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Decongestion Strategies in patients presenting with acutely decompensated heart failure : a worldwide survey among physicians
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Vazir, Ali, Kapelios, Chris J., Agaoglu, Elif, Metra, Marco, Lopatin, Yury, Seferovic, Petar, Mullens, Wilfred, Filippatos, Gerasimos, Rosano, Giuseppe, Coats, Andrew J. S. and Chioncel, Ovidiu (2023) Decongestion Strategies in patients presenting with acutely decompensated heart failure : a worldwide survey among physicians. European Journal of Heart Failure, 25 (9). pp. 1555-1570. doi:10.1002/ejhf.2985 ISSN 1388-9842.
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Official URL: https://doi.org/10.1002/ejhf.2985
Abstract
AbstractBackgroundDecongestion strategies for acute decompensated heart failure (ADHF) characterised by volume overload differ widely. The aim of this independent international academic web‐based survey was to capture the therapeutic strategies that physicians use to treat ADHF and to assesses differences in therapeutic approaches between cardiologists vs non‐cardiologists.MethodsPhysicians were invited to complete a web‐based questionnaire, capturing anonymized data on physicians’ characteristics and treatment preferences based on a hypothetical clinical scenario of a patient hospitalised with ADHF.ResultsA total of 641 physicians from 60 countries participated. A wide variation in the management of the patient was observed. There was conservative use of diuretics, i.e. only 7% started intravenous furosemide at a dose ≥2 times the baseline oral dose, and infrequent use of ultrasound in assessing congestion (20.4%). Spot urinary sodium was infrequently or never measured by ≥85% of physicians. A third considered a patient with ongoing oedema as being stabilised. There were significant differences between cardiologists and non‐cardiologists in the management of ADHF, the targets for daily body weight loss and urine output, diuretic escalation strategies (66.3% vs 40.7%, would escalate diuresis by adding a thiazide) and assessment of response to treatment (27.0% vs 52.9%, considered patients with minimal congestion as stabilized).ConclusionsThere is substantial variability amongst physicians and between cardiologist and non‐cardiologists in the management of patients with ADHF, with regards to clinical parameters used to tailor treatment, treatment goals ,diuretic dosing and escalation strategies.This article is protected by copyright. All rights reserved.
Item Type: | Journal Article | ||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
SWORD Depositor: | Library Publications Router | ||||||||
Journal or Publication Title: | European Journal of Heart Failure | ||||||||
Publisher: | John Wiley & Sons Ltd. | ||||||||
ISSN: | 1388-9842 | ||||||||
Official Date: | September 2023 | ||||||||
Dates: |
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Volume: | 25 | ||||||||
Number: | 9 | ||||||||
Page Range: | pp. 1555-1570 | ||||||||
DOI: | 10.1002/ejhf.2985 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Restricted or Subscription Access |
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