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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24209

Title: Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure Current Status and Prospects for Further Research
Authors: Costanzo, Maria Rosa
Ronco, Claudio
Abraham, William T.
Agostoni, Piergiuseppe
Barasch, Jonathan
Fonarow, Gregg C.
Gottlieb, Stephen S.
Jaski, Brian E.
Kazory, Amir
Levin, Allison P.
Levin, Howard R.
Marenzi, Giancarlo
Mullens, Wilfried
Negoianu, Dan
Redfield, Margaret M.
Tang, W. H. Wilson
Testani, Jeffrey M.
Voors, Adriaan A.
Issue Date: 2017
Abstract: More than 1 million heart failure hospitalizations occur annually, and congestion is the predominant cause. Rehospitalizations for recurrent congestion portend poor outcomes independently of age and renal function. Persistent congestion trumps serum creatinine increases in predicting adverse heart failure outcomes. No decongestive pharmacological therapy has reduced these harmful consequences. Simplified ultrafiltration devices permit fluid removal in lower-acuity hospital settings, but with conflicting results regarding safety and efficacy. Ultrafiltration performed at fixed rates after onset of therapy-induced increased serum creatinine was not superior to standard care and resulted in more complications. In contrast, compared with diuretic agents, some data suggest that adjustment of ultrafiltration rates to patients' vital signs and renal function may be associated with more effective decongestion and fewer heart failure events. Essential aspects of ultrafiltration remain poorly defined. Further research is urgently needed, given the burden of congestion and data suggesting sustained benefits of early and adjustable ultrafiltration. (C) 2017 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Notes: [Costanzo, Maria Rosa] Advocate Heart Inst, Naperville, IL USA. [Ronco, Claudio] San Bortolo Hosp, Dept Nephrol Dialysis & Transplantat, Vicenza, Italy. [Ronco, Claudio] Int Renal Res Inst Vicenza, Vicenza, Italy. [Abraham, William T.] Ohio State Univ, Div Cardiovasc Med, Columbus, OH 43210 USA. [Agostoni, Piergiuseppe; Marenzi, Giancarlo] Ctr Cardiol Monzino, IRCCS, Milan, Italy. [Agostoni, Piergiuseppe] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy. [Barasch, Jonathan] Columbia Univ, Coll Phys & Surg, Dept Med, New York, NY USA. [Fonarow, Gregg C.] Ahmanson Univ Calif Los Angeles, Cardiomyopathy Ctr, Div Cardiol, Los Angeles, CA USA. [Gottlieb, Stephen S.] Univ Maryland, Sch Med, Div Cardiovasc Med, Baltimore, MD 21201 USA. [Gottlieb, Stephen S.] Baltimore Vet Affairs Med Ctr, Baltimore, MD USA. [Jaski, Brian E.] Sharp Healthcare, San Diego, CA USA. [Jaski, Brian E.] San Diego Cardiac Ctr, San Diego, CA USA. [Kazory, Amir] Univ Florida, Div Nephrol Hypertens & Renal Transplantat, Gainesville, FL USA. [Levin, Allison P.] Columbia Univ, New York Presbyterian Hosp, Med Ctr, Dept Med,Div Cardiol, New York, NY USA. [Levin, Howard R.] Coridea LLC, New York, NY USA. [Mullens, Wilfried] Hasselt Univ, Ziekenhuis Oost Limburg, Genk Biomed Res Inst, Fac Med & Life Sci,Dept Cardiol, Diepenbeek, Belgium. [Negoianu, Dan] Univ Penn, Med Ctr, Div Nephrol, Philadelphia, PA 19104 USA. [Redfield, Margaret M.] Mayo Clin, Dept Cardiovasc Dis, Rochester, MN 55901 USA. [Tang, W. H. Wilson] Cleveland Clin, Inst Heart & Vasc, Dept Cardiovasc Med, Cleveland, OH 44106 USA. [Testani, Jeffrey M.] Yale Univ, Sch Med, Dept Internal Med, Program Appl Translat Res, New Haven, CT 06510 USA. [Voors, Adriaan A.] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands.
URI: http://hdl.handle.net/1942/24209
DOI: 10.1016/j.jacc.2017.03.528
ISI #: 000400743100011
ISSN: 0735-1097
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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