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Emergency Department Therapy of Acute Heart Failure

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Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Acute heart failure is a major cause of morbidity and mortality. Most patients present with dyspnea as their predominant symptom, and the emergency department therapy is largely directed toward the alleviation of this. Management is rapidly evolving from an approach that is focused largely on diuresis to one that responds more directly to the complex interplay of underlying disease and acute precipitant. To do this effectively, acute care providers must appreciate the existence of divergent patient profiles and understand various therapeutic options for targeted patient stabilization. This chapter will provide the basics of such an approach, with a focus on treatment options to reduce preload, afterload, and work of breathing.

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References

  1. Ho EC, Parker JD, Austin PC, Tu JV, Wang X, Lee DS. Impact of nitrate use on survival in acute heart failure: a propensity‐matched analysis. J Am Heart Assoc. 2016;5(2):e002531.

    PubMed  PubMed Central  Google Scholar 

  2. Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, Nichol G, et al. Forecasting the impact of heart failure in the united states a policy statement from the american heart association. Circ Heart Fail. 2013;6(3):606–19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, Haase N, et al. Heart disease and stroke statistics—2009 update a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):e21–181.

    Article  PubMed  Google Scholar 

  4. Gheorghiade M, Pang PS. Acute heart failure syndromes. J Am Coll Cardiol. 2009;53(7):557–73.

    Article  PubMed  Google Scholar 

  5. Lindenfeld J, Albert NM, Boehmer JP, et al. HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010;16(6):e1–194.

    Article  PubMed  Google Scholar 

  6. Mebazaa A, Gheorghiade M, Pina IL, et al. Practical recommendations for prehospital and early in-hospital management of patients presenting with acute heart failure syndromes. Crit Care Med. 2008;36(1 Suppl):S129–39.

    Article  PubMed  Google Scholar 

  7. Hunt SA, Abraham WT, Chin MH, et al. Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119(14):e391–479.

    Article  PubMed  Google Scholar 

  8. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–245.

    Article  PubMed  Google Scholar 

  9. Storrow AB, Jenkins CA, Self WH, et al. The burden of acute heart failure on U.S. emergency departments. JCHF. 2014;2(3):269–77. doi:10.1016/j.jchf.2014.01.006.

    Google Scholar 

  10. Felker GM, Pang PS, Adams KF, et al. Clinical trials of pharmacological therapies in acute heart failure syndromes: lessons learned and directions forward. Circ Heart Fail. 2010;3(2):314–25.

    Article  PubMed  Google Scholar 

  11. Hasselblad V, Gattis Stough W, Shah MR. Relation between dose of loop diuretics and outcomes in a heart failure population: results of the ESCAPE trial. Eur J Heart Fail. 2007;9(10):1064–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Weintraub NL, Collins SP, Pang PS, et al. Acute heart failure syndromes: emergency department presentation, treatment, and disposition: current approaches and future aims: a scientific statement from the American Heart Association. Circulation. 2010;122(19):1975–96.

    Article  PubMed  Google Scholar 

  13. Collins S, Storrow AB, Kirk JD, et al. Beyond pulmonary edema: diagnostic, risk stratification, and treatment challenges of acute heart failure management in the emergency department. Ann Emerg Med. 2008;51(1):45–57.

    Article  PubMed  Google Scholar 

  14. Nohria A, Tsang SW, Fang JC, et al. Clinical assessment identifies hemodynamic profiles that predict outcomes in patients admitted with heart failure. J Am Coll Cardiol. 2003;41(10):1797–804.

    Article  PubMed  Google Scholar 

  15. De Luca L, Fonarow GC, Adams Jr KF, et al. Acute heart failure syndromes: clinical scenarios and pathophysiologic targets for therapy. Heart Fail Rev. 2007;12(2):97–104.

    Article  PubMed  Google Scholar 

  16. Gheorghiade M, Abraham WT, Albert NM, et al. Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA. 2006;296(18):2217–26.

    Article  CAS  PubMed  Google Scholar 

  17. Peacock F, Emerman C, Costanzo M, et al. Early initiation of intravenous vasoactive therapy improves heart failure outcomes: an analysis from the ADHERE registry database. Ann Emerg Med. 2003;42:s29.

    Google Scholar 

  18. Kaluski E, Kobrin I, Zimlichman R, et al. RITZ-5: randomized intravenous TeZosentan (an endothelin-A/B antagonist) for the treatment of pulmonary edema: a prospective, multicenter, double-blind, placebo-controlled study. J Am Coll Cardiol. 2003;41(2):204–10.

    Article  CAS  PubMed  Google Scholar 

  19. Peacock F, Amin A, Granger CB, et al. Hypertensive heart failure: patient characteristics, treatment, and outcomes. Am J Emerg Med. 2010;29(8):855–62.

    Article  PubMed  Google Scholar 

  20. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Jaarsma T, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur J Heart Fail. 2012;14(8):803–69.

    Article  CAS  PubMed  Google Scholar 

  21. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Johnson MR, et al. ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147–239.

    Article  PubMed  Google Scholar 

  22. Ignarro LJ. After 130 years, the molecular mechanism of action of nitroglycerin is revealed. Proc Natl Acad Sci U S A. 2002;99(12):7816–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Bussmann WD, Kaltenbach M. Sublingual nitroglycerin in the treatment of left ventricular failure and pulmonary edema. Eur J Cardiol. 1976;4(3):327–33.

    CAS  PubMed  Google Scholar 

  24. Bussmann WD, Kaltenbach M. Sublingual nitroglycerin for left ventricular failure and pulmonary edema. Compr Ther. 1977;3(8):29–36.

    CAS  PubMed  Google Scholar 

  25. Imhof PR, Ott B, Frankhauser P, et al. Difference in nitroglycerin dose–response in the venous and arterial beds. Eur J Clin Pharmacol. 1980;18(6):455–60.

    Article  CAS  PubMed  Google Scholar 

  26. Bayley S, Valentine H, Bennett ED. The haemodynamic responses to incremental doses of intravenous nitroglycerin in left ventricular failure. Intensive Care Med. 1984;10(3):139–45.

    Article  CAS  PubMed  Google Scholar 

  27. Herling IM. Intravenous nitroglycerin: clinical pharmacology and therapeutic considerations. Am Heart J. 1984;108(1):141–9.

    Article  CAS  PubMed  Google Scholar 

  28. Haber HL, Simek CL, Bergin JD, et al. Bolus intravenous nitroglycerin predominantly reduces afterload in patients with excessive arterial elastance. J Am Coll Cardiol. 1993;22(1):251–7.

    Article  CAS  PubMed  Google Scholar 

  29. Munir S, Guilcher A, Kamalesh T, et al. Peripheral augmentation index defines the relationship between central and peripheral pulse pressure. Hypertension. 2008;51(1):112–8.

    Article  CAS  PubMed  Google Scholar 

  30. Elkayam U, Akhter MW, Singh H, et al. Comparison of effects on left ventricular filling pressure of intravenous nesiritide and high-dose nitroglycerin in patients with decompensated heart failure. Am J Cardiol. 2004;93(2):237–40.

    Article  CAS  PubMed  Google Scholar 

  31. Gori T, Parker JD. Nitrate tolerance: a unifying hypothesis. Circulation. 2002;106(19):2510–3.

    Article  PubMed  Google Scholar 

  32. Alexander P, Alkhawam L, Curry J, Levy P, Pang PS, Storrow AB, Collins SP. Lack of evidence for intravenous vasodilators in ED patients with acute heart failure: a systematic review. Am J Emerg Med. 2015;33(2):133–41.

    Article  PubMed  Google Scholar 

  33. Levy P, Compton S, Welch R, et al. Treatment of severe decompensated heart failure with high-dose intravenous nitroglycerin: a feasibility and outcome analysis. Ann Emerg Med. 2007;50(2):144–52.

    Article  PubMed  Google Scholar 

  34. Cotter G, Faibel H, Barash P, et al. High-dose nitrates in the immediate management of unstable angina: optimal dosage, route of administration, and therapeutic goals. Am J Emerg Med. 1998;16(3):219–24.

    Article  CAS  PubMed  Google Scholar 

  35. Sharon A, Shpirer I, Kaluski E, et al. High-dose intravenous isosorbide-dinitrate is safer and better than Bi-PAP ventilation combined with conventional treatment for severe pulmonary edema. J Am Coll Cardiol. 2000;36(3):832–7.

    Article  CAS  PubMed  Google Scholar 

  36. Breidthardt T, Noveanu M, Potocki M, et al. Impact of a high-dose nitrate strategy on cardiac stress in acute heart failure: a pilot study. J Intern Med. 2010;267(3):322–30.

    Article  CAS  PubMed  Google Scholar 

  37. Guiha NH, Cohn JN, Mikulic E, et al. Treatment of refractory heart failure with infusion of nitroprusside. N Engl J Med. 1974;291(12):587–92.

    Article  CAS  PubMed  Google Scholar 

  38. Nieminen MS, Bohm M, Cowie MR, et al. Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J. 2005;26(4):384–416.

    Article  PubMed  Google Scholar 

  39. Burger MR, Burger AJ. BNP in decompensated heart failure: diagnostic, prognostic and therapeutic potential. Curr Opin Investig Drugs. 2001;2(7):929–35.

    CAS  PubMed  Google Scholar 

  40. Young JB, Abraham WT, Stevenson LW, Horton DP, Elkayam U, Bourge RC. Intravenous nesiritide vs nitroglycerin for treatment of decompensated congestive heart failure-A randomized controlled trial. JAMA J Am Med Assoc. 2002;287(12):1531–40.

    CAS  Google Scholar 

  41. Peacock WF, Holland R, Gyarmathy R, et al. Observation unit treatment of heart failure with nesiritide: results from the proaction trial. J Emerg Med. 2005;29(3):243–52.

    Article  PubMed  Google Scholar 

  42. Hauptman PJ, Schnitzler MA, Swindle J, et al. Use of nesiritide before and after publications suggesting drug-related risks in patients with acute decompensated heart failure. JAMA. 2006;296(15):1877–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. O’Connor CM, Starloing RC, Hernandez AF, et al. Acute Study of clinical effectiveness of nesiritide in decompensated heart failure trial (ASCEND-HF). N Engl J Med. 2011;365:32–43.

    Article  PubMed  Google Scholar 

  44. Lisy O, Huntley BK, McCormick DJ, et al. Design, synthesis, and actions of a novel chimeric natriuretic peptide: CD-NP. J Am Coll Cardiol. 2008;52(1):60–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Levy PD, Laribi S, Mebazaa A. Vasodilators in acute heart failure: review of the latest studies. Curr Emerg Hosp Med Rep. 2014;2(2):126–32.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Emani S, Meyer M, Palm D, Holzmeister J, Haas GJ. Ularitide: a natriuretic peptide candidate for the treatment of acutely decompensated heart failure. Future Cardiol. 2015;11(5):531–46.

    Article  CAS  PubMed  Google Scholar 

  47. The CONSENSUS. Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987;316(23):1429–35.

    Article  Google Scholar 

  48. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325(5):293–302.

    Article  Google Scholar 

  49. The SOLVD Investigattors. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327(10):685–91.

    Article  Google Scholar 

  50. Levy PD, Bellou A. Acute heart failure treatment. Curr Emerg Hosp Med Rep. 2013;1(2).

    Google Scholar 

  51. Gheorghiade M, Zannad F, Sopko G, Klein L, Piña IL, Konstam MA, Filippatos G, et al. Acute heart failure syndromes current state and framework for future research. Circulation. 2005;112(25):3958–68.

    Article  PubMed  Google Scholar 

  52. Epstein SE, Braunwald E. Beta-adrenergic receptor blocking drugs. Mechanisms of action and clinical applications. N Engl J Med. 1966;275(20):1106–12. contd.

    Article  CAS  PubMed  Google Scholar 

  53. Grossman E, Messerli FH, Grodzicki T, et al. Should a moratorium be placed on sublingual nifedipine capsules given for hypertensive emergencies and pseudoemergencies? JAMA. 1996;276(16):1328–31.

    Article  CAS  PubMed  Google Scholar 

  54. Peacock FW, Varon J, Ebrahimi R, et al. Clevidipine for severe hypertension in acute heart failure: a VELOCITY trial analysis. Congest Heart Fail. 2010;16(2):55–9.

    Article  CAS  PubMed  Google Scholar 

  55. Peacock WF, Chandra A, Char D, Collins S, Der Sahakian G, Ding L, Hu MY, et al. Clevidipine in acute heart failure: results of the a study of blood pressure control in acute heart failure—a pilot study (PRONTO). Am Heart J. 2014;167(4):529–36.

    Article  CAS  PubMed  Google Scholar 

  56. Teichman SL, Unemori E, Dschietzig T, et al. Relaxin, a pleiotropic vasodilator for the treatment of heart failure. Heart Fail Rev. 2009;14(4):321–9.

    Article  CAS  PubMed  Google Scholar 

  57. Teerlink JR, Cotter G, Davison BA, Felker GM, Filippatos G, Greenberg BH, Dorobantu MI, et al. Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised, placebo-controlled trial. Lancet. 2013;381(9860):29–39.

    Article  CAS  PubMed  Google Scholar 

  58. Filippatos G, Teerlink JR, Farmakis D, Cotter G, Davison BA, Felker GM, Unemori E, et al. Serelaxin in acute heart failure patients with preserved left ventricular ejection fraction: results from the RELAX-AHF trial. Eur Heart J. 2014;35(16):1041–50.

    Article  CAS  PubMed  Google Scholar 

  59. Pang PS, Levy P. Pathophysiology of volume overload in acute heart failure syndromes. Congest Heart Fail. 2010;16 Suppl 1:S1–6.

    Article  Google Scholar 

  60. Brater DC. Diuretic therapy. N Engl J Med. 1998;339(6):387–95.

    Article  CAS  PubMed  Google Scholar 

  61. Steimle AE, Stevenson LW, Chelimsky-Fallick C, et al. Sustained hemodynamic efficacy of therapy tailored to reduce filling pressures in survivors with advanced heart failure. Circulation. 1997;96(4):1165–72.

    Article  CAS  PubMed  Google Scholar 

  62. Dikshit K, Vyden JK, Forrester JS, et al. Renal and extrarenal hemodynamic effects of furosemide in congestive heart failure after acute myocardial infarction. N Engl J Med. 1973;288(21):1087–90.

    Article  CAS  PubMed  Google Scholar 

  63. Francis GS, Siegel RM, Goldsmith SR, et al. Acute vasoconstrictor response to intravenous furosemide in patients with chronic congestive heart failure. Activation of the neurohumoral axis. Ann Intern Med. 1985;103(1):1–6.

    Article  CAS  PubMed  Google Scholar 

  64. Mebazaa A, Pang PS, Tavares M, et al. The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study. Eur Heart J. 2010;31(7):832–41.

    Article  PubMed  Google Scholar 

  65. Salvador DR, Rey NR, Ramos GC, et al. Continuous infusion versus bolus injection of loop diuretics in congestive heart failure. Cochrane Database Syst Rev. 2005;(3):CD003178.

    Google Scholar 

  66. Felker GM. On behalf of the heart failure research network: the diuretic optimization strategies evaluation (DOSE) study: a randomized, double blind, placebo-controlled trial of diuretic strategies in acute decompensated heart failure. Presented at the American College of Cardiology 59th Annual Scientific Session. Atlanta; 14–16 Mar 2010.

    Google Scholar 

  67. Felker GM, Lee KL, Bull DA, Redfield MM, Stevenson LW, Goldsmith SR, Anstrom KJ, et al. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med. 2011;364(9):797–805.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Neuberg GW, Miller AB, O’Connor CM, Belkin RN, Carson PE, Cropp AB, Packer M, et al. Diuretic resistance predicts mortality in patients with advanced heart failure. Am Heart J. 2002;144(1):31–8.

    Article  PubMed  Google Scholar 

  69. Channer KS, McLean KA, Lawson-Matthew P, et al. Combination diuretic treatment in severe heart failure: a randomized controlled trial. Br Heart J. 1994;71(2):146–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Dormans TP, Gerlag PG, Russel FG, et al. Combination diuretic therapy in severe congestive heart failure. Drugs. 1998;55(2):165–72.

    Article  CAS  PubMed  Google Scholar 

  71. Trullàs JC, Morales-Rull JL, Casado J, Ramírez AF, Manzano L, Formiga F. Rationale and Design of the “Safety and Efficacy of the Combination of Loop with Thiazide-type Diuretics in Patients with Decompensated Heart Failure (CLOROTIC) Trial:” A Double-Blind, Randomized, Placebo-Controlled Study to Determine the Effect of Combined Diuretic Therapy (Loop Diuretics With Thiazide-Type Diuretics) Among Patients With Decompensated Heart Failure. J Card Failure 2016;22(7):529–36.

    Google Scholar 

  72. De Luca L, Orlandi C, Udelson JE, et al. Overview of vasopressin receptor antagonists in heart failure resulting in hospitalization. Am J Cardiol. 2005;96(12A):24L–33.

    Article  PubMed  CAS  Google Scholar 

  73. Gheorghiade M, Konstam MA, Burnett Jr JC, et al. Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST Clinical Status Trials. JAMA. 2007;297(12):1332–43.

    Article  CAS  PubMed  Google Scholar 

  74. Konstam MA, Gheorghiade M, Burnett Jr JC, et al. Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST outcome trial. JAMA. 2007;297(12):1319–31.

    Article  CAS  PubMed  Google Scholar 

  75. Yoshioka K, Matsue Y, Kagiyama N, Yoshida K, Kume T, Okura H, Hashimoto Y, et al. Recovery from hyponatremia in acute phase is associated with better in-hospital mortality rate in acute heart failure syndrome. J Cardiol. 2016;67(5):406–11.

    Article  PubMed  Google Scholar 

  76. Costanzo MR, Guglin ME, Saltzberg MT, et al. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am Coll Cardiol. 2007;49(6):675–83.

    Article  CAS  PubMed  Google Scholar 

  77. Bart BA, Goldsmith SR, Lee KL, Givertz MM, O’Connor CM, Bull DA, et al. Ultrafiltration in decompensated heart failure with cardiorenal syndrome. N Engl J Med. 2012;367(24):2296–304.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Burger AJ, Elkayam U, Neibaur MT, et al. Comparison of the occurrence of ventricular arrhythmias in patients with acutely decompensated congestive heart failure receiving dobutamine versus nesiritide therapy. Am J Cardiol. 2001;88(1):35–9.

    Article  CAS  PubMed  Google Scholar 

  79. Leier CV, Webel J, Bush CA. The cardiovascular effects of the continuous infusion of dobutamine in patients with severe cardiac failure. Circulation. 1977;56(3):468–72.

    Article  CAS  PubMed  Google Scholar 

  80. Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. 2005;46(6):e1–82.

    Article  PubMed  Google Scholar 

  81. Tariq S, Aronow WS. Use of inotropic agents in treatment of systolic heart failure. Int J Mol Sci. 2015;16(12):29060–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Colucci WS, Wright RF, Braunwald E. New positive inotropic agents in the treatment of congestive heart failure. Mechanisms of action and recent clinical developments. 1. N Engl J Med. 1986;314(5):290–9.

    Article  CAS  PubMed  Google Scholar 

  83. Lowes BD, Tsvetkova T, Eichhorn EJ, et al. Milrinone versus dobutamine in heart failure subjects treated chronically with carvedilol. Int J Cardiol. 2001;81(2–3):141–9.

    Article  CAS  PubMed  Google Scholar 

  84. Colucci WS, Wright RF, Braunwald E. New positive inotropic agents in the treatment of congestive heart failure. Mechanisms of action and recent clinical developments. 2. N Engl J Med. 1986;314(6):349–58.

    Article  CAS  PubMed  Google Scholar 

  85. Colucci WS, Wright RF, Jaski BE, et al. Milrinone and dobutamine in severe heart failure: differing hemodynamic effects and individual patient responsiveness. Circulation. 1986;73(3 Pt 2):III175–83.

    CAS  PubMed  Google Scholar 

  86. Cuffe MS, Califf RM, Adams Jr KF, et al. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002;287(12):1541–7.

    Article  CAS  PubMed  Google Scholar 

  87. Gilbert EM, Hershberger RE, Wiechmann RJ, et al. Pharmacologic and hemodynamic effects of combined beta-agonist stimulation and phosphodiesterase inhibition in the failing human heart. Chest. 1995;108(6):1524–32.

    Article  CAS  PubMed  Google Scholar 

  88. Metra M, Nodari S, D’Aloia A, et al. Beta-blocker therapy influences the hemodynamic response to inotropic agents in patients with heart failure: a randomized comparison of dobutamine and enoximone before and after chronic treatment with metoprolol or carvedilol. J Am Coll Cardiol. 2002;40(7):1248–58.

    Article  CAS  PubMed  Google Scholar 

  89. Katz AM. The “modern” view of heart failure: how did we get here? Circ Heart Fail. 2008;1(1):63–71.

    Article  CAS  PubMed  Google Scholar 

  90. Trial M, Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 1997;336:525–33.

    Article  Google Scholar 

  91. Gheorghiade M, Braunwald E. Reconsidering the role for digoxin in the management of acute heart failure syndromes. JAMA. 2009;302(19):2146–7.

    Article  PubMed  Google Scholar 

  92. Slawsky MT, Colucci WS, Gottlieb SS, et al. Acute hemodynamic and clinical effects of levosimendan in patients with severe heart failure. Study investigators. Circulation. 2000;102(18):2222–7.

    Article  CAS  PubMed  Google Scholar 

  93. Gheorghiade M, Blair JE, Filippatos GS, et al. Hemodynamic, echocardiographic, and neurohormonal effects of istaroxime, a novel intravenous inotropic and lusitropic agent: a randomized controlled trial in patients hospitalized with heart failure. J Am Coll Cardiol. 2008;51(23):2276–85.

    Article  CAS  PubMed  Google Scholar 

  94. Tavares M, Rezlan E, Vostroknoutova I, et al. New pharmacologic therapies for acute heart failure. Crit Care Med. 2008;36(1 Suppl):S112–20.

    Article  CAS  PubMed  Google Scholar 

  95. Mebazaa A, Nieminen MS, Packer M, et al. Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. JAMA. 2007;297(17):1883–91.

    Article  CAS  PubMed  Google Scholar 

  96. Teerlink JR, Felker GM, McMurray JJ, Ponikowski P, Metra M, Filippatos GS, Lei L, et al. Acute treatment with omecamtiv mecarbil to increase contractility in acute heart failure: the ATOMIC-AHF study. J Am Coll Cardiol. 2016;67(12):1444–55.

    Article  CAS  PubMed  Google Scholar 

  97. Hoffman JR, Reynolds S. Comparison of nitroglycerin, morphine and furosemide in treatment of presumed pre-hospital pulmonary edema. Chest. 1987;92(4):586–93.

    Article  CAS  PubMed  Google Scholar 

  98. Sacchetti A, Ramoska E, Moakes ME, et al. Effect of ED management on ICU use in acute pulmonary edema. Am J Emerg Med. 1999;17(6):571–4.

    Article  CAS  PubMed  Google Scholar 

  99. Peacock WF, Hollander JE, Diercks DB, et al. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008;25(4):205–9.

    Article  CAS  PubMed  Google Scholar 

  100. Masip J, Roque M, Sanchez B, et al. Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis. JAMA. 2005;294(24):3124–30.

    Article  CAS  PubMed  Google Scholar 

  101. Collins SP, Mielniczuk LM, Whittingham HA, et al. The use of noninvasive ventilation in emergency department patients with acute cardiogenic pulmonary edema: a systematic review. Ann Emerg Med. 2006;48(3):260–9. 269.e261–4.

    Article  PubMed  Google Scholar 

  102. Gray A, Goodacre S, Newby DE, et al. Noninvasive ventilation in acute cardiogenic pulmonary edema. N Engl J Med. 2008;359(2):142–51.

    Article  CAS  PubMed  Google Scholar 

  103. Pang D, Keenan SP, Cook DJ, et al. The effect of positive pressure airway support on mortality and the need for intubation in cardiogenic pulmonary edema: a systematic review. Chest. 1998;114(4):1185–92.

    Article  CAS  PubMed  Google Scholar 

  104. Yan AT, Bradley TD, Liu PP. The role of continuous positive airway pressure in the treatment of congestive heart failure. Chest. 2001;120(5):1675–85.

    Article  CAS  PubMed  Google Scholar 

  105. Masip J, Paez J, Merino M, et al. Risk factors for intubation as a guide for noninvasive ventilation in patients with severe acute cardiogenic pulmonary edema. Intensive Care Med. 2003;29(11):1921–8.

    Article  PubMed  Google Scholar 

  106. Adnet F, Le Toumelin P, Leberre A, et al. In-hospital and long-term prognosis of elderly patients requiring endotracheal intubation for life-threatening presentation of cardiogenic pulmonary edema. Crit Care Med. 2001;29(4):891–5.

    Article  CAS  PubMed  Google Scholar 

  107. Levy PD, Ye H, Compton S, et al. Factors associated with neurologically intact survival for patients with acute heart failure and in-hospital cardiac arrest. Circ Heart Fail. 2009;2(6):572–81.

    Article  PubMed  Google Scholar 

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Velasco, C.E., Diercks, D., Levy, P.D. (2017). Emergency Department Therapy of Acute Heart Failure. In: Peacock, W. (eds) Short Stay Management of Acute Heart Failure. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-44006-4_13

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  • DOI: https://doi.org/10.1007/978-3-319-44006-4_13

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-44005-7

  • Online ISBN: 978-3-319-44006-4

  • eBook Packages: MedicineMedicine (R0)

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