Public Health

Acute Heart Failure by Alexandre Mebazaa, Mihai Gheorghiade, Faiez Zannad, Joseph

By Alexandre Mebazaa, Mihai Gheorghiade, Faiez Zannad, Joseph E. Parrillo

For decades, there was loads of paintings performed on continual congestive middle failure whereas acute middle failure has been thought of a tough to address and hopeless syndrome. in spite of the fact that, in recent times acute middle failure has develop into a turning out to be sector of analysis. there was massive quantities of recent info mentioned and lots of new thoughts were proposed within the final 3-4 years taking a look at the epidemiology, diagnostic and remedy of acute middle failure.

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Mortality in large placebo-controlled trials of oral inotropes indicates short-term hemodynamic benefit, but all have been associated with increased mortality. Also, trials of chronic inotropic therapy demonstrate conflicting results in regard to subsequent quality of life56. Levosimendan, available in Australia with restricted prescribing, is an inotrope described as a calcium sensitiser; it possesses theoretical advantages over the traditional inotropes59. It has been shown to be efficacious in a number of studies in acute heart failure60,61,62.

This research is most needed for a better understanding of the mechanisms as well as for an improvement in prevention and treatment of this syndrome. References 1. The Task Force on Acute Heart Failure of the ESC. Executive summary of the guideline on the diagnosis and treatment of acute heart failure. European Heart Journal 2005;26:384–416. 2. Cleland JGF, Swedberg K, Cohen-Solal A, et al. A survey on the quality of care among patients with heart failure in Europe. European Heart Journal 2000;24:123–32.

It has been shown to be efficacious in a number of studies in acute heart failure60,61,62. However, two large recently presented studies, REVIVE and SURVIVE, while confirming clinical benefits, did not demonstrate a survival advantage over placebo or dobutamine63. One important advantage of levosimendan is the overcoming of therapeutic confusion that occurs when using catecholamines, where an intravenous beta-agonist is prescribed for a patient established on oral beta-blockers.

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