@article{b62381038f9f44c99e896d3800e8ef56,
title = "The use of diuretics in heart failure with congestion - a position statement from the Heart Failure Association of the European Society of Cardiology",
abstract = "The vast majority of acute heart failure episodes are characterized by increasing symptoms and signs of congestion with volume overload. The goal of therapy in those patients is the relief of congestion through achieving a state of euvolaemia, mainly through the use of diuretic therapy. The appropriate use of diuretics however remains challenging, especially when worsening renal function, diuretic resistance and electrolyte disturbances occur. This position paper focuses on the use of diuretics in heart failure with congestion. The manuscript addresses frequently encountered challenges, such as (i) evaluation of congestion and clinical euvolaemia, (ii) assessment of diuretic response/resistance in the treatment of acute heart failure, (iii) an approach towards stepped pharmacologic diuretic strategies, based upon diuretic response, and (iv) management of common electrolyte disturbances. Recommendations are made in line with available guidelines, evidence and expert opinion.",
keywords = "Diuretics, Heart failure, Acute heart failure, Pharmacotherapy, Loop diuretics, REDUCED EJECTION FRACTION, RENAL-FUNCTION, PROGNOSTIC VALUE, NATRIURETIC RESPONSE, LUNG ULTRASOUND, VENOUS-PRESSURE, LOOP DIURETICS, AGGRESSIVE DECONGESTION, INTRAVENOUS FUROSEMIDE, PULMONARY CONGESTION",
author = "Wilfried Mullens and Kevin Damman and Veli-Pekka Harjola and Alexandre Mebazaa and {Brunner-La Rocca}, Hans-Peter and Pieter Martens and Testani, {Jeffrey M.} and Tang, {W. H. Wilson} and Francesco Orso and Patrick Rossignol and Marco Metra and Gerasimos Filippatos and Seferovic, {Petar M.} and Frank Ruschitzka and Coats, {Andrew J.}",
note = "Funding Information: Conflict of interest: W.M. has received research grants from Novartis, Vifor, Medtronic, Biotronik, Abbott and Boston Scientific. V.P.H. has received research grants from Abbott Laboratories, and personal fees from Bayer, Boehringer-Ingelheim, MSD, Orion Pharma, Pfizer, Roche Diagnostics, Thermo Fisher and Vifor. A.M. received speaker{\textquoteright}s honoraria from Abbott, Orion, Roche and Servier and fee as member of advisory board and/or Steering Committee and/or research grant from BMS, Adrenomed, Neu-rotronik, Roche, Sanofi and Sphyngotec. H.P.B.L.R. has received research grants from Roche Diagnostics, Novartis, Servier and Vifor pharma, and advisory board fees from Novartis, Roche Diagnostics, Vifor Pharma and Servier. P.M. has received a research grant from Vifor pharma and Fonds Wetenschappelijk Onder-zoek (grant number: 1127917N) and consultancy fees from AstraZeneca, Boehringer-Ingelheim, Novartis and Vifor pharma. J.M.T. has received research grants from the NIH, FDA, Boehringer Ingelheim, Sanofi, Abbott, FIRE1, Sequana Medical, Otsuka and consulting fees from Sanofi, Boehringer Ingelheim, Novartis, BMS, AstraZeneca, FIRE1, Sequana Medical, Cardionomic, and Renal-Guard. W.H.W.T. has been supported by grants from the NIH (R01HL103931) and has served as a consultant for the Advisory Board Company, MyoKardia Inc, and Sequana Medical Inc. P.R. reports personal fees (consulting) from Fresenius, Gr{\"u}nen-thal, Idorsia, Novartis, Novo-Nordisk, Relypsa, Stealth Peptides, Vifor Fresenius Medical Care Renal Pharma, Vifor, as well as lecture fees from Bayer and CVRx; he is a cofounder of CardioRenal. M.M. has received consulting honoraria from Bayer, Novartis, and Servier, and speaker{\textquoteright}s fees from Abbott Vascular and Novartis. G.F. has served on the committees of trials supported by Bayer, Novar-tis, Servier, Vifor, BI and Medtronic. P.S. reports grants/research supports from Ministry of education, science and technological development of Republic of Serbia; and honoraria or consultation fees from Servier, Boehringher Ingelheim, Hemofarm, Novartis, AstraZeneca; he participated in a company sponsored speaker{\textquoteright}s bureau: Fondazione Internationale Menarini. F.R. reports grants and personal fees from SJM/Abbott, Novartis, Bayer, Servier; personal Publisher Copyright: {\textcopyright} 2019 The Authors. European Journal of Heart Failure {\textcopyright} 2019 European Society of Cardiology",
year = "2019",
month = feb,
doi = "10.1002/ejhf.1369",
language = "English",
volume = "21",
pages = "137--155",
journal = "European journal of heart failure",
issn = "1388-9842",
publisher = "Wiley",
number = "2",
}