🧵 Why do loop diuretics stop working in acute heart failure? Dr. Ana Belen Mendez Fernandez breaks it down at #HeartFailure26
Diuretic resistance = mismatch between drug delivery & tubular response. 3 main culprits:
1️⃣ Impaired drug delivery
• Gut edema → poor oral absorption
• Reduced renal perfusion
• Hypoalbuminemia
2️⃣ Tubular adaptation (“braking phenomenon”)
• Distal nephron hypertrophy
• ↑ Na reabsorption distal to loop of Henle
3️⃣ Neurohormonal activation
• RAAS activation
• Sympathetic nervous system activation
Know the mechanism → pick the right counterstrategy 💡
#CardioTwitter #HeartFailure #Cardiology #Diuretics
Diuretic resistance is not a therapeutic dead end → it’s a signal that we need a smarter strategy.”
The perfect closing slide from Dr. Ana Belen Mendez Fernandez at #HeartFailure26 👏
5-step framework for smarter decongestion:
1️⃣ Recognize the problem
Multifactorial, common, predictable — requires a structured approach
2️⃣ Objective assessment
Weight, ultrasound, BNP, renal function, volume status, urine output
3️⃣ Optimize loop diuretics
Adequate dose & frequency, IV route, check absorption
4️⃣ Sequential nephron blockade
Target different nephron segments, overcome compensatory mechanisms
5️⃣ Treat the drivers
Venous congestion, low cardiac output, neurohormonal activation
And the line that should be on every HF ward wall:
“Decongestion is not just symptomatic relief. It changes outcomes.”
#CardioTwitter #HeartFailure #Cardiology #Decongestion #Diuretics
Presentación de ESC consenso de Salud Mental y Enfermedad CV. #ESC25
Con #HectorBueno (🇪🇸) como chairperson y @MartaFarrero (🇪🇸) como task force co-ordinator
Documento muy necesario para todos, profesionales y pacientes.
Rehabilitación Cardiaca presente en estas guías.
Manejo farmacológico. Aviso sobre el uso inadecuado de BZD, hipnóticos, antidepresivos, sedantes…
#LaSECteLleva el resumen de esta guía a partir de esta tarde.
We are thrilled to share our new publication on CA125 for diagnosis of HFpEF. CA125 showed an acceptable discriminative accuracy and a promising PPV. Our findings support the potential of CA125 to complement NT-proBNP as a diagnostic biomarker.
https://t.co/C53JbmBp5o
#ESC2025 our real-world study in diabetic patients showed a higher prognostic benefit from iSGLT2+GLP1ra compared with monotherapies being higher in women! @secardiologia@escardio
Trial of an SGLT-2 Inhibitor in Patients with Heart Failure and Valvular Disease
Dapagliflozin was safe and reduced HF events soon after transcatheter aortic valve replacement in an older cohort, but it did not improve survival. https://t.co/hqGoB8HM1M
@SheaHogan7@NEJM#TAVR
Our registry showed a reduction of Incidence of Mortality related to Cancer with Combined therapy with #SGLT2i and #GLP1ra vs monotherapies, hypothesis generator that need mechanistic/clinical trials to explore new therapeutic targets. @secardiologia@SOGACAR_@escardio
@david_gv presenting at the #ESCPrev2025 real world data results on the Santiago-Barbanza populations. Combined therapy with #SGLT2i and #GLP1ar vs Monotherapie showed reduced risk all-cause mortality in patients w #DM regardless of sex. @CIBER_CV @idis_research@cardiologiaCHUS
Inhibidores del cotransportador 2 de sodio-glucosa, agonistas del receptor de péptido 1 similar al glucagón y mortalidad por cáncer. Registro de la práctica real #REC@david_gv@SergioCinza@JoseJuanatey@cardiologiaCHUS https://t.co/4VD2tgvxbQ
📢 Galicia, primera Comunidad Autónoma en integrar #AriadnApp en su sistema de emergencias 🫀🚑
Gracias al acuerdo con SERGAS, voluntarios con formación en #RCP recibirán avisos inmediatos para actuar en paradas cardiacas.
🔗 Noticia aquí: https://t.co/tbpXS64BDD
🔴 Innovación en emergencias cardiacas desde Galicia
Mañana viernes 21 a las 08:30 h, nos vemos en el Complexo Hospitalario Universitario de Ourense para descubrir cómo #AriadnApp transforma la respuesta ante la parada cardiaca extrahospitalaria.
📍 Si eres especialista, no te pierdas la oportunidad de conocer una herramienta que puede marcar la diferencia y ayudar a #Salvar1vida.
Juntos, podemos hacer que la atención sea más rápida y eficaz. ¡Te esperamos!
@SanidadeXunta@ifdezlozano@CruzRojaEsp@cuidarcorazon