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• W2555447466 abstract "Acute heart failure syndromes (AHFS) encompass a heterogeneous group of clinical entities involving new or worsening signs or symptoms of heart failure (HF) resulting in hospitalization. AHFS are the leading cause of hospitalization for persons more than 65 years of age with more than 1 million hospitalizations annually in the United States. 1 Renal impairment is common in all categories of HF irrespective of ejection fraction or overt symptoms, 2,3 and it serves as an independent risk factor for morbidity and mortality. 4 Only recently has a framework for this dual organ dysfunction termed cardiorenal syndrome (CRS) been offered to clinicians, and a consensus definition has not been definitively established. Ronco and colleagues 5 outline 4 categories of CRS that stress the complex and bidirectional interplay between the failing heart and kidney in both the acute and chronic disease states. The underlying pathophysiology of CRS is incompletely understood but likely involves variable contributions in different patients of central venous congestion, neurohormonal and renal sympathetic activity, oxidative stress, and anemia, plus additional undefined mechanisms. 6 Because of the lack of consensus definitions, limited understanding of the pathophysiology and high mortality of CRS, patients with renal dysfunction have largely been excluded from HF trials. Consequently, the appropriate management for patients with CRS is unknown even with respect to medicines that are well validated and evidence basedforthegeneralHFpopulation(eg,b-blockers and angiotensin-converting enzyme inhibitors). Somedatasupportthatthosewithrenaldysfunction may be the group to benefit the most from HF therapies. 7 The heterogeneity of AHFS, but the commonalityofCRS,makesthispatientpopulation a key target for investigation of novel therapies. Recent clinical trials investigating novel HF therapies with potential effects on CRS have failed to show benefit with respect to key end points. 8–10 Possible explanations for these recent disappointments include the lack of understanding of underlying pathophysiology and the heterogeneity of the AHFS patient population, compounded by the lack" @default.
• W2555447466 created "2016-11-30" @default.
• W2555447466 creator A5084329252 @default.
• W2555447466 date "2011-01-01" @default.
• W2555447466 modified "2023-09-23" @default.
• W2555447466 title "Cardiorenal Clinical Trial End Points" @default.
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