Journal of Clinical Medicine (Jan 2023)
Acute Heart Failure: Diagnostic–Therapeutic Pathways and Preventive Strategies—A Real-World Clinician’s Guide
- Ciro Mauro,
- Salvatore Chianese,
- Rosangela Cocchia,
- Michele Arcopinto,
- Stefania Auciello,
- Valentina Capone,
- Mariano Carafa,
- Andreina Carbone,
- Giuseppe Caruso,
- Rossana Castaldo,
- Rodolfo Citro,
- Giulia Crisci,
- Antonello D’Andrea,
- Roberta D’Assante,
- Maria D’Avino,
- Francesco Ferrara,
- Antonio Frangiosa,
- Domenico Galzerano,
- Vincenzo Maffei,
- Alberto Maria Marra,
- Rahul M. Mehta,
- Rajendra H. Mehta,
- Fiorella Paladino,
- Brigida Ranieri,
- Monica Franzese,
- Giuseppe Limongelli,
- Salvatore Rega,
- Luigia Romano,
- Andrea Salzano,
- Chiara Sepe,
- Olga Vriz,
- Raffaele Izzo,
- Filippo Cademartiri,
- Antonio Cittadini,
- Eduardo Bossone
Affiliations
- Ciro Mauro
- Cardiology Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Salvatore Chianese
- Cardiology Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Rosangela Cocchia
- Cardiology Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Michele Arcopinto
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
- Stefania Auciello
- First Aid—Short Intensive Observation Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Valentina Capone
- Cardiology Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Mariano Carafa
- Emergency Medicine Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Andreina Carbone
- Unit of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy
- Giuseppe Caruso
- Long-Term Care Division, Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Rossana Castaldo
- Istituto di Ricovero e Cura a Carattere Scientifico SYNLAB SDN, Via Emanuele Gianturco, 113, 80143 Naples, Italy
- Rodolfo Citro
- Heart Department, University Hospital of Salerno, 84131 Salerno, Italy
- Giulia Crisci
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
- Antonello D’Andrea
- Department of Cardiology, Umberto I Hospital Nocera Inferiore, 84014 Nocera, Italy
- Roberta D’Assante
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
- Maria D’Avino
- Long-Term Care Division, Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Francesco Ferrara
- Heart Department, University Hospital of Salerno, 84131 Salerno, Italy
- Antonio Frangiosa
- Post Operative Intensive Care Division, A. Cardarelli Hospital, 80131 Naples, Italy
- Domenico Galzerano
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
- Vincenzo Maffei
- Post Operative Intensive Care Division, A. Cardarelli Hospital, 80131 Naples, Italy
- Alberto Maria Marra
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
- Rahul M. Mehta
- ProMedica Monroe Regional Hospital, Monroe, MI 48162, USA
- Rajendra H. Mehta
- Duke Clinical Research Institute, 300 W Morgan St., Durham, NC 27701, USA
- Fiorella Paladino
- First Aid—Short Intensive Observation Division, A. Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Brigida Ranieri
- Istituto di Ricovero e Cura a Carattere Scientifico SYNLAB SDN, Via Emanuele Gianturco, 113, 80143 Naples, Italy
- Monica Franzese
- Istituto di Ricovero e Cura a Carattere Scientifico SYNLAB SDN, Via Emanuele Gianturco, 113, 80143 Naples, Italy
- Giuseppe Limongelli
- Unit of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy
- Salvatore Rega
- Department of Public Health University “Federico II” of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy
- Luigia Romano
- Department of General and Emergency Radiology, Antonio Cardarelli Hospital, Via Cardarelli, 9, 80131 Naples, Italy
- Andrea Salzano
- Istituto di Ricovero e Cura a Carattere Scientifico SYNLAB SDN, Via Emanuele Gianturco, 113, 80143 Naples, Italy
- Chiara Sepe
- Technical Nursing and Rehabilitation Service (SITR) Department, Cardarelli Hospital, 80131 Naples, Italy
- Olga Vriz
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
- Raffaele Izzo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, 80131 Naples, Italy
- Filippo Cademartiri
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1, 56124 Pisa, Italy
- Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy
- Eduardo Bossone
- Department of Public Health University “Federico II” of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy
- DOI
- https://doi.org/10.3390/jcm12030846
- Journal volume & issue
-
Vol. 12,
no. 3
p. 846
Abstract
Acute heart failure (AHF) is the most frequent cause of unplanned hospital admission in patients of >65 years of age and it is associated with significantly increased morbidity, mortality, and healthcare costs. Different AHF classification criteria have been proposed, mainly reflecting the clinical heterogeneity of the syndrome. Regardless of the underlying mechanism, peripheral and/or pulmonary congestion is present in the vast majority of cases. Furthermore, a marked reduction in cardiac output with peripheral hypoperfusion may occur in most severe cases. Diagnosis is made on the basis of signs and symptoms, laboratory, and non-invasive tests. After exclusion of reversible causes, AHF therapeutic interventions mainly consist of intravenous (IV) diuretics and/or vasodilators, tailored according to the initial hemodynamic status with the addition of inotropes/vasopressors and mechanical circulatory support if needed. The aim of this review is to discuss current concepts on the diagnosis and management of AHF in order to guide daily clinical practice and to underline the unmet needs. Preventive strategies are also discussed.
Keywords
- acute heart failure
- biomarkers
- cardiac ultrasound
- computer tomography
- therapeutic interventions
- preventive strategies