Mechanical Preload Reduction: Harnessing a Cornerstone of Heart Failure Management to Improve Clinical Outcomes

ASAIO J. 2024 Oct 1;70(10):821-831. doi: 10.1097/MAT.0000000000002240. Epub 2024 Jun 3.

Abstract

Decongestion is a cornerstone therapeutic goal for those presenting with decompensated heart failure. Current approaches to clinical decongestion include reducing cardiac preload, which is typically limited to diuretics and hemofiltration. Several new technologies designed to mechanically reduce cardiac preload are in development. In this review, we discuss the pathophysiology of decompensated heart failure; the central role of targeting cardiac preload; emerging mechanical preload reduction technologies; and potential application of these devices.

Publication types

  • Review

MeSH terms

  • Diuretics / therapeutic use
  • Heart Failure* / physiopathology
  • Heart Failure* / therapy
  • Hemofiltration / methods
  • Humans
  • Treatment Outcome

Substances

  • Diuretics