Publish in this journal
Journal Information
Share
Share
Download PDF
More article options
ePub
Visits
Not available
Review article
Available online 28 August 2022
Assessment of filling pressures and fluid overload in heart failure: an updated perspective
Evaluación de las presiones de llenado y la sobrecarga de volumen en la insuficiencia cardiaca: una visión actualizada
Visits
...
Rafael de la Espriellaa,, Marta Cobob,, Enrique Santasa, Frederik H. Verbruggec,d, Marat Fudime, Nicolas Girerdf, Gema Miñanaa, José Luis Górrizg,h, Antoni Bayés-Genísi,j,k, Julio Núñeza,h,k,
Corresponding author
yulnunez@gmail.com
juenuvi@uv.es

Corresponding author.
a Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, Spain
b Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
c Centre for Cardiovascular Diseases, University Hospital Brussels, Jette, Belgium
d Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
e Division of Cardiology, Department of Medicine, Duke University, and Duke Clinical Research Institute, Durham, North Carolina, United States
f Université de Lorraine, Centre d’Investigation Clinique-Plurithématique Inserm CIC-P 1433, Inserm U1116, CHRU Nancy Brabois, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
g Servicio de Nefrología, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, Spain
h Departamento de Medicina, Universitat de Valencia, Valencia, Spain
i Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
j Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
k Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
Received 10 June 2022. Accepted 19 July 2022
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (10)
Show moreShow less
Additional material (1)
Abstract

Congestion plays a major role in the pathogenesis, presentation, and prognosis of heart failure and is an important therapeutic target. However, its severity and organ and compartment distribution vary widely among patients, illustrating the complexity of this phenomenon. Although clinical symptoms and signs are useful to assess congestion and manage volume status in individual patients, they have limited sensitivity and do not allow identification of congestion phenotype. This leads to diagnostic uncertainty and hampers therapeutic decision-making. The present article provides an updated overview of circulating biomarkers, imaging modalities (ie, cardiac and extracardiac ultrasound), and invasive techniques that might help clinicians to identify different congestion profiles and guide the management strategy in this diverse population of high-risk patients with heart failure.

Keywords:
Congestion
Biomarkers
POCUS
Precision medicine
Abbreviations:
CVP
HF
RAP
Resumen

La congestión desempeña un papel fundamental en la patogénesis, la presentación y el pronóstico de la insuficiencia cardiaca y es un objetivo terapéutico importante. Sin embargo, su gravedad y su distribución por órganos y compartimentos varían mucho entre los pacientes, lo que ilustra la complejidad de este fenómeno. Aunque los síntomas y signos clínicos son útiles para evaluar la congestión y controlar el estado del volumen en un paciente individual, tienen poca sensibilidad y no permiten fenotipificar la congestión. Esto conduce a la incertidumbre diagnóstica y dificulta la toma de decisiones terapéuticas. En este artículo se ofrece una visión general actualizada de los biomarcadores circulantes, las modalidades de imagen (es decir, la ecografía cardiaca y extracardiaca) y las técnicas invasivas que podrían ayudar a los clínicos a identificar los diferentes perfiles de congestión y guiar la estrategia de tratamiento para esta población diversa de pacientes de alto riesgo con insuficiencia cardiaca.

Palabras clave:
Congestión
Biomarcadores
POCUS
Medicina de precisión

Article

These are the options to access the full texts of the publication Revista Española de Cardiología (English Edition)
Member
Members of SEC
Use the Society's website login and password here
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Cardiología (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

View newsletter history
Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?