PURPOSE OF REVIEW: To provide a review of current transcatheter structural heart interventions in women, with a focus on sex-specific considerations in diagnosis, treatment and outcomes. RECENT FINDINGS: Transcatheter in...PURPOSE OF REVIEW: To provide a review of current transcatheter structural heart interventions in women, with a focus on sex-specific considerations in diagnosis, treatment and outcomes. RECENT FINDINGS: Transcatheter interventions have transformed structural heart disease treatment, including valvular heart disease and left atrial appendage closure. Historically, low female enrollment in cardiovascular trials has limited sex-specific data integration into clinical guidelines. Recently, the changing landscape of female representation has provided insight into distinct pathophysiology, high-risk features, clinical characteristics, disease surveillance, referral barriers, and treatment responses. The success of transcatheter structural heart interventions relies on judicious patient selection and timely intervention. This review evaluates contemporary female representation in transcatheter studies, highlighting sex-specific prevalence, anatomic and physiologic variations, clinical presentations and both short- and long-term outcomes. Knowledge gaps and future research directions are identified to address diagnostic and therapeutic disparities, ultimately improving individualized lifetime care in women with structural heart disease.
PURPOSE OF REVIEW: To identify potential preoperative risk factors that predispose a patient to developing a left ventricular assist device driveline infection. RECENT FINDINGS: The fully magnetically-levitated left vent...PURPOSE OF REVIEW: To identify potential preoperative risk factors that predispose a patient to developing a left ventricular assist device driveline infection. RECENT FINDINGS: The fully magnetically-levitated left ventricular assist device has proven to be a safe and effective durable option for patients with advanced heart failure. However, driveline infections are a significant adverse event that impact patient mortality, morbidity, and quality of life. Potential preoperative risk factors such as INTERMACS score, temporary cardiovascular support, body mass index, hemoglobin A1C, prealbumin, infection, and hospital length of stay do not appear to significantly predispose a patient to developing a left ventricular assist device driveline infection. There is a need for more extensive research on postoperative patient and driveline management in order to identify high risk patients and delineate best practice to decrease the risk and burden of driveline infections.
PURPOSE OF REVIEW: This review explores the intercontinental disparities in endovascular treatment for aortic diseases, focusing on North America, Europe, Africa and Asia with special focus Southeast Asia(India). It high...PURPOSE OF REVIEW: This review explores the intercontinental disparities in endovascular treatment for aortic diseases, focusing on North America, Europe, Africa and Asia with special focus Southeast Asia(India). It highlights device availability, cost, accessibility, patient outcomes, and the necessity for improved healthcare equity. RECENT FINDINGS: The management of aortic diseases such as aneurysms and dissections has improved with endovascular techniques like thoracic endovascular aortic repair and fenestrated-branched repair. These minimally invasive procedures offer benefits over traditional surgery, including lower morbidity and mortality rates, reduced hospital stays, faster recovery times, and generally higher patient satisfaction. However, their adoption varies across continents due to differences in healthcare infrastructure, economic resources, regulatory environments, and physician expertise. By examining the current landscape of endovascular aortic treatment globally, we can better understand the challenges and opportunities for enhancing aortic care and ensuring equitable access for all patients, regardless of their geographic location and socioeconomic status.
Wassif H, Ghandakly E, Layoun H
… +5 more, Bhalla JS, Littlejohn E, Wang TKM, Husni E, Klein A
Curr Cardiol Rep
· 2025 Jul · PMID 40665038
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PURPOSE OF REVIEW: To provide an overview of the diagnosis and updated therapeutic approach to autoimmune pericarditis. RECENT FINDINGS: Subtypes of autoimmune pericarditis may benefit from IL-1 inhibition and future phe...PURPOSE OF REVIEW: To provide an overview of the diagnosis and updated therapeutic approach to autoimmune pericarditis. RECENT FINDINGS: Subtypes of autoimmune pericarditis may benefit from IL-1 inhibition and future phenotyping based on clinical presentation, biomarkers, and imaging may aid in guiding future therapeutic approaches. Autoimmune pericarditis is a unique phenotype of pericarditis for which there is scarce data. The clinical spectrum of pericardial involvement associated with autoimmune disorders varies in acuity, recurrence, severity, and symptomatic presentation. There is a pathophysiologic distinction that separates autoimmune and autoinflammatory pericarditis from other pericarditis presentations. This review explores the state of the art in diagnosis and therapeutic management.
PURPOSE OF REVIEW: To examine sex-specific differences in pulmonary embolism management in the era of expanding advanced therapies. RECENT FINDINGS: Women with pulmonary embolism demonstrate unique risk profiles and clin...PURPOSE OF REVIEW: To examine sex-specific differences in pulmonary embolism management in the era of expanding advanced therapies. RECENT FINDINGS: Women with pulmonary embolism demonstrate unique risk profiles and clinical presentations compared to men. Recent advances in pulmonary embolism management, including Pulmonary Embolism Response Teams, catheter-based mechanical thrombectomy, and reduced-dose thrombolytics, have transformed treatment paradigms. In patients presenting with right ventricular dysfunction or hemodynamic instability, timely intervention and optimal treatment selection are crucial. Current literature, mostly retrospective, signals disparities in diagnostic testing, treatment approaches, and outcomes, despite women presenting with higher prognostic risk stratification. Important sex-based differences exist in risk factors, clinical presentations, diagnosis and management of pulmonary embolism. While contemporary device trials show balanced female representation, female-specific analyses remain limited. Prospective studies are needed to clarify treatment responses in women and establish evidence-based guidelines.
PURPOSE OF REVIEW: The purpose of this review is to provide an updated overview of recent findings and trends in heart transplantation among female patients in the United States. RECENT FINDINGS: Female patients continue...PURPOSE OF REVIEW: The purpose of this review is to provide an updated overview of recent findings and trends in heart transplantation among female patients in the United States. RECENT FINDINGS: Female patients continue to make up a smaller proportion of both transplant recipients and those on the waiting list and tend to experience longer wait times for transplantation. However, under the new allocation system, some positive shifts have emerged. Outcomes for female patients with ventricular assist devices have improved, and women are now being transplanted earlier than men, with more receiving a transplant within six months of listing. Additionally, offer acceptance rates for female candidates have increased. In pediatric transplantation, the proportion of female patients on the waitlist has also risen. Despite these advancements, significant challenges persist. Women continue to face lower levels of social and emotional support, higher rates of vascular complications, and reduced utilization of mechanical circulatory support. Although women remain underrepresented in heart transplantation, emerging trends suggest improvements in certain areas, potentially due to the new allocation system. Continued efforts are needed to further address and mitigate these disparities.
Curr Cardiol Rep
· 2025 Jul · PMID 40646403
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PURPOSE OF THE REVIEW: We sought to review the various intracoronary imaging modalities (intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy) and the latest evidence supporting their us...PURPOSE OF THE REVIEW: We sought to review the various intracoronary imaging modalities (intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy) and the latest evidence supporting their use in clinical practice. RECENT FINDINGS: There is an increasing body of evidence that demonstrates that imaging-guided strategies are superior to angiography alone to improve outcomes of percutaneous coronary intervention (PCI). An intriguing and promising application is use of these devices to identify and treat high-risk or vulnerable plaques. The application of these modalities in special clinical scenarios is also reviewed. Intravascular imaging provides information beyond the angiogram that can be used to improve patient outcomes during PCI. The emerging evidence has been incorporated into the most recent practice Guideline recommendations. Future research is underway to establish the benefit of intravascular imaging for detection and treatment of vulnerable plaques.
PURPOSE OF REVIEW: To summarize the current understanding of the impact of mental health conditions on cardiovascular disease in women. RECENT FINDINGS: Chronic psychological stress, anxiety, depression, post-traumatic s...PURPOSE OF REVIEW: To summarize the current understanding of the impact of mental health conditions on cardiovascular disease in women. RECENT FINDINGS: Chronic psychological stress, anxiety, depression, post-traumatic stress disorder, adverse childhood experiences, and sexual trauma are strongly associated with a higher prevalence of cardiovascular disease and worse outcomes in women, especially in women veterans. Autonomic dysregulation, pro-inflammatory responses, and maladaptive behaviors play important roles in the interplay between mental and cardiovascular health. Stress management strategies offer cardiovascular benefits. Mental health conditions and psychosocial stress have emerged as important non-traditional risk factors for the development cardiovascular disease in women. They disproportionately affect women and are associated with a significantly higher risk of adverse cardiovascular health. Mental health disorders produce adverse effects on the vascular, immune, inflammatory, and metabolic processes and can lead to unhealthy lifestyle choices, which collectively can exacerbate cardiovascular disease. Effective management strategies require integrated care.
Srikantharajah M, Gopalan D, Wilson-Morkeh H
… +3 more, Siddiqui S, McAdoo SP, Youngstein T
Curr Cardiol Rep
· 2025 Jul · PMID 40632386
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PURPOSE OF REVIEW: This review highlights recent advances in the pathophysiology, diagnosis, and treatment of cardiac disease in patients with Eosinophilic granulomatosis with polyangiitis (EGPA). We outline a diagnostic...PURPOSE OF REVIEW: This review highlights recent advances in the pathophysiology, diagnosis, and treatment of cardiac disease in patients with Eosinophilic granulomatosis with polyangiitis (EGPA). We outline a diagnostic approach to facilitate early identification of affected patients. RECENT FINDINGS: Recent advancements in diagnostic techniques including cardiac magnetic resonance (CMR) have improved recognition of cardiac disease in patients with EGPA. CMR has demonstrated a high prevalence of cardiac abnormalities, even in the absence of clinical symptoms, electrocardiographic or echocardiographic findings. Cardiac disease is a major cause of mortality in patients with EGPA, accounting for around 50% of disease-related deaths. However, due to the lack of standardised screening and diagnostic criteria, the true incidence remains unknown. Systemic immunosuppressive therapy is warranted to prevent acute complications as well as mitigate the long-term impact of chronic inflammation and tissue damage. Given the challenges in early detection and the prognostic significance of cardiac involvement, we recommend including CMR in the baseline evaluation of all EGPA patients at diagnosis.
Curr Cardiol Rep
· 2025 Jul · PMID 40613952
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PURPOSE OF REVIEW: This review explores the causes, consequences, and management approaches of hospital-acquired insomnia in patients with heart failure (HF). It examines the key factors contributing to insomnia in hospi...PURPOSE OF REVIEW: This review explores the causes, consequences, and management approaches of hospital-acquired insomnia in patients with heart failure (HF). It examines the key factors contributing to insomnia in hospitalized HF patients, its impact on health outcomes, and effective management strategies to address the issue. RECENT FINDINGS: Recent research highlights that environmental factors (such as noise, lighting, and medical interventions) and clinical symptoms (including dyspnea and nocturia) significantly contribute to insomnia in hospitalized HF patients. Insomnia exacerbates HF symptoms, increasing hospitalization rates, healthcare costs, and the risk of cardiovascular complications. Non-pharmacological interventions have improved sleep quality and overall well-being, including Cognitive Behavioral Therapy for Insomnia (CBT-I), sleep hygiene education, and supervised exercise programs. Hospital-acquired insomnia negatively affects both the physical and psychosocial health of HF patients. Effective management requires a multidisciplinary approach, incorporating both pharmacological and non-pharmacological strategies. Nurses play a crucial role in implementing sleep-promoting interventions. Creating a hospital environment that supports sleep, raising healthcare professionals' awareness, and integrating evidence-based interventions can enhance recovery outcomes. Future research should focus on long-term studies evaluating the efficacy of insomnia management strategies in HF patients.
PURPOSE OF REVIEW: Atherosclerotic cardiovascular disease (ASCVD) continues to remain a leading cause of morbidity and mortality worldwide. Risk estimation is fundamental for primary prevention by ensuring that intervent...PURPOSE OF REVIEW: Atherosclerotic cardiovascular disease (ASCVD) continues to remain a leading cause of morbidity and mortality worldwide. Risk estimation is fundamental for primary prevention by ensuring that interventions such as lipid lowering or antihypertensive therapy are targeted towards the populations that would most benefit from their use. The Pooled Cohort Equations (PCE), developed in 2013 by the American College of Cardiology (ACC) and American Heart Association (AHA), have been extensively applied to ASCVD risk estimation. However, limitations posed by the PCE include, but are not limited to, race-based adjustments, overdependence on age, limited generalizability, and the development of larger epidemiologic cohorts, all of which eventually necessitated the development of the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations. The PREVENT equations are intended to address the limitations posed by the former equations by expanding the applicable age range, including additional risk factors, and providing 10- and 30-year predictions for cardiovascular disease (CVD), ASCVD, and heart failure (HF). The purpose of this review is to evaluate the rationale for risk estimation, the evolution of cardiovascular risk prediction tools, the derivation and limitations surrounding PREVENT, and its potential implications for recommendations regarding preventive therapy initiation and continuation. Further, this review elects to focus on the outcome of ASCVD and not discuss HF. RECENT FINDINGS: Analysis of the PREVENT equation, especially in comparison to the PCE, shows that PREVENT leads to lower predicted risk and therefore lower provision of preventive therapies, including reducing statin eligibility by 17.3 million U.S. adults. This review summarizes the recent data regarding the changes in risk stratification, the potential changes in preventive treatment allocation, and some of the limitations that arise from the new risk prediction equations. While the PREVENT equations are an improvement in cardiovascular risk prediction, their impact on treatment raises questions that will need to be carefully studied as PREVENT is implemented in clinical practice. Future studies will need to evaluate the clinical impact of PREVENT across diverse populations and ascertain the impact on preventive care and cardiovascular outcomes.
Manickavasagar R, Krishnan A, Azzam O
… +1 more, Schlaich MP
Curr Cardiol Rep
· 2025 Jul · PMID 40601167
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PURPOSE OF REVIEW: The endothelin system is a highly relevant component of the pathophysiology of hypertension, which is currently unopposed by existing treatment approaches. We examined the role of dual endothelin recep...PURPOSE OF REVIEW: The endothelin system is a highly relevant component of the pathophysiology of hypertension, which is currently unopposed by existing treatment approaches. We examined the role of dual endothelin receptor antagonists in the treatment of resistant hypertension. RECENT FINDINGS: The recent PRECISION trial demonstrated significant blood pressure lowering effect with the use of the dual endothelin receptor antagonist aprocitentan in the treatment of resistant hypertension. Aprocitentan was shown to be particularly effective in patients over 75 years of age, African-American patients, and patients with diabetes and advanced CKD. There was also a decrease in proteinuria. Aprocitentan was well tolerated and the risk of fluid retention can be mitigated by close clinical monitoring and titration of diuretic therapy. Aprocitentan presents a novel treatment option for resistant hypertension, with particular efficacy noted in patient cohorts who have historically been challenging to achieve blood pressure targets in.
PURPOSE OF REVIEW: This review examines extracardiac manifestations of cardiac amyloidosis and their potential role in early diagnosis and management. Multisystem involvement, including musculoskeletal, peripheral nervou...PURPOSE OF REVIEW: This review examines extracardiac manifestations of cardiac amyloidosis and their potential role in early diagnosis and management. Multisystem involvement, including musculoskeletal, peripheral nervous system, and other extracardiac findings are highlighted to serve as red flags for earlier detection. RECENT FINDINGS: Early screening for high-risk individuals over 50 with CTS or spinal stenosis could enable earlier intervention. Peripheral neuropathy and CTS often precede cardiac involvement by 5-10 years, while spinal stenosis can precede it by 5-15 years. Other indicators include biceps tendon rupture, trigger finger, and gastrointestinal issues. MRI shows promise in detecting amyloid-related changes, especially wrist MRI. More studies are needed. Recognizing extracardiac findings may enable earlier diagnosis and intervention before significant cardiac dysfunction. Current workflows use extracardiac manifestations to detect cardiac amyloidosis after cardiac involvement. Integrating these insights earlier could identify amyloidosis years before cardiac issues, improving screening, patient outcomes, and guiding future therapies.
Curr Cardiol Rep
· 2025 Jun · PMID 40560431
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PURPOSE OF REVIEW: Atrial arrhythmias are an increasingly recognized cardiovascular issue for cancer patients and can lead to increased morbidity and mortality independent of the oncologic prognosis. This review highligh...PURPOSE OF REVIEW: Atrial arrhythmias are an increasingly recognized cardiovascular issue for cancer patients and can lead to increased morbidity and mortality independent of the oncologic prognosis. This review highlights the epidemiology of atrial arrhythmias in cancer patients including risk factors and arrhythmogenic cancer treatments as well as the current state of knowledge regarding the prevention and treatment of atrial arrhythmias in this population. RECENT FINDINGS: There appears to be bidirectional risk of atrial arrhythmias and cancer, with increased rates of atrial fibrillation identified in cancer patients but also increased cancer in patients with know atrial fibrillation. Moreover, as the cancer treatment landscape has continued to evolve, many novel treatments have been shown to be arrhythmogenic. Currently, the recommendations for the prevention and treatment of cancer associated arrhythmias are the same as the general population. Atrial arrhythmias are common in cancer patients due to multiple factors including shared risk factors and the cancer treatments themselves. Additional research is essential to better understand risk and also to provide cancer-specific recommendations for the prophylaxis and management of atrial arrhythmias and their associated thromboembolic complications.
PURPOSE OF REVIEW: Lipoprotein(a) [Lp(a)] is an apolipoprotein B-containing lipoprotein that is a genetic causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease. This revi...PURPOSE OF REVIEW: Lipoprotein(a) [Lp(a)] is an apolipoprotein B-containing lipoprotein that is a genetic causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease. This review focuses on new findings and treatment approaches for individuals with elevated Lp(a) across the spectrum of ASCVD. RECENT FINDINGS: One in five individuals globally have elevated Lp(a) (> 125 nmol/L or > 50 mg/dL). Emerging knowledge related to Lp(a) includes demonstration of poor rates of Lp(a) testing, comparison of methods for Lp(a) measurement, natural variability in Lp(a) levels, the continuous association between Lp(a) and ASCVD risk, atherogenicity in comparison with LDL, risk in context of other risk factors, coronary plaque characteristics, and the association of Lp(a) with a broader range of outcomes. Optimal risk factor control, including LDL-cholesterol lowering, is a cornerstone of management. When indicated, shared decision-making to discuss antiplatelet therapy for individuals with very-high Lp(a) may also be helpful. Several Lp(a)-lowering therapies are under investigation in ASCVD outcome trials. While Lp(a) is a well-established risk factor for ASCVD, there are several areas of growing knowledge related to Lp(a), and management strategies of individuals with elevated Lp(a) continue to evolve with targeted therapies currently in late-stage clinical trials.
Särnholm J, Gaffey AE, Turchio MR
… +2 more, Biviano A, Burg MM
Curr Cardiol Rep
· 2025 Jun · PMID 40560300
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PURPOSE OF REVIEW: Cardiac arrhythmias, including atrial fibrillation (AF) and ventricular arrhythmias (VA), are associated with anxiety, depression, and poor quality of life (QoL). These and related aspects of psycholog...PURPOSE OF REVIEW: Cardiac arrhythmias, including atrial fibrillation (AF) and ventricular arrhythmias (VA), are associated with anxiety, depression, and poor quality of life (QoL). These and related aspects of psychological health significantly influence the clinical course and prognosis of arrhythmia patients, yet their integration into routine arrhythmia care remain limited. This focused review examines the use of psychological interventions, particularly cognitive behavioral therapy (CBT), in addressing psychological health in arrhythmia patients and discusses strategies for integrating these interventions into arrhythmia care. RECENT FINDINGS: CBT has demonstrated efficacy in reducing anxiety, depression, cardiac-related fears, and avoidance behaviors while improving QoL in arrhythmia patients. Further research is necessary to evaluate the effectiveness of these interventions in real-world care systems. Multidisciplinary care collaborations are essential for advancing the integration of psychological health within arrhythmia care. Integrating CBT for psychological health into arrhythmia care can improve clinical outcomes.
PURPOSE OF REVIEW: To review current available risk scores for pericarditis risk stratification. RECENT FINDINGS: Four recent published scores have provided new clinical tools for the evaluation of risk of recurrent peri...PURPOSE OF REVIEW: To review current available risk scores for pericarditis risk stratification. RECENT FINDINGS: Four recent published scores have provided new clinical tools for the evaluation of risk of recurrent pericarditis after a first episode or acute pericarditis (Athens score) or complicated pericarditis (Torino score), diagnosis of pericarditis (pericarditis INFLA-score) or clinical remission (Cleveland Clinic/ Klein score). Recent scores for pericarditis diagnosis or risk stratification have been developed by tertiary referral centres with the aim of improving risk stratification and diagnosis and allowing an individualized approach for treatment and follow-up identifying the high-risk group of patients. While these scores are helpful in developing a more evidence-based approach for risk stratification of pericarditis, they have some limitations (single-centre, tertiary centres with referral bias, relatively limited sample size, new therapies not always included) and require further validation before clinical implementation in large unselected populations.
PURPOSE OF REVIEW: The goal of this review is to examine the evolving role of exercise stress echocardiography (ESE) in the diagnosis and management of pulmonary vascular diseases (PVD), particularly pulmonary hypertensi...PURPOSE OF REVIEW: The goal of this review is to examine the evolving role of exercise stress echocardiography (ESE) in the diagnosis and management of pulmonary vascular diseases (PVD), particularly pulmonary hypertension (PH). We sought to explore how ESE can assess dynamic cardiopulmonary interactions, distinguish between PH subtypes, evaluate right ventricular (RV) contractile function and reserve, and provide a noninvasive alternative for early detection, risk stratification, and clinical decision-making in patients with unexplained dyspnea and PVD. RECENT FINDINGS: Although right heart catheterization (RHC) remains the diagnostic gold standard, ESE has emerged as a promising noninvasive tool to assess dynamic changes in ventricular function, interventricular interactions, cardiopulmonary hemodynamics, and systemic circulation under stress conditions. Beyond traditional ischemic evaluation, ESE has demonstrated potential for identifying underlying causes of dyspnea in populations with rising cardiopulmonary risk factors such as aging, cardiovascular disease, obesity, COPD, and left heart failure. Recent studies highlight the ability of ESE to differentiate PH subtypes and offer prognostic insights. However, important knowledge gaps remain, particularly regarding standardized protocols and interpretation across different PH groups. Our review affirms that ESE offers a valuable, noninvasive approach for the early identification and risk stratification of PH, complementing or, in selected cases, providing an alternative to invasive hemodynamics. By evaluating dynamic cardiopulmonary interactions and RV reserve, ESE can refine diagnosis, improve clinical management, and potentially guide earlier therapeutic interventions in at-risk patients. Future research should focus on standardizing ESE methodologies, validating noninvasive surrogate measures of hemodynamics, and expanding its role in clinical practice to optimize the care of patients with PVD.
INTRODUCTION: Acetazolamide is used in heart failure to improve diuresis and reduce volume overload. It acts as a diuretic in the proximal tubule, inhibiting the reabsorption of bicarbonate, water, and sodium. METHODS: A...INTRODUCTION: Acetazolamide is used in heart failure to improve diuresis and reduce volume overload. It acts as a diuretic in the proximal tubule, inhibiting the reabsorption of bicarbonate, water, and sodium. METHODS: A systematic review with meta-analysis of studies between 2014 and 2024 was conducted to evaluate the efficacy of Acetazolamide in decompensated heart failure compared to other drugs. Observational studies and clinical trials were considered. Searches were conducted in Medline, Scopus, Web of Science, CENTRAL and the World Health Organization clinical trials registry. A sensitivity analysis was performed for each outcome. RESULTS: The addition of Acetazolamide to standard diuretic treatment in patients with heart failure produces greater diuretic efficiency, a reduction in fluid balance, and a promotion of sodium loss. A decrease in Pro-BNP-NT levels and an improvement in volume overload symptoms have also been observed. The most notable result was natriuresis, where a mean difference in favour of Acetazolamide was observed: MD of 56.98 with a 95% CI (27.7-86.2). CONCLUSIONS: Acetazolamide may be an effective option for managing congestion in patients with heart failure, improving the signs and symptoms of volume overload. Its effect on mean diuresis is comparable to or slightly higher than that observed with other diuretics. In addition, it induces favourable changes in sodium excretion, optimizing the management of electrolyte balance.