlled Trial
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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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