Abstract：
Because signs of congestion are associated with adverse outcomes in patients with acute heart failure (AHF), attempts were made to decongest patients as much as possible with diuretic agents (loop diuretic agents, thiazides, acetazolamide) or mechanical devices. Those interventions improved signs of congestion but failed to meaningfully improve patients\' symptoms, improve quality of life, or reduce early readmissions or deaths. Recent studies have shown that implementation of guideline-directed medical therapies after an AHF admission led to both more decongestion and improved symptoms, quality of life, and outcomes. Therefore, for most patients with AHF whose symptoms and congestion can be controlled with loop diuretic agents, the main focus should be rapid guideline-directed medical therapy uptitration. Enhanced decongestion, ie, adding a second-line diuretic agent to a loop diuretic agent, should be reserved for those patients who do not respond to loop diuretic agents.
摘要：
因为充血的迹象与急性心力衰竭（AHF）患者的不良后果有关，尝试使用利尿剂（loop利尿剂，噻嗪类,乙酰唑胺）或机械设备。这些干预措施改善了充血的迹象，但未能有意义地改善患者的症状，提高生活质量,或减少早期再入院或死亡。最近的研究表明，AHF入院后实施指南指导的药物治疗会导致更多的充血和症状改善。生活质量,和结果。因此,对于大多数AHF患者，其症状和充血可以通过环路利尿剂控制，重点应该是快速的指导药物治疗上调.缓解充血，ie,在环状利尿剂中加入二线利尿剂，应保留给那些对环路利尿剂无反应的患者。
