Over the last 35 years, cardiology, especially the field of heart failure (HF), has witnessed a true therapeutic revolution based on scientific evidence. First, with vasodilators, moving on to the neurohumoral pathophysiological hypothesis with ACE inhibitors (ACEI), beta-blockers, mineralocorticoid antagonists, and, more recently, neprilysin inhibitors and SGLT2 inhibitors, caused a reduction in morbimortality rarely seen in the history of medicine. However, virtually all evidence associated with this impressive reduction in events comes at the expense of benefits in patients with […]

Abstract The administration of hypertonic saline (HS) in decompensated heart failure (HF) seems counterintuitive, given the concept that sodium is universally harmful for these patients. However, increasingly, strict sodium restrictions have been questioned due to the lack of proven benefits. On the other hand, we know that in acute HF complicated with diuretic resistance, there is hyperactivation of the renin-angiotensin-aldosterone system (RAAS), resulting in a state of excessive increase in renal avidity for sodium, hindering the action of loop diuretics. […]

Pathophysiology Over the last few decades, much has been discovered about the pathophysiological processes of chronic HF, especially myocardial remodeling, signaling important pharmacological targets that have proven to impact clinical outcomes. In the scenario of post-infarction HF, some peculiarities in these processes have been better understood, helping to understand specific characteristics of this clinical phenotype of HF and enabling a more targeted approach in this scenario. Initially, ischemia leads to loss of contractile function and consequently enlarges the ventricular cavity, […]

Abstract Nearly 80% of all patients hospitalized for decompensated heart failure (HF) present hypervolemia with signs and symptoms of congestion,, for which decongestion is an essential pillar of treatment. Most guidelines recommend the use of loop diuretics as soon as the patient is admitted.– Despite this, a post-hoc analysis of the DOSE-AHF and CARRESS-HF studies showed that only half of these patients were free of congestion at the moment of high discharge, this being the group with the highest mortality […]

Introduction Heart failure (HF) syndrome was first described as an emerging epidemic almost 30 years ago. Due to population growth and aging, the total number of patients with HF has increased over the past years. Acute decompensated HF (ADHF) is estimated to be the leading cause of hospitalization, based on data available from 50% of the South American population. The standard treatment for patients with ADHF includes diuretics, vasodilators, and sodium restriction. […]

Abstract Background: Patients with chronic heart failure (CHF) have a decreased ability to walk, which has been related to the occurrence of hospitalizations and mortality and appears to be associated with the severity of the disease. Objective: To describe spatiotemporal gait characteristics of adult patients hospitalized with CHF. Method: Cross-sectional observational study. Participants diagnosed with CHF, between 18 and 60 years old, functional classification II and III, who were medically authorized to walk as prescribed in their medical records, were […]

Abstract High-output heart failure (HOHF) is a less common form of heart failure and presents as the inability of the heart to supply enough blood for the body’s needs. HOHF can be divided into two categories: 1. increased demand for increased metabolism or 2. arteriovenous shunts increasing venous circulation flow and decreasing resistance, leading to increased oxygen consumption and low systemic vascular resistance. The most common causes are obesity, liver disease, shunts, lung disease, myeloproliferative diseases, hyperthyroidism, and thiamine deficiency.

Abstract Background: Early detection of heart failure makes it possible to intervene in risk factors, and treatment is capable of modifying the natural history of the disease. For diagnostic confirmation, natriuretic peptide (NP) testing or transthoracic echocardiography can be performed; the former is preferable when considering cost and accessibility. Although this test was incorporated into the Brazilian Unified Health System (SUS) in 2018, requests for this test were registered in only 4.63% of municipalities in the SUS Outpatient Information System […]

Abstract Heart failure (HF) is a progressive condition, characterized by variable periods of symptomatic stability frequently interrupted by episodes of A worsening condition. These moments of clinical deterioration have been recognized as a distinct phase in the course of HF and indicate a considerably worse prognosis. Preventing readmissions of patients with HF is a growing priority for medical providers, researchers, and healthcare managers. Although evidence-based therapies for treating patients with HF have increased, consistent implementation of these therapies and the […]

Introduction Heart failure (HF) can be a serious disease if not treated properly. One of the markers of severity is precisely hospitalization due to HF, often called acute HF or acutely decompensated (ADHF). ADHF involves patients with new HF or an exacerbation of chronic HF. The most common symptoms and signs in ADHF are dyspnea and edema of the lower limbs. Dyspnea, when it occurs in isolation, with no specific signs of HF, can hinder the diagnosis. In this context, […]