caa a22 4500 605478627 CHVBK 20210128100406.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s10741-014-9438-7 doi (NATIONALLICENCE)springer-10.1007/s10741-014-9438-7 Water and Sodium in Heart Failure: A Spotlight on Congestion [Elektronische Daten] [Gaspare Parrinello, Stephen Greene, Daniele Torres, Michael Alderman, Joseph Bonventre, Pietro Di Pasquale, Luna Gargani, Anju Nohria, Gregg Fonarow, Muthiah Vaduganathan, Javed Butler, Salvatore Paterna, Lynne Stevenson, Mihai Gheorghiade] Despite all available therapies, the rates of hospitalization and death from heart failure (HF) remain unacceptably high. The most common reasons for hospital admission are symptoms related to congestion. During hospitalization, most patients respond well to standard therapy and are discharged with significantly improved symptoms. Post-discharge, many patients receive diligent and frequent follow-up. However, rehospitalization rates remain high. One potential explanation is a persistent failure by clinicians to adequately manage congestion in the outpatient setting. The failure to successfully manage these patients post-discharge may represent an unmet need to improve the way congestion is both recognized and treated. A primary aim of future HF management may be to improve clinical surveillance to prevent and manage chronic fluid overload while simultaneously maximizing the use of evidence-based therapies with proven long-term benefit. Improvement in cardiac function is the ultimate goal and maintenance of a "dry” clinical profile is important to prevent hospital admission and improve prognosis. This paper focuses on methods for monitoring congestion, and strategies for water and sodium management in the context of the complex interplay between the cardiac and renal systems. A rationale for improving recognition and treatment of congestion is also proposed. Springer Science+Business Media New York, 2014 Heart failure nationallicence Congestion nationallicence Post-discharge nationallicence Fluid intake nationallicence Sodium diet nationallicence Management nationallicence Outcome nationallicence Parrinello Gaspare Biomedical Department of Internal and Specialty Medicine (Di.Bi.M.I.S.), A.O.U.P "Paolo Giaccone”, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy aut Greene Stephen Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut Torres Daniele Biomedical Department of Internal and Specialty Medicine (Di.Bi.M.I.S.), A.O.U.P "Paolo Giaccone”, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy aut Alderman Michael Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, USA aut Bonventre Joseph Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA aut Di Pasquale Pietro Division of Cardiology, GF Ingrassia Hospital, Palermo, Italy aut Gargani Luna Institute of Clinical Physiology, National Council of Research, Pisa, Italy aut Nohria Anju Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA aut Fonarow Gregg Ronald Reagan-UCLA Medical Center, Los Angeles, CA, USA aut Vaduganathan Muthiah Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA aut Butler Javed Division of Cardiology, Emory University, Atlanta, GA, USA aut Paterna Salvatore Biomedical Department of Internal and Specialty Medicine (Di.Bi.M.I.S.), A.O.U.P "Paolo Giaccone”, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy aut Stevenson Lynne Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA aut Gheorghiade Mihai Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut Heart Failure Reviews Springer US; http://www.springer-ny.com 20/1(2015-01-01), 13-24 1382-4147 20:1<13 2015 20 10741 https://doi.org/10.1007/s10741-014-9438-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10741-014-9438-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Parrinello Gaspare Biomedical Department of Internal and Specialty Medicine (Di.Bi.M.I.S.), A.O.U.P "Paolo Giaccone”, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy aut NATIONALLICENCE 700 1- Greene Stephen Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Torres Daniele Biomedical Department of Internal and Specialty Medicine (Di.Bi.M.I.S.), A.O.U.P "Paolo Giaccone”, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy aut NATIONALLICENCE 700 1- Alderman Michael Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, USA aut NATIONALLICENCE 700 1- Bonventre Joseph Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Di Pasquale Pietro Division of Cardiology, GF Ingrassia Hospital, Palermo, Italy aut NATIONALLICENCE 700 1- Gargani Luna Institute of Clinical Physiology, National Council of Research, Pisa, Italy aut NATIONALLICENCE 700 1- Nohria Anju Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Fonarow Gregg Ronald Reagan-UCLA Medical Center, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Vaduganathan Muthiah Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Butler Javed Division of Cardiology, Emory University, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Paterna Salvatore Biomedical Department of Internal and Specialty Medicine (Di.Bi.M.I.S.), A.O.U.P "Paolo Giaccone”, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy aut NATIONALLICENCE 700 1- Stevenson Lynne Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Gheorghiade Mihai Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 773 0- Heart Failure Reviews Springer US; http://www.springer-ny.com 20/1(2015-01-01), 13-24 1382-4147 20:1<13 2015 20 10741