The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

The Pharmacologic Treatment of Acute Heart Failure

급성 심부전의 약물적 치료

  • Kim, Hyung-Seop (Division of Cardiology, Department of Internal Medicine, Keimyung University School of Medicine)
  • 김형섭 (계명대학교 의과대학 심장내과학교실)
  • Published : 2012.06.01
⟨ Previous Next ⟩

Abstract

Acute heart failure (HF) is commonly encountered in the emergency department and thus, the hospital admissions for worsening HF are increasing. However, the patients presenting with acute HF are heterogenous and complex at high risk of morbidity and mortality. The main goals of treatment for hospitalized patients with HF are to restore euvolemia and to maintain the hemodynamic status without causing adverse events. Currently, the recommendations are usually based on a clinical factor considering the initial systolic blood pressure and other symptoms. Accordingly, initial managements in the hospital generally include diuretics, vasodilators, morphine, and inotropic agents, all of which have been considered as traditional therapies. These agents should mainly increase cardiac output and improve symptoms, and importantly it should improve the clinical outcomes. The aim of this review is to describe the available and new pharmacologic drugs for patients presenting with acute HF.

Keywords

References

  1. Shin DD, Brandimarte F, De Luca L, et al. Review of current and investigational pharmacologic agents for acute heart failure syndromes. Am J Cardiol 2007;99(2A):4A-23A. https://doi.org/10.1016/S0002-9149(07)00488-2
  2. Cuffe MS, Califf RM, Adams KF Jr, et al. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA 2002; 287:1541-1547. https://doi.org/10.1001/jama.287.12.1541
  3. Felker GM, Benza RL, Chandler AB, et al. Heart failure etiology and response to milrinone in decompensated heart failure: results from the OPTIME-CHF study. J Am Coll Cardiol 2003;41:997-1003. https://doi.org/10.1016/S0735-1097(02)02968-6
  4. Hunt SA, Abraham WT, Chin MH, et al. 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines Developed in Collaboration with the International Society for Heart and Lung Transplantation. J Am Coll Cardiol 2009;53:e1-e90. https://doi.org/10.1016/j.jacc.2008.11.013
  5. Peacock WF 4th, Fonarow GC, Emerman CL, Mills RM, Wynne J; ADHERE Scientific Advisory Committee and Investigators; Adhere Study Group. Impact of early initiation of intravenous therapy for acute decompensated heart failure on outcomes in ADHERE. Cardiology 2007;107:44-51. https://doi.org/10.1159/000093612
  6. Maisel AS, Peacock WF, McMullin N, et al. Timing of immunoreactive B-type natriuretic peptide levels and treatment delay in acute decompensated heart failure: an ADHERE (Acute Decompensated Heart Failure National Registry) analysis. J Am Coll Cardiol 2008;52:534-540. https://doi.org/10.1016/j.jacc.2008.05.010
  7. Felker GM, Lee KL, Bull DA, et al. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med 2011;364:797-805. https://doi.org/10.1056/NEJMoa1005419
  8. Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J 2008;25:205-209. https://doi.org/10.1136/emj.2007.050419
  9. Dickstein K, Cohen-Solal A, Filippatos G, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology: developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail 2008;10:933-989. https://doi.org/10.1016/j.ejheart.2008.08.005
  10. Gheorghiade M, Gattis WA, O'Connor CM, et al. Effects of tolvaptan, a vasopressin antagonist, in patients hospitalized with worsening heart failure: a randomized controlled trial. JAMA 2004;291:1963-1971. https://doi.org/10.1001/jama.291.16.1963
  11. Konstam MA, Gheorghiade M, Burnett JC Jr, et al. Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST Outcome Trial. JAMA 2007;297: 1319-1331. https://doi.org/10.1001/jama.297.12.1319
  12. Teerlink JR, Metra M, Felker GM, et al. Relaxin for the treatment of patients with acute heart failure (Pre-RELAXAHF): a multicentre, randomised, placebo-controlled, parallelgroup, dose-finding phase IIb study. Lancet 2009;373: 1429-1439. https://doi.org/10.1016/S0140-6736(09)60622-X
  13. O'Connor CM, Starling RC, Hernandez AF, et al. Effect of nesiritide in patients with acute decompensated heart failure. N Engl J Med 2011;365:32-43. https://doi.org/10.1056/NEJMoa1100171
  14. Kobayashi D, Yamaguchi N, Takahashi O, Deshpande GA, Fukui T. Human atrial natriuretic peptide treatment for acute heart failure: a systematic review of efficacy and mortality. Can J Cardiol 2012;28:102-109. https://doi.org/10.1016/j.cjca.2011.04.011
  15. Voors AA, Dittrich HC, Massie BM, et al. Effects of the adenosine A1 receptor antagonist rolofyllineon renal function in patients with acute heart failure and renal dysfunction: results from PROTECT (Placebo-Controlled Randomized Study of the Selective Adenosine A1 Receptor Antagonist Rolofylline for Patients Hospitalized with Acute Decompensated Heart Failure and Volume Overload to Assess Treatment Effect on Congestion and Renal Function). J Am Coll Cardiol 2011;57:1899-1907. https://doi.org/10.1016/j.jacc.2010.11.057