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Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)
Author(s) -
Harjola VeliPekka,
Mullens Wilfried,
Banaszewski Marek,
Bauersachs Johann,
BrunnerLa Rocca HansPeter,
Chioncel Ovidiu,
Collins Sean P.,
Doehner Wolfram,
Filippatos Gerasimos S.,
Flammer Andreas J.,
Fuhrmann Valentin,
Lainscak Mitja,
Lassus Johan,
Legrand Matthieu,
Masip Josep,
Mueller Christian,
Papp Zoltán,
Parissis John,
Platz Elke,
Rudiger Alain,
Ruschitzka Frank,
Schäfer Andreas,
Seferovic Petar M.,
Skouri Hadi,
Yilmaz Mehmet Birhan,
Mebazaa Alexandre
Publication year - 2017
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.872
Subject(s) - medicine , heart failure , organ dysfunction , cardiogenic shock , intensive care medicine , cardiology , pathophysiology , multiple organ dysfunction syndrome , myocardial infarction , sepsis
Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post‐discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient‐centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field.