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Hypertensive acute heart failure: a critical perspective on definition, epidemiology, pathophysiology, and prognosis-a narrative review: a joint session with the Romanian Society of Cardiology (part II).

期刊: Heart failure reviews 日期: 2025-01-01 PMID: 40892348 DOI: 10.1007/s10741-025-10551-w 浏览: 4
作者: Geavlete Oliviana; Collins Sean P; Mebazaa Alexandre; Ye Linda; Palazzuoli Alberto; Antohi Laura; Biegus Jan; Pagnesi Matteo; Seferovic Petar; Radu Razvan I; Grupper Avishay; Miro Oscar; Davison Beth; Abdelhamid Magdy; Polovina Marija; Lainscak Mitja; Adamo Marianna; Cotter Gad; Savarese Gianluigi; Yilmaz Mehmet Birhan; Volterani Maurizio; Rosano Giuseppe M C; Butler Javed; Ambrosy Andrew P; Chioncel Ovidiu
Oliviana, G., P, C.S., Alexandre, M., Linda, Y., Alberto, P., Laura, A., Jan, B., Matteo, P., Petar, S., I, R.R., Avishay, G., Oscar, M., Beth, D., Magdy, A., Marija, P., Mitja, L., Marianna, A., Gad, C., Gianluigi, S., . . . Ovidiu, C. (2025). Hypertensive acute heart failure: a critical perspective on definition, epidemiology, pathophysiology, and prognosis-a narrative review: a joint session with the Romanian Society of Cardiology (part II).. Heart failure reviews. https://doi.org/10.1007/s10741-025-10551-w
Oliviana G, P CS, Alexandre M, Linda Y, Alberto P, Laura A, et al. Hypertensive acute heart failure: a critical perspective on definition, epidemiology, pathophysiology, and prognosis-a narrative review: a joint session with the Romanian Society of Cardiology (part II).. Heart failure reviews. 2025; doi: 10.1007/s10741-025-10551-w
Oliviana G, P CS, Alexandre M, et al. Hypertensive acute heart failure: a critical perspective on definition, epidemiology, pathophysiology, and prognosis-a narrative review: a joint session with the Romanian Society of Cardiology (part II).[J]. Heart failure reviews. 2025. DOI: 10.1007/s10741-025-10551-w.
@article{oliviana2025,
  author = {Geavlete Oliviana and Collins Sean P and Mebazaa Alexandre and Ye Linda and Palazzuoli Alberto and Antohi Laura and Biegus Jan and Pagnesi Matteo and Seferovic Petar and Radu Razvan I and Grupper Avishay and Miro Oscar and Davison Beth and Abdelhamid Magdy and Polovina Marija and Lainscak Mitja and Adamo Marianna and Cotter Gad and Savarese Gianluigi and Yilmaz Mehmet Birhan and Volterani Maurizio and Rosano Giuseppe M C and Butler Javed and Ambrosy Andrew P and Chioncel Ovidiu},
  title = {Hypertensive acute heart failure: a critical perspective on definition, epidemiology, pathophysiology, and prognosis-a narrative review: a joint session with the Romanian Society of Cardiology (part II).},
  journal = {Heart failure reviews},
  year = {2025},
  doi = {10.1007/s10741-025-10551-w},
  note = {PMID: 40892348},
}
TY  - JOUR
AU  - Geavlete Oliviana
AU  - Collins Sean P
AU  - Mebazaa Alexandre
AU  - Ye Linda
AU  - Palazzuoli Alberto
AU  - Antohi Laura
AU  - Biegus Jan
AU  - Pagnesi Matteo
AU  - Seferovic Petar
AU  - Radu Razvan I
AU  - Grupper Avishay
AU  - Miro Oscar
AU  - Davison Beth
AU  - Abdelhamid Magdy
AU  - Polovina Marija
AU  - Lainscak Mitja
AU  - Adamo Marianna
AU  - Cotter Gad
AU  - Savarese Gianluigi
AU  - Yilmaz Mehmet Birhan
AU  - Volterani Maurizio
AU  - Rosano Giuseppe M C
AU  - Butler Javed
AU  - Ambrosy Andrew P
AU  - Chioncel Ovidiu
TI  - Hypertensive acute heart failure: a critical perspective on definition, epidemiology, pathophysiology, and prognosis-a narrative review: a joint session with the Romanian Society of Cardiology (part II).
T2  - Heart failure reviews
PY  - 2025
DO  - 10.1007/s10741-025-10551-w
AN  - PMID:40892348
ER  - 

摘要

Hypertensive acute heart failure (HT-AHF) has historically been recognized as a distinct clinical phenotype of AHF, characterized by acute pulmonary congestion in the context of elevated systolic blood pressure (SBP), typically > 140 mmHg. However, emerging evidence has begun to challenge the diagnostic accuracy, clinical utility, and relevance of this category. A main criticism of HT-AHF is its considerable overlap with other AHF clinical profiles, including acute decompensated heart failure (ADHF) and acute pulmonary oedema (APO). Clinical features such as dyspnea and pulmonary congestion are not unique to HT-AHF. Additionally, some HT-AHF patients concurrently fulfill diagnostic criteria for the ADHF phenotype, including a history of HF or signs of volume overload, leading to ambiguity in diagnosis. HT-AHF is associated with very low in-hospital mortality (0-2%) compared to other AHF phenotypes. Notably, there is no robust evidence linking high SBP to poor short- or long-term outcomes, nor are there randomized clinical trials validating distinct management strategies for HT-AHF. Often associated with the management of HT-AHF, vasodilators have shown limited benefit across trials, contributing to a downgrade in guideline recommendations. The relatively favorable short-term prognosis and the lack of a standardized, evidence-based treatment approach weaken the rationale for classifying HT-AHF as a standalone AHF category. Given the heterogeneity of clinical presentations, overlap with other AHF phenotypes, and lack of prognostic distinction or targeted therapy, the term "AHF with high SBP at presentation" offers a more flexible and clinically meaningful descriptor, encouraging a more nuanced approach to treatment.

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