{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:56:10Z","timestamp":1793382970102,"version":"4.5.0"},"reference-count":110,"publisher":"Oxford University Press (OUP)","issue":"44","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Acute heart failure (AHF) represents the most frequent cause of unplanned hospital admission in patients older than 65 years. Symptoms and clinical signs of AHF (e.g. dyspnoea, orthopnoea, oedema, jugular vein distension, and variation of body weight) are mostly related to systemic venous congestion secondary to various mechanisms including extracellular fluids, increased ventricular filling pressures, and\/or auto-transfusion of blood from the splanchnic into the pulmonary circulation. Thus, the initial management of AHF patients should be mostly based on decongestive therapies on admission followed, before discharge, by rapid implementation of guideline-directed oral medical therapies for heart failure. The therapeutic management of AHF requires the identification and rapid diagnosis of the disease, the diagnosis of the cause (or triggering factor), the evaluation of severity, the presence of comorbidities, and, finally, the initiation of a rapid treatment. The most recent guidelines from ESC and ACC\/AHA\/HFSA have provided updated recommendations on AHF management. Recommended pharmacological treatment for AHF includes diuretic therapy aiming to relieve congestion and achieve optimal fluid status, early and rapid initiation of oral therapies before discharge combined with a close follow-up. Non-pharmacological AHF management requires risk stratification in the emergency department and non-invasive ventilation in case of respiratory failure. Vasodilators should be considered as initial therapy in AHF precipitated by hypertension. On the background of recent large randomized clinical trials and international guidelines, this state-of-the-art review describes current pharmacological treatments and potential directions for future research in AHF.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehad617","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T12:03:08Z","timestamp":1697630588000},"page":"4634-4649","source":"Crossref","is-referenced-by-count":45,"title":["Acute heart failure: current pharmacological treatment and perspectives"],"prefix":"10.1093","volume":"44","author":[{"given":"Benjamin","family":"Deniau","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Burn and Critical Care, University Hospitals Saint-Louis\u2014Lariboisi\u00e8re, AP-HP , 2 rue Ambroise Par\u00e9, 75010 Paris , France"},{"name":"UMR-S 942, INSERM, MASCOT, Universit\u00e9 de Paris Cit\u00e9 , Paris , France"},{"name":"Universit\u00e9 de Paris Cit\u00e9 , Paris , France"},{"name":"FHU PROMICE, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosa","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Midwest Cardiovascular Institute , Naperville, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8272-0911","authenticated-orcid":false,"given":"Karen","family":"Sliwa","sequence":"additional","affiliation":[{"name":"Cape Heart Institute, Department of Cardiology and Medicine, Faculty of Health Sciences, University of Cape Town, Groote Schuur Hospital, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayu","family":"Asakage","sequence":"additional","affiliation":[{"name":"UMR-S 942, INSERM, MASCOT, Universit\u00e9 de Paris Cit\u00e9 , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9995-8590","authenticated-orcid":false,"given":"Wilfried","family":"Mullens","sequence":"additional","affiliation":[{"name":"Ziekenhuis Oost-Limburg A.V. , Genk , Belgium"},{"name":"Hasselt University , Diepenbeek\/Hasselt , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8715-7753","authenticated-orcid":false,"given":"Alexandre","family":"Mebazaa","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Burn and Critical Care, University Hospitals Saint-Louis\u2014Lariboisi\u00e8re, AP-HP , 2 rue Ambroise Par\u00e9, 75010 Paris , France"},{"name":"UMR-S 942, INSERM, MASCOT, Universit\u00e9 de Paris Cit\u00e9 , Paris , France"},{"name":"Universit\u00e9 de Paris Cit\u00e9 , Paris , France"},{"name":"FHU PROMICE, 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