The use of vasoactive therapy for acute decompensated heart failure: hemodynamic and renal considerations.

J Thomas Heywood, Tariq A Khan

Journal: Reviews in cardiovascular medicine 2008;8 Suppl 5():S22-9

PMID: 18192950

Abstract

Although diuretics remain the most commonly used intravenous medication for acute decompensated heart failure, vasoactive agents play an important role in select patient populations. Inotropes and pressor agents are critical in order to maintain blood pressure and cardiac output in a small subset of patients, and can preserve and even improve renal function. However, they should not be used in the majority of patients with preserved cardiac output. Vasodilators improve hemodynamics and symptoms in normotensive individuals. Their influence on renal function is less clear cut, although more recent data suggest a neutral effect.

Address: Heart Failure Recovery and Research Program, Scripps Clinic, La Jolla, California, USA.

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MeSH Terms: Acute Disease, Cardiac Output, Cardiotonic Agents, Heart Failure, Hemodynamics, Humans, Kidney, Milrinone, Natriuretic Agents, Natriuretic Peptide, Brain, Nitrates, Sympathomimetics, Vasodilator Agents