| Fluid overload contributing to heart failure. | |
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MedLine Citation:
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PMID: 16024828 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In advanced heart failure, the compensatory responses to reduced cardiac output, in spite of fluid retention, lead to maladaptive consequences. METHODS: We performed a Medline survey for fluid overload and heart failure as well as reviewing textbook chapters. RESULTS: The increased sympathetic nervous system, renin-angiotensin-aldosterone system, and antidiuretic hormone stimulation and release lead to a vicious cycle--augmenting pre-load, contractility and after-load, as well as increased fluid overload. The elevated work load on an already failed cardio-circulatory system results in further deterioration. Plasma volume is usually increased in untreated patients with increased extracellular fluid. However, it may range from reduced to increased in treated patients. Currently, diuretics remain the initial first line of therapy. In refractory cases, restoring plasma volume and osmolality, by adding albumin or hypertonic saline solutions, neurohormonal antagonists such as vasopressin receptors antagonists, aldosterone antagonists, or administration of nesiritide, may help in overcoming fluid overload. CONCLUSION: Exact measurement of plasma volume in various forms of heart failure and adjusting the treatment accordingly, establishing favourable and detrimental effects of various therapies, and introducing additional and new therapeutic options require further investigation. |
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Authors:
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Avraham Shotan; Samir Dacca; Michael Shochat; Marc Kazatsker; David S Blondheim; Simcha Meisel |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 20 Suppl 7 ISSN: 1460-2385 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-07-18 Completed Date: 2008-04-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: vii24-7 Citation Subset: IM |
Affiliation:
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Heart Institute, Hillel Yaffe Medical Center, Hadera, 38100, Israel. shotana@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Output
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physiology Diuretics Heart Failure / etiology*, physiopathology*, therapy Heart Transplantation Humans Plasma Volume / physiology Renal Dialysis Water-Electrolyte Balance / physiology* |
| Chemical | |
Reg. No./Substance:
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0/Diuretics |
| Comments/Corrections | |
Comment In:
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Nephrol Dial Transplant. 2005 Jul;20 Suppl 7:vii37-40
[PMID:
16024832
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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