Cox Zachary L, Damman Kevin, Testani Jeffrey M
Department of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, TN, USA.
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
Nat Rev Cardiol. 2025 Apr 28. doi: 10.1038/s41569-025-01152-z.
Heart failure is a leading cause of hospitalization worldwide, and congestion is the predominant cause of heart failure symptoms and hospitalization. The primary therapy used to treat and prevent congestion has historically been loop diuretics. However, many patients are discharged from hospital with residual congestion, which is associated with persistent heart failure symptoms, adverse outcomes and hospital readmission. Multiple medical strategies and devices have been and are being investigated with the aim of improving decongestion and subsequent heart failure outcomes. Numerous questions exist about the design of clinical trials to test emerging medical and device therapies, including the magnitude of benefit on congestive, kidney and post-discharge outcomes relative to conventional decongestion practices, and how best to implement novel therapies. In this Review, we discuss emerging medical and device strategies targeting congestion in patients with heart failure.
心力衰竭是全球住院治疗的主要原因，而充血是心力衰竭症状和住院治疗的主要原因。历史上，用于治疗和预防充血的主要疗法是袢利尿剂。然而，许多患者出院时仍有残余充血，这与持续的心力衰竭症状、不良后果和再次入院有关。为了改善充血状况及后续心力衰竭的治疗效果，人们已经并正在研究多种药物策略和设备。关于测试新兴药物和设备疗法的临床试验设计存在许多问题，包括相对于传统的充血治疗方法，对充血、肾脏和出院后结局的益处程度，以及如何最好地实施新疗法。在本综述中，我们讨论了针对心力衰竭患者充血状况的新兴药物和设备策略。
