glossary of terms and definitions

adHF/adCHF - Acute decompensated heart failure. See Congestive Heart Failure and Compensated/Decompensated.

American Heart Association (AHA) - an organization whose mission is to fight heart disease and stroke. Additional information is available on AHAs Web site at www.americanheart.org.

Angiotensin Converting Enzyme (ACE) inhibitors - medications which keep blood vessels open, decrease blood pressure and lower the amount of salt and water in the body. ACE inhibitors block the enzyme in the body that is responsible for causing blood vessels to narrow.

Aquadex FlexFlow™ - CHF Solutions system that allows AquapheresisTM therapy to be delivered in a diverse range of clinical settings by various clinical specialists. Primary components include an electromechanical console and a single-use, disposable blood circuit.

Aquapheresis™ - safe, convenient, and predictable salt and water removal from patients with fluid overload delivered by the Aquadex FlexFlow system.

Arrhythmia - a disturbance in the normal rate and rhythm of the heart.

Ascites - abnormal accumulation of fluid (edema) in the abdominal cavity.

Beta-blockers - medications that relax the heart and reduce the vigor of its contractions. Recent studies have indicated that treatment with beta-blockers in certain congestive heart failure patients can reduce future hospitalizations.

Chasing K/Pushing K - colloquial phrases physicians use referring to the need to prescribe potassium, or K, supplements in an attempt to deal with the frequent potassium imbalances caused by diuretic therapy.

Compensated/Decompensated - terms used with CHF to describe the current condition of the patient the result of physiological adaptations that may help heart function maintain near normal performance (compensated). If these adaptations can no longer maintain near normal performance either acutely or chronically, then the heart failure is described as decompensated.

Congestive heart failure (CHF) - the state in which ineffective pumping of the heart results in a buildup of fluid in the lungs and elsewhere in the body. It does not mean the heart has stopped working altogether. Different diseases can cause the condition, including coronary artery disease, heart attacks and diseased heart valves. Common warning signs and symptoms include: fatigue, shortness of breath, and swelling or pain in the abdomen or lower limbs. Also referred to as heart failure.

Diuretics - medications which help the body eliminate excess sodium and water. By decreasing the amount of salt and fluid in the body, diuretics can reduce congestive heart failure symptoms, such as shortness of breath and swelling of the lower limbs. Administered orally or intravenously.

Dyspnea - shortness of breath, difficult or labored breathing.

Edema - the accumulation of fluid in parts of the body. Edema in the lower limbs causes swelling in the legs, ankles and/or feet and is referred to as peripheral edema. See also ascites.

Electrolyte - any of a number of substances that dissociate into ions in solution and are important to biological functioning. Common electrolytes found in blood are sodium, potassium, chloride, calcium and phosphate.

EUPHORIA - Prospective clinical trial that tested if aquapheresis before any IV D in PTS with decompensated HF and diuretic resistance reestablishes euvolemia and permits HOSP discharge in 3 days. Stands for Early Ultrafiltration Therapy in Patients with Decompensated Heart Failure and Observed Resistance to Intervention with Diuretic Agents

Euvolemia - a normal or balanced patient fluid status.

Flogging the heart - physicians colloquial phrase referring to prescribing inotropic drugs.

Flogging the kidneys - colloquial phrase physicians use for prescribing increasing doses of diuretics.

Fluid - the isotonic plasma water removed by ultrafiltration or Aquapheresis. Also referred to as ultrafiltrate.

Fluid management - giving or removing fluid from a patient - usually with the goal of achieving euvolemia or normal fluid status.

Fluid Overload/Volume Overload/Hypervolemia - an abnormal patient fluid status in which excess fluid is stored throughout the body, causing edema. Begins with an accumulation of sodium in the patient.

Heart Failure Society of America (HFSA) - an organization that provides a forum for all those interested in heart function, heart failure and congestive heart failure research and patient care. HFSA promotes research related to all aspects of heart failure, educates physicians, enhances the quality and duration of life for individuals with heart failure, and promotes and facilitates the training of physicians, scientists and allied health care providers in the field of heart failure. More information is available at www.hfsa.org.

Heart failure (HF) - see Congestive heart failure (CHF).

Heart rhythm - the coordinated rhythmic pattern of electrical activity and/or muscle contractions in the heart.

Hematocrit (Hct) - the percentage of red blood cells in whole blood. A measure of the solid portion of the blood. Its complement is (1-Hct) which is a measure of the liquid or plasma portion of the blood.

Hemodialysis - circulating a patients blood through a machine with a filter or semipermeable membrane to remove toxins and/or excess fluids.

Hemofiltration - a type of filtration in which excess fluids are removed from the blood.

Hyper - prefix meaning high.

Hypo - prefix meaning low.

Hypotension - low blood pressure. Hypotension can occur if large amounts of fluid are removed from the blood vessels too quickly during dialysis or blood filtering. Hypotension symptoms can include a fast pulse, dizziness, nausea, vomiting and fainting.

Inotropic drugs - medications, such as digitalis, which stimulate the heart to expel more blood with each beat. Such drugs can increase blood flow throughout the body and reduce swelling in hands and ankles.

Intubation - the process of inserting a breathing tube through the mouth, nose or into the trachea to ensure an unobstructed airway to deliver anesthetic gases and oxygen.

Isotonic - having the same salt concentration as the normal cells of the body and the blood.

Loop diuretics - a type of diuretic drug (e.g., furosemide, Lasix) administered through an I.V. that acts by inhibiting reabsorption of sodium and chloride, not only in the proximal and distal tubules but also in Henle's loop of the kidney.

Plasma - the liquid part of the blood and lymphatic fluid. Composed primarily of water, antibodies and other proteins.

RAPID - Randomized, multicenter clinical trial that tested if patients hospitalized for CHF treated with a single, 8 hour UF session in addition to best medical therapy will achieve greater weight loss 24 hours after enrollment compared to pts receiving best medical therapy alone. Stands for Randomized Controlled Trial of Ultrafiltration Versus Usual Care for Hospitalized Patients with Heart Failure.

Ultrafiltrate - see Fluid.

Ultrafiltration (UF) - the process of removing water from the blood by exerting positive or negative pressure on the blood during treatment with a dialysis machine or similar filtration device, such as the CHF Solutions Aquadex FlexFlow.

UNLOAD - Randomized, multicenter clinical trial equally randomized to UF alone or IV diuretics (Control). Stands for UltrafiltratioN versus IV Diuretics for Patients HospitaLized for Acute Decompensated Congestive Heart Failure: A Prospective Randomized Clinical Trial. Enrollment complete in July 2005, publications expected in early 2006.

Vasodilator drugs - medications, such as nitroglycerin or nesiritide (Natrecor®), which cause blood vessels to expand, thereby increasing blood flow.