Pharmacological therapy remains the cornerstone of volume management in heart failure, with novel approaches and new agents offering promising options for this vulnerable population.
This review highlights the ongoing importance of pharmacological therapy as the cornerstone for managing fluid overload and congestion in heart failure.
Introduction: Heart failure is a major public health concern that is expected to increase over the decades to come. Despite significant advances, fluid overload and congestion remain a major therapeutic challenge. Vascular congestion and neurohormonal activation are intricately linked and the goal of therapy fundamentally aims to reduce both.Areas covered: The authors briefly review a number of core concepts that elucidate the link between fluid overload and neuro-hormonal activation. This is followed by a review of heart–kidney interactions and the impact of diuresis in this setting. Following an in-depth review of currently available pharmacological agents, the rationale and evidence behind their use, the authors end with a brief note on novel agents/approaches to aid volume management in HF.Expert opinion: A number of non-pharmacological advances in the management of volume overload in heart failure, though promising – are associated with a number of shortcomings. Pharmacological therapy remains the cornerstone of volume management. A number of novel approaches, utilizing existing therapies as well as the emergence of new agents over the past decade bode well for the vulnerable HF population.
Narasimhan et al. (Tue,) conducted a review in Heart failure. Pharmacological therapy for fluid management was evaluated. Pharmacological therapy remains the cornerstone of volume management in heart failure, with novel approaches and new agents offering promising options for this vulnerable population.