Impact of early treatment with intravenous vasodilators and blood pressure reduction in acute heart failure

Open Heart
Takeshi KitaiYuya Matsue

Abstract

Although vasodilators are used in acute heart failure (AHF) management, there have been no clear supportive evidence regarding their routine use. Recent European guidelines recommend systolic blood pressure (SBP) reduction in the range of 25% during the first few hours after diagnosis. This study aimed to examine clinical and prognostic significance of early treatment with intravenous vasodilators in relation to their subsequent SBP reduction in hospitalised AHF. We performed post hoc analysis of 1670 consecutive patients enrolled in the Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure. Intravenous vasodilator use within 6 hours of hospital arrival and subsequent SBP changes were analysed. Outcomes were gauged by 1-year mortality and diuretic response (DR), defined as total urine output 6 hours posthospital arrival per 40 mg furosemide-equivalent diuretic use. Over half of the patients (56.0%) were treated with intravenous vasodilators within the first 6 hours. In this vasodilator-treated cohort, 554 (59.3%) experienced SBP reduction ≤25%, while 381 (40.7%) experienced SBP reduction >25%. In patients experiencing ≤25% drop in SBP, use of vasodilator was associated with gre...Continue Reading

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Citations

Jul 19, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Yoshihito AraoToyoaki Murohara
Mar 12, 2020·European Heart Journal Cardiovascular Imaging·Kazuto HayasakaTetsuo Sasano
Feb 22, 2021·Current Hypertension Reports·Nicholas HarrisonPhillip Levy

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