Wittczak Andrzej, Ślot Maciej, Bielecka-Dabrowa Agata
Department of Preventive Cardiology and Lipidology, Medical University of Lodz, 90-419 Lodz, Poland.
Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute, 93-338 Lodz, Poland.
Biomedicines. 2023 Sep 30;11(10):2684. doi: 10.3390/biomedicines11102684.
Heart failure (HF) is a leading cause of morbidity and mortality and a major public health problem. Both overhydration and dehydration are non-physiological states of the body that can adversely affect human health. Congestion and residual congestion are common in patients hospitalized for HF and are associated with poor prognosis and high rates of rehospitalization. However, the clinical problem of dehydration is also prevalent in healthcare and community settings and is associated with increased morbidity and mortality. This article provides a comprehensive review of the issue of congestion and dehydration in HF, including HF guidelines, possible causes of dehydration in HF, confirmed and potential new diagnostic methods. In particular, a full database search on the relationship between dehydration and HF was performed and all available evidence in the literature was reviewed. The novel hypothesis of chronic subclinical hypohydration as a modifiable risk factor for HF is also discussed. It is concluded that maintaining euvolemia is the cornerstone of HF management. Physicians have to find a balance between decongestion therapy and the risk of dehydration.
心力衰竭（HF）是发病和死亡的主要原因，也是一个重大的公共卫生问题。水合过多和脱水都是身体的非生理状态，会对人类健康产生不利影响。充血和残余充血在因HF住院的患者中很常见，并且与预后不良和再住院率高有关。然而，脱水的临床问题在医疗保健和社区环境中也很普遍，并且与发病率和死亡率增加有关。本文全面综述了HF中充血和脱水问题，包括HF指南、HF中脱水的可能原因、已证实和潜在的新诊断方法。特别是，对脱水与HF之间的关系进行了全面的数据库搜索，并对文献中的所有现有证据进行了综述。还讨论了慢性亚临床脱水作为HF可改变危险因素的新假说。结论是维持正常血容量是HF管理的基石。医生必须在解除充血治疗和脱水风险之间找到平衡。
