{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T19:26:24Z","timestamp":1776108384016,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,12,20]],"date-time":"2015-12-20T00:00:00Z","timestamp":1450569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Fluid accumulation is the hallmark of heart failure decompensation. Fluid overload and congestion are associated with recurrent hospitalizations, poor quality of life, and increased mortality in heart failure. Despite the use of high\u2010dose intravenous loop diuretic therapy, acutely decompensated heart failure patients may develop diuretic resistance. Diuretic refractoriness can be a result of elevated intra\u2010abdominal pressure (<jats:styled-content style=\"fixed-case\">IAP<\/jats:styled-content>) in acutely decompensated heart failure. Increased renal venous and interstitial pressures in patients with elevated <jats:styled-content style=\"fixed-case\">IAP<\/jats:styled-content> may lead to renal impairment and diuretic resistance. Routine approaches such as sequential nephron blockade with a combination of loop and thiazide or thiazide\u2010like diuretics, continuous diuretic infusion, and ultrafiltration may not be sufficient. Presented here is a case illustrating the importance of recognizing intra\u2010abdominal hypertension in patients with diuretic resistance. Lowering <jats:styled-content style=\"fixed-case\">IAP<\/jats:styled-content> improves renal perfusion, renal filtration, and diuresis. When elevated, <jats:styled-content style=\"fixed-case\">IAP<\/jats:styled-content> is an easily reversible cause of diuretic resistance. Additionally, abdominal perfusion pressure can be used to guide therapy to reverse end\u2010organ damage and avoid permanent renal replacement therapy.<\/jats:p>","DOI":"10.1002\/clc.22489","type":"journal-article","created":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T05:12:42Z","timestamp":1450674762000},"page":"37-40","source":"Crossref","is-referenced-by-count":16,"title":["Intra\u2010abdominal Hypertension: An Important Consideration for Diuretic Resistance in Acute Decompensated Heart Failure"],"prefix":"10.1002","volume":"39","author":[{"given":"Vinh Q.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Tulane University Heart and Vascular Institute Tulane School of Medicine  New Orleans Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taraka V.","family":"Gadiraju","sequence":"additional","affiliation":[{"name":"Tulane University Heart and Vascular Institute Tulane School of Medicine  New Orleans Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiren","family":"Patel","sequence":"additional","affiliation":[{"name":"Tulane University Heart and Vascular Institute Tulane School of Medicine  New Orleans Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minnsun","family":"Park","sequence":"additional","affiliation":[{"name":"Tulane University Heart and Vascular Institute Tulane School of Medicine  New Orleans Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry H.","family":"Le Jemtel","sequence":"additional","affiliation":[{"name":"Tulane University Heart and Vascular Institute Tulane School of Medicine  New Orleans Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Tulane University Heart and Vascular Institute Tulane School of Medicine  New Orleans Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,12,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.019"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs104"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2014.215"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.09.014"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.08.083"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.10.910"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.79.931.268"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2906-z"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0349-5"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181a021fa"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200010000-00008"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.09.043"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.070"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010121222"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-17-10"},{"key":"e_1_2_7_17_1","article-title":"Cardiovascular implications of abdominal compartment syndrome","volume":"98","author":"Cheatham ML","year":"2007","journal-title":"Acta Clin Belg Suppl."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-4804(82)90186-X"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-4804(76)90112-8"},{"issue":"2","key":"e_1_2_7_20_1","first-page":"R208","article-title":"Cardiovascular responses to elevation of intra\u2010abdominal hydrostatic pressure","volume":"248","author":"Barnes GE","year":"1985","journal-title":"Am J Physiol"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)81148-1"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-199804000-00002"},{"key":"e_1_2_7_23_1","first-page":"419","article-title":"The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra\u2010abdominal pressure","volume":"183","author":"MacDonnell SP","year":"1996","journal-title":"J Am Coll Surg."},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318192678e"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2008.02.010"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24786"},{"key":"e_1_2_7_27_1","first-page":"2087","article-title":"AASLD Practice Guidelines Committee","volume":"49","author":"Runyon BA","year":"2009","journal-title":"Management of adult patients with ascites due to cirrhosis: an update. 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