Manejo Integral de la Falla Cardiaca Aguda
Manejo Integral de la Falla Cardiaca Aguda
##plugins.themes.bootstrap3.article.sidebar##
PDF (Español (España))
FLIP
##plugins.themes.bootstrap3.article.main##
La insuficiencia cardiaca (IC) se define como la incapacidad del corazón para suministrar oxígeno a los tejidos y cumplir con
los requerimientos metabólicos, pese a presiones de llenado normales o al aumentar anormalmente dichas presiones. (1,2)
Es un síndrome clínico complejo, heterogéneo que implica una alta morbilidad y mortalidad, siendo una de las principales
causas de internación hospitalaria en mayores de 65 años. Generando mortalidades de hasta el 9,2% en el primer episodio
y 14,5% al año. Por tal motivo es importante hacer una adecuado diagnostico e instaurar un tratamiento oportuno e indicado,
que se basa principalmente en diuréticos y/o vasodilatadores por vía intravenosa (IV), y en algunos contextos la necesidad
de adición de inotrópicos/vasopresores y soporte circulatorio mecánico.
Downloads
##plugins.themes.bootstrap3.article.details##
Ponikowski P, Voors AA, Anker SD, et al. Guia ESC 2016 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y
cronica. Rev Esp Cardiol. 2016; 69:1167.e1-85.
Viana Tejedor A. Insuficiencia cardiaca aguda: formas clinicas, diagnóstico y tratamiento. En: Nunez Gil IJ, Viana Tejedor A. Cardio
Agudos. Volumen I. Madrid: Sociedad Espanola de Cardiologia-CTO Editorial; 2015.
Martinez Santos P, Bover Freire R, Esteban Fernandez A, et al. Mortalidad hospitalaria y reingresos por insuficiencia cardiaca en
Espana. Un estudio de los episodios indice y los reingresos por causas cardiacas a los 30 dias y al ano. Rev Esp Cardiol. 2019; 72:998-
Arjun K Gupta 1, Daniela Tomasoni 2, Kiran Sidhu 3, Marco Metra 2, Justin A Ezekowitz 4. Evidence-Based Management of Acute
Heart Failure. Can J Cardiol. 2021 Apr; 37(4):621-631. doi: 10.1016/j.cjca.2021.01.002.
D. Farmakis, J. Parissis, J. Lekakis, G. Filippatos. Insuficiencia cardíaca aguda: epidemiología, factores de riesgo y prevención.
Revista Española de Cardiología., 68 (2015), pp. 245-248, 10.1016/j.rec.2014.11.004
Rafael de la Espriella un b, Enrique Santas un bIsabel Zegri Reiriz b cJosé Luis Górriz b d eMarta Cobo Marcos b f gJulio Núñez
un b e g. Quantification and Treatment of Congestion in Heart Failure: A Clinical and Pathophysiological Overview. Nefrología. Volume 42,
Issue 2, March–April 2022, Pages 145-162
Shah K.S., Xu H., Matsouaka R.A., et. al.: Insuficiencia cardíaca con fracción de eyección preservada, limítrofe y reducida:
resultados a 5 años. J Am Coll Cardiol 2017; 70: págs. 2476-2486.
Sameer KurmaniAutor para correspondencia1 e Iain Squire2. Acute Heart Failure: Definition, Classification and Epidemiology. Curr
Heart Fail Rep (2017) 14:385–392 DOI 10.1007/s11897-017-0351-y.
Milton Packer, MD. Acute Heart Failure Is an Event. Rather Than a Disease, Plea for a Radical Change in Thinking and in
Therapeutic Drug Development. JACC: Heart Failure Vol. 6, No. 1, 2018. ª 2018 By The American College Of Cardiology Foundation.
R.F.S Revista Facultad de Salud Manejo Integral de la Falla Cardiaca Aguda
Número suplementar, diciembre 2023: 58-74
R.F.S. Revista Facultad de Salud 72
Authors/Task Force Members: Theresa A. McDonagh. 2023 Focused Update of the 2021 ESC, Guidelines for the diagnosis and
treatment, of acute and chronic heart failure. European Heart Journal (2023) 00, 1–13. https://doi.org/10.1093/eurheartj/ehad195.
Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP, Hochadel M, Komajda M, Lassus J, Lopez-Sendon JL,
Ponikowski P, Tavazzi L. EuroHeart Survey Investigators. Heart Failure Association of the European Society of Cardiology. EuroHeart
Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. Eur Heart J. 2006; 27:2725–
Guías de Práctica Clínica. Guía ESC 2021 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica. Rev
Esp Cardiol. 2022; 75(6):523.e1–523.e114
Steven M. Hollenberg, MD, FACC, Chair. Lynne Warner Stevenson, MD, FACC, Vice Chair Heart Failure Hospitalization Pathway
OCTOBER 15, 2019:1966 – 2011, JACC VOL. 74, NO. 15, 2019.
McDonagh T.A., Metra M., Adamo M., Gardner R.S., Baumbach A., Böhm M., Burri H., Butler J., Čelutkienė J., Chioncel O., et al.
ESC Guidelines for the diagnosis and chronic cardiac failure (Directrices de la ESC de 2021 para el diagnóstico y tratamiento de la
insuficiencia cardíaca aguda y crónica). Eur. Corazón J. 42; 3599:3726–10. doi: 1093.368/eurheartj/ehab.
Ciro Mauro, 1,† Salvatore Chianese,1,2,† Rosangela Cocchia,1 Michele Arcopinto,3 Stefania Auciello. Acute Heart Failure:
Diagnostic–Therapeutic Pathways and Preventive Strategies—A Real-World Clinician’s Guide. J Clin Med. 2023 Feb; 12(3): 846.
Wilfried Mullens, Kevin Damman, Veli-Pekka Harjola, Alexandre Mebazaa, Hans-Peter Brunner-La Rocca, Pieter Martens, Jeffrey
M. Testani, W.H. Wilson Tang. The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association
of the European Society of Cardiology. 01 January 2019 https://doi.org/10.1002/ejhf.1369
Metra M, Davison B, Bettari L, Sun H, Edwards C, Lazzarini V, Piovanelli B, Carubelli V, Bugatti S, Lombardi C, Cotter G, Dei Cas
L. Is worsening renal function an ominous prognostic sign in patients with acute heart failure? The role of congestion and its interaction with
renal function. Circ Heart Fail 2012; 5: 54–62.
Maggioni AP, Dahlstrom U, Filippatos G, Chioncel O, Crespo LM, Drozdz J, Fruhwald F, Gullestad L, Logeart D, Fabbri G, Urso
R, Metra M, Parissis J, Persson H, Ponikowski P, Rauchhaus M, Voors AA, Nielsen OW, Zannad F, Tavazzi L; Heart Failure Association
of the European Society of Cardiology (HFA). EURObservational Research Programme: regional differences and 1-year follow-up results
of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail 2013; 15: 808–817.
Rubio-Gracia J, Demissei BG, Ter Maaten JM, Cleland JG, O'Connor CM, Metra M, Ponikowski P, Teerlink JR, Cotter G, Davison
BA, Givertz MM, Bloomfield DM, Dittrich H, Damman K, Perez-Calvo JI, Voors AA. Prevalence, predictors and clinical outcome of residual
congestion in acute decompensated heart failure. Int J Cardiol 2018; 258: 185–191.
Coiro S, Rossignol P, Ambrosio G, Carluccio E, Alunni G, Murrone A, Tritto I, Zannad F, Girerd N. Prognostic value of residual
pulmonary congestion at discharge assessed by lung ultrasound imaging in heart failure. Eur J Heart Fail 2015; 17: 1172–1181.
Thavendiranathan P, Yingchoncharoen T, Grant A, Seicean S, Landers SH, Gorodeski EZ, Marwick TH. Prediction of 30-day heart
failure-specific readmission risk by echocardiographic parameters. Am J Cardiol 2014; 113: 335–341.
Brater DC. Pharmacokinetics of loop diuretics in congestive heart failure. Br Heart J 1994; 72: S40–S43.
Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, Gonzalez-Juanatey JR, Harjola VP, Jankowska EA,
Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer
P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment
of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure
Association (HFA) of the ESC. Eur J Heart Fail 2016; 18: 891–975.
Felker GM, Lee KL, Bull DA, Redfield MM, Stevenson LW, Goldsmith SR, LeWinter MM, Deswal A, Rouleau JL, Ofili EO, Anstrom
KJ, Hernandez AF, McNulty SE, Velazquez EJ, Kfoury AG, Chen HH, Givertz MM, Semigran MJ, Bart BA, Mascette AM, Braunwald E,
O'Connor CM; NHLBI Heart Failure Clinical Research Network. Diuretic strategies in patients with acute decompensated heart failure. N
Engl J Med 2011; 364: 797–805.
Faris RF, Flather M, Purcell H, Poole-Wilson PA, Coats AJ. Diuretics for heart failure. Cochrane Database Syst Rev 2012; 2:
CD003838.
Brisco MA, Zile MR, Hanberg JS, Wilson FP, Parikh CR, Coca SG, Tang WH, Testani JM. Relevance of changes in serum
creatinine during a heart failure trial of decongestive strategies: insights from the DOSE trial. J Card Fail. 2016; 22:753– 760.
Matsue Y, Damman K, Voors AA, Kagiyama N, Yamaguchi T, Kuroda S, Okumura T, Kida K, Mizuno A, Oishi S, Inuzuka Y,
Akiyama E, Matsukawa R, Kato K, Suzuki S, Naruke T, Yoshioka K, Miyoshi T, Baba Y, Yamamoto M, Murai K, Mizutani K, Yoshida K, Kitai
T. Time-to-furosemide treatment and mortality in patients hospitalized with acute heart failure. J Am Coll Cardiol 2017; 69: 3042–3051.
Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, Katz SD, Klapholz M, Moser DK, Rogers JG, Starling
RC, Stevenson WG, Tang WH, Teerlink JR, Walsh MN. HFSA 2010 comprehensive heart failure practice guideline. J Card Fail 2010; 16:
e1–e194.
R.F.S Revista Facultad de Salud Manejo Integral de la Falla Cardiaca Aguda
Número suplementar, diciembre 2023: 58-74
R.F.S. Revista Facultad de Salud 73
Ellison DH, Felker GM. Diuretic treatment in heart failure. N Engl J Med 2017; 377: 1964–1975.
Verbrugge FH, Dupont M, Bertrand PB, Nijst P, Penders J, Dens J, Verhaert D, Vandervoort P, Tang WH, Mullens W. Determinants
and impact of the natriuretic response to diuretic therapy in heart failure with reduced ejection fraction and volume overload. Acta Cardiol
; 70: 265–273.
Testani JM, Hanberg JS, Cheng S, Rao V, Onyebeke C, Laur O, Kula A, Chen M, Wilson FP, Darlington A, Bellumkonda L, Jacoby
D, Tang WH, Parikh CR. Rapid and highly accurate prediction of poor loop diuretic natriuretic response in patients with heart failure. Circ
Heart Fail 2016; 9:e002370.
Pietribiasi M, Katzarski K, Galach M, Stachowska-Pietka J, Schneditz D, Lindholm B, Waniewski J. Kinetics of plasma refilling
during hemodialysis sessions with different initial fluid status. ASAIO J 2015; 61: 350–356.
Buckley LF, Carter DM, Matta L, Cheng JW, Stevens C, Belenkiy RM, Burpee LJ, Young MA, Weiffenbach CS, Smallwood JA,
Stevenson LW, Desai AS. Intravenous diuretic therapy for the management of heart failure and volume overload in a multidisciplinary
outpatient unit. JACC Heart Fail 2016; 4: 1–8.
Bart BA, Goldsmith SR, Lee KL, Givertz MM, O'Connor CM, Bull DA, Redfield MM, Deswal A, Rouleau JL, LeWinter MM, Ofili EO,
Stevenson LW, Semigran MJ, Felker GM, Chen HH, Hernandez AF, Anstrom KJ, McNulty SE, Velazquez EJ, Ibarra JC, Mascette AM,
Braunwald E; Heart Failure Clinical Research Network. Ultrafiltration in decompensated heart failure with cardiorenal syndrome. N Engl J
Med 2012; 367: 2296–2304.
Grodin JL, Stevens SR, de Las FL, Kiernan M, Birati EY, Gupta D, Bart BA, Felker GM, Chen HH, Butler J, Davila-Roman VG,
Margulies KB, Hernandez AF, Anstrom KJ, Tang WH. Intensification of medication therapy for cardiorenal syndrome in acute
decompensated heart failure. J Card Fail 2016; 22: 26–32.
Grodin JL, Carter S, Bart BA, Goldsmith SR, Drazner MH, Tang WH. Direct comparison of ultrafiltration to pharmacological
decongestion in heart failure: a per-protocol analysis of CARRESS-HF. Eur J Heart Fail 2018; 20: 1148–1156.
Knauf H, Mutschler E. Pharmacodynamic and kinetic considerations on diuretics as a basis for differential therapy. Klin Wochenschr
; 69: 239–250.
Agarwal R, Sinha AD. Thiazide diuretics in advanced chronic kidney disease. J Am Soc Hypertens 2012; 6: 299–308.
Brisco-Bacik MA, Ter Maaten JM, Houser SR, Vedage NA, Rao V, Ahmad T, Wilson FP, Testani JM. Outcomes Associated With a
Strategy of Adjuvant Metolazone or High-Dose Loop Diuretics in Acute Decompensated Heart Failure: A Propensity Analysis. J Am Heart
Assoc 2018; 7(18): e009149.
Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, Katz SD, Klapholz M, Moser DK, Rogers JG, Starling
RC, Stevenson WG, Tang WH, Teerlink JR, Walsh MN. HFSA 2010 comprehensive heart failure practice guideline. J Card Fail 2010; 16:
e1–e194.
Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J. The effect of spironolactone on morbidity and
mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999; 341: 709–717.
Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H, Vincent J, Pocock SJ, Pitt B; EMPHASIS-HF Study Group.
Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med 2011; 364: 11–21.
Butler J, Anstrom KJ, Felker GM, Givertz MM, Kalogeropoulos AP, Konstam MA, Mann DL, Margulies KB, McNulty SE, Mentz RJ,
Redfield MM, Tang WH, Whellan DJ, Shah M, Desvigne-Nickens P, Hernandez AF, Braunwald E; National Heart Lung and Blood Institute
Heart Failure Clinical Research Network. Efficacy and safety of spironolactone in acute heart failure: the ATHENA-HF randomized clinical
trial. JAMA Cardiol 2017; 2: 950–958.
Verbrugge FH, Martens P, Ameloot K, Haemels V, Penders J, Dupont M, Tang WHW, Droogne W, Mullens W. Spironolactone to
increase natriuresis in congestive heart failure with cardiorenal syndrome. Acta Cardiol 2018; 1–8.
Ferreira JP, Rossignol P, Machu JL, Sharma A, Girerd N, Anker SD, Cleland JG, Dickstein K, Filippatos G, Hillege HL, Lang CC, Ter
Maaten JM, Metra M, Ng L, Ponikowski P, Samani NJ, van Veldhuisen DJ, Zwinderman AH, Voors A, Zannad F. Mineralocorticoid receptor
antagonist pattern of use in heart failure with reduced ejection fraction: findings from BIOSTAT-CHF. Eur J Heart Fail 2017; 19: 1284–1293.
Mullens W, Dauw J, Martens P, Verbrugge FH, Nijst P, Meekers E, et al. Acetazolamide in acute decompensated heart failure with
volume overload. N Engl J Med 2022; 387:1185–95.
Trullàs JC, Morales-Rull JL, Casado J, Carrera-Izquierdo M, Sánchez-Marteles M, Conde-Martel A, et al. Combining loop with thiazide
diuretics for decompensated heart failure: the CLOROTIC trial. Eur Heart J 2023; 44:411–21.
Liu J, Li L, Li S, Wang Y, Qin X, Deng K, et al. Sodium-glucose co-transporter-2 inhibitors and the risk of diabetic ketoacidosis in
patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Diabetes Obes Metab 2020; 22:1619–
Voors AA, Angermann CE, Teerlink JR, Collins SP, Kosiborod M, Biegus J, et al. The SGLT2 inhibitor empagliflozin in patients
hospitalized for acute heart failure: a multinational randomized trial. Nat Med 2022; 28:568–74.
R.F.S Revista Facultad de Salud Manejo Integral de la Falla Cardiaca Aguda
Número suplementar, diciembre 2023: 58-74
R.F.S. Revista Facultad de Salud 74
Liu J, Li L, Li S, Wang Y, Qin X, Deng K, et al. Sodium-glucose co-transporter-2 inhibitors and the risk of diabetic ketoacidosis in
patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Diabetes Obes Metab 2020; 22:1619–
Costanzo MR, Negoianu D, Jaski BE, Bart BA, Heywood JT, Anand IS, Smelser JM, Kaneshige AM, Chomsky DB, Adler ED, Haas
GJ, Watts JA, Nabut JL, Schollmeyer MP, Fonarow GC. Aquapheresis versus intravenous diuretics and hospitalizations for heart failure.
JACC Heart Fail 2016; 4: 95–105.
Costanzo MR, Ronco C, Abraham WT, Agostoni P, Barasch J, Fonarow GC, Gottlieb SS, Jaski BE, Kazory A, Levin AP, Levin HR,
Marenzi G, Mullens W, Negoianu D, Redfield MM, Tang WH, Testani JM, Voors AA. Extracorporeal ultrafiltration for fluid overload in heart
failure: current ststus and prospects for future research. J Am Coll Cardiol 2017; 69: 2428–2445.
Patarroyo M, Wehbe E, Hanna M, Taylor DO, Starling RC, Demirjian S, Tang WH. Cardiorenal outcomes after slow continuous
ultrafiltration therapy in refractory patients with advanced decompensated heart failure. J Am Coll Cardiol 2012; 60: 1906–1912.
: Publication Committee for the VMAC Investigators (Vasodilatation in the Management of Acute CHF). Intravenous nesiritide vs
nitroglycerin for treatment of decompensated congestive heart failure: a randomized controlled trial. JAMA. 2002; 287:1531–1540.
Mebazaa A, Motiejunaite J, Gayat E, Crespo-Leiro MG, Lund LH, Maggioni AP, Chioncel O, Akiyama E, Harjola VP, Seferovic P,
Laroche C, Julve MS, Roig E, Ruschitzka F, Filippatos G. ESC Heart Failure Long-Term Registry Investigators. Long-term safety of
intravenous cardiovascular agents in acute heart failure: results from the European Society of Cardiology heart failure long-term registry.
Eur J Heart Fail. 2018; 20:332–341.
Freund Y, Cachanado M, Delannoy Q, Laribi S, Yordanov Y, Gorlicki J, Chouihed T, Feral-Pierssens AL, Truchot J, Desmettre T,
Occelli C, Bobbia X, Khellaf M, Ganansia O, Bokobza J, Balen F, Beaune S, Bloom B, Simon T, Mebazaa A. Effect of an emergency
department care bundle on 30-day hospital discharge and survival among elderly patients with acute heart failure: the ELISABETH
randomized clinical trial. JAMA. 2020; 324:1948–1956.
Khot UN, Novaro GM, Popovic ZB, Mills RM, Thomas JD, Tuzcu EM, Hammer D, Nissen SE, Francis GS. Nitroprusside in critically ill
patients with left ventricular dysfunction and aortic stenosis. N Engl J Med. 2003; 348:1756–1763.
Leopold V, Gayat E, Pirracchio R, Spinar J, Parenica J, Tarvasmaki T, Lassus J, Harjola VP, Champion S, Zannad F, Valente S,
Urban P, Chua HR, Bellomo R, Popovic B, Ouweneel DM, Henriques JPS, Simonis G, Levy B, Kimmoun A, Gaudard P, Basir MB, Markota
A, Adler C, Reuter H, Mebazaa A, Chouihed T. Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis
of 2583 patients. Intensive Care Med. 2018; 44:847–856.
Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated
heart failure: an ADHERE analysis. Emerg Med J. 2008; 25:205–209.
Tomasoni D, Lombardi CM, Sbolli M, Cotter G, Metra M. Acute heart failure: more questions than answers. Prog Cardiovasc Dis.
; 63:599–606
