Chronic congestion
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Understanding Chronic Congestion: Mechanisms, Impacts, and Management
Chronic Passive Venous Congestion and Hepatic Fibrosis
Keywords: Chronic passive venous congestion, hepatic fibrosis, sinusoidal thrombosis
Chronic passive hepatic congestion, also known as congestive hepatopathy, is a condition where prolonged venous congestion leads to liver fibrosis. Research has shown that this process involves sinusoidal thrombosis and mechanical forces. In a murine model, partial ligation of the inferior vena cava (pIVCL) resulted in increased hepatic fibrosis and portal pressure, which were associated with hepatic stellate cell (HSC) activation. The study also found that liver stiffness, as measured by magnetic resonance elastography, correlated with portal pressure and preceded fibrosis. Treatments such as warfarin and tissue factor pathway inhibitor (TFPI) overexpression were found to protect against fibrosis development and HSC activation, indicating that both thrombosis and mechanical strain play crucial roles in this process 1.
Chronic Nasal Congestion: Symptoms and Consequences
Keywords: Chronic nasal congestion, sleep-disordered breathing, daytime sleepiness
Chronic nasal congestion, characterized by a "stuffy" or blocked nose, results from swollen nasal tissues and blood vessels filled with excess fluid. This condition can lead to significant issues such as sleep-disordered breathing, fragmented sleep, reduced sleep quality, and daytime sleepiness. In infants, chronic nasal congestion can be particularly serious, as it may interfere with nursing and breathing 2.
Refractory Congestion in Heart Failure: Diagnosis and Management
Keywords: Refractory congestion, heart failure, cardiorenal syndrome
Refractory congestion is a common and challenging issue in both acute and chronic heart failure, significantly affecting renal function, hospital admissions, and survival rates. The interplay between heart failure and chronic kidney disease (CKD) is complex, involving various pathophysiological mechanisms. New diagnostic tools, including biomarkers and ultrasound imaging, are being used to detect subclinical forms of congestion. Treatment strategies include the optimal use of diuretics, alternative therapies like subcutaneous furosemide, and extracorporeal therapies such as ultrafiltration and dialysis. These approaches aim to manage congestion effectively and improve patient outcomes 3.
Persistent Congestion and Inflammatory Cytokines in Acute Heart Failure
Keywords: Persistent congestion, acute heart failure, inflammatory cytokines
In patients with acute heart failure, persistent congestion and chronic kidney dysfunction (CKD) are linked to poor prognosis. Elevated levels of inflammatory biomarkers, such as TNF-α and soluble tumor necrosis factor receptors, are associated with worse outcomes. These cytokines may mediate the adverse effects of congestion and CKD on heart failure prognosis. Effective management of congestion and inflammation is crucial for improving patient outcomes 4.
Histological Changes in the Pancreas Due to Chronic Passive Congestion
Keywords: Chronic passive congestion, pancreatic fibrosis, venous stasis
Chronic passive congestion can lead to significant histological changes in the pancreas, including fibrosis and induration. These changes are often secondary to venous stasis caused by chronic diseases of the heart, liver, or lungs. Despite the frequency of chronic congestion in abdominal organs, its role in chronic pancreatitis is considered minor, although it can cause slight proliferation of interstitial connective tissue 5.
Clinical Congestion Patterns in Chronic Heart Failure
Keywords: Clinical congestion, chronic heart failure, prognosis
The longitudinal pattern of clinical congestion in chronic heart failure patients significantly impacts their prognosis. A study involving patients with chronic heart failure found that a higher Clinical Congestion Index at baseline was associated with increased mortality and reduced hospitalization-free survival. Successful decongestion was linked to better outcomes, highlighting the importance of effective congestion management in these patients 6.
Pulmonary Congestion in Heart Failure: Diagnostic and Prognostic Value
Keywords: Pulmonary congestion, lung ultrasound, heart failure
Pulmonary congestion is a critical feature in heart failure, and lung ultrasound (LUS) has proven to be a valuable tool for its detection. LUS can quantify pulmonary congestion by identifying B-lines, which correlate with fluid overload. This method is useful for both acute and chronic heart failure, providing prognostic information and guiding treatment decisions to improve patient outcomes 789.
Conclusion
Chronic congestion, whether in the liver, nasal passages, or heart, poses significant health challenges. Understanding the underlying mechanisms, such as thrombosis and mechanical strain in hepatic congestion, or the role of inflammatory cytokines in heart failure, is crucial for developing effective management strategies. Diagnostic tools like lung ultrasound and biomarkers are enhancing our ability to detect and treat congestion, ultimately improving patient outcomes across various conditions.
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Most relevant research papers on this topic
Chronic passive venous congestion drives hepatic fibrogenesis via sinusoidal thrombosis and mechanical forces
Chronic hepatic congestion leads to sinusoidal thrombosis and strain, which in turn promote hepatic fibrosis.
Non-RCT
Animal Study
Rigorous Journal
Highly CitedChronic nasal congestion
Chronic nasal congestion can lead to sleep-disordered breathing, reduced sleep time, and daytime sleepiness, especially in infants.
Multimodal Strategies for the Diagnosis and Management of Refractory Congestion. An Integrated Cardiorenal Approach
An integrated multimodal diagnostic algorithm using biomarkers and ultrasound can improve diagnosis and management of refractory congestion in heart failure patients.
Literature ReviewPersistent congestion, renal dysfunction and inflammatory cytokines in acute heart failure: a prognosis study
In patients with acute heart failure, persistent congestion and chronic kidney dysfunction are associated with increased cytokine levels, which may also impact the outcome.
Observational StudyThe Histological Alterations of the Pancreas in Chronic Passive Congestion.
Chronic passive congestion in the pancreas can cause significant histological changes, but its role in chronic pancreatitis remains unresolved.
Prognostic Significance of Longitudinal Clinical Congestion Pattern in Chronic Heart Failure: Insights From TIME-CHF Trial.
Longitudinal clinical congestion in chronic heart failure patients is associated with poor outcomes, emphasizing the importance of appropriate decongestion.
Observational StudyDynamic changes and prognostic value of pulmonary congestion by lung ultrasound in acute and chronic heart failure: a systematic review
Pulmonary congestion by lung ultrasound shows dynamic changes and has prognostic value in acute and chronic heart failure patients.
Systematic ReviewHighly CitedPulmonary Congestion in Chronic Heart Disease
Radiologic findings are a reliable measure of increased pulmonary congestion in chronic heart disease, while lung auscultation may not accurately correlate to pressures.
Observational StudyClinical value of pulmonary congestion detection by lung ultrasound in patients with chronic heart failure
Lung ultrasound can effectively detect pulmonary congestion in patients with chronic heart failure, potentially improving their quality of life and outcomes.
Literature Review
Very Rigorous JournalCongestion in heart failure: a circulating biomarker‐based perspective. A review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology
Circulating biomarkers can help assess and manage different fluid overload phenotypes in heart failure, aiding in fluid overload classification and management.
Literature ReviewHighly Cited