Mocan Daniela, Lala Radu Ioan, Puschita Maria, Pilat Luminita, Darabantiu Dan Alexandru, Pop-Moldovan Adina
Multidisciplinary Doctoral School, Vasile Goldis Western University of Arad, 310025 Arad, Romania.
Cardiology Department, Arad County Clinical Emergency Hospital, 310037 Arad, Romania.
Biomedicines. 2024 Apr 24;12(5):951. doi: 10.3390/biomedicines12050951.
Congestion not only represents a cardinal sign of heart failure (HF) but is also now recognized as the primary cause of hospital admissions, rehospitalization, and mortality among patients with acute heart failure (AHF). Congestion can manifest through various HF phenotypes in acute settings: volume overload, volume redistribution, or both. Recognizing the congestion phenotype is paramount, as it implies different therapeutic strategies for decongestion. Among patients with AHF, achieving complete decongestion is challenging, as more than half still experience residual congestion at discharge. Residual congestion is one of the strongest predictors of future cardiovascular events and poor outcomes. Through this review, we try to provide a better understanding of the congestion phenomenon among patients with AHF by highlighting insights into the pathophysiological mechanisms behind congestion and new diagnostic and management tools to achieve and maintain efficient decongestion.
充血不仅是心力衰竭（HF）的主要体征，现在还被认为是急性心力衰竭（AHF）患者住院、再次住院和死亡的主要原因。在急性情况下，充血可通过各种HF表型表现出来：容量超负荷、容量重新分布或两者兼而有之。识别充血表型至关重要，因为这意味着不同的消肿治疗策略。在AHF患者中，实现完全消肿具有挑战性，因为超过一半的患者在出院时仍有残余充血。残余充血是未来心血管事件和不良结局的最强预测因素之一。通过本综述，我们试图通过强调对充血背后病理生理机制的见解以及实现和维持有效消肿的新诊断和管理工具，更好地理解AHF患者的充血现象。
