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1、JournaloftheAmericanCollegeofCardiologyVol.53,No.7,2009©2009bytheAmericanCollegeofCardiologyFoundationISSN0735-1097/09/$36.00PublishedbyElsevierInc.doi:10.1016/j.jacc.2008.10.041STATE-OF-THE-ARTPAPERAcuteHeartFailureSyndromesMihaiGheorghiade,MD,FACC,*PeterS.Pang,M
2、DChicago,IllinoisHeartfailureresultinginhospitalizationrepresentsasignificantandgrowinghealthcareburden.Heterogeneitycharacterizesthisgroupintermsofmodeofpresentation,pathophysiology,andprognosis.Thevastmajorityofpatientssymptomaticallyimproveduringhospitalization;
3、however,theirearlypost-dischargerehospitalizationandmortalityratescontinuetobehigh.Worseningsignsandsymptoms,neurohormonal,andrenalabnormali-tiesoccurringsoonafterdischargemaycontributetothesehighpost-dischargeeventrates.Currentlyavailableassessmentmodalitiescombi
4、nedwithrecentadvancesincardiovasculartherapiesprovidepresent-dayopportu-nitiestoimprovepost-dischargeoutcomes.Furtherinvestigationintopathophysiologictargetsandnovelap-proachestoclinicaltrialdesignareneeded.Improvingpost-dischargeoutcomesisthesinglemostimportantgo
5、alinthemanagementofacuteheartfailuresyndromes.(JAmCollCardiol2009;53:557–73)©2009bytheAmericanCollegeofCardiologyFoundationHospitalizationforacuteheartfailuresyndromes(AHFS)is1dischargemortalityandpreventionofreadmissionsareofthemostimportantpredictorsofpost-disch
6、argemortalitythemostimportantgoalsinAHFS.andreadmissioninpatientswithchronicHF(1,2).Over1ThisreviewreflectsconceptsdevelopedbytheInter-millionhospitalizationswithaprimarydiagnosisofHFoccurnationalWorkingGrouponAHFSthatmetannuallyforeachyearintheU.S.(3).Asadiagnosis
7、athospitaldischarge,thelast5years,composedofcardiologists,hospitalists,HFhastripledoverthelast3decades.Thistrendwilllikelyemergencyphysicians,industry,andgovernmentalagen-continueduetoanagingpopulation,improvedsurvivalaftercies(5).myocardialinfarction(MI),andbette
8、rpreventionofsuddencardiacdeath(3,4).DefinitionsManagementofAHFSischallenginggiventheheter-AHFScanbedefinedasnewonsetorgradualorrapidlyogeneityofthepatien
