Heart failure management guidelines: New recommendations and implementation
Why the study?
Heart failure prevalence is rising due to aging populations, alongside important advances in care and new recommendations from the recent ACC/AHA/HFSA Guideline.
Key Points
- The aim is to summarize new heart failure management guidelines and highlight recent advances in diagnosis and treatment.
- Review of the American College of Cardiology, American Heart Association, and Heart Failure Society of America guidelines.
- Inclusion of relevant studies published after the guideline release.
- Discussion of advancements in heart failure care including medical treatments and device implementation.
- New guidelines define heart failure more clearly and recommend therapies based on ejection fraction.
- Advancements in diagnosing and treating amyloidosis and iron deficiency are emphasized.
- Implementation tools for better management of heart failure are highlighted.
Design
Review
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“One primary goal with the new guideline was to use recently published data to update our recommendations for the evaluation and management of heart failure. One focus was prevention of heart failure through optimizing blood pressure control and adherence to a healthy lifestyle.”
MKMichelle KittlesonHeart failure specialist, Cedars-Sinai Smidt Heart Institute
“SGLT2 inhibitors, of course, burst onto the scene in the last 5 years. It's really becoming a cornerstone of care for patients with heart failure across the spectrum of ejection fraction.”
TMThomas M. MaddoxDirector, Healthcare Innovation Lab, Washington University
“What we realize now is that the more quickly we can get patients on all four of these drug classes and escalate to target doses or maximally tolerated doses ideally within 3 months, the better the outcome. Unfortunately, right now there is very incomplete realization and recognition of that in clinical practice.”
Implication
Guides clinicians to apply EF-based therapies plus amyloid/iron protocols now; reinforces 2022 ACC/AHA/HFSA recommendations with implementation tools.
Abstract
The prevalence of heart failure has increased in many developed countries including Japan and the USA, due in large part to the aging of their populations. The lifetime risk of heart failure is now 20-30 % in the USA. Fortunately, there have been important advances in therapy that increase quality and length of life for those with heart failure. This review discusses the important advances in care including treatment and diagnosis and the new recommendations for this care from the recent American College of Cardiology (ACC)/ American Heart Association (AHA)/ Heart Failure Society of America (HFSA) Guideline. Relevant studies that have been published since the guideline was released are also included. Of the many recommendations in the ACC/AHA/HFSA Guideline, this review focuses on the definition of heart failure, the medical treatments specific to left ventricular ejection fraction, use of devices for treatment and diagnosis, diagnosis and treatment of amyloidosis, treatment of iron deficiency, screening for asymptomatic left ventricular dysfunction, use of patient reported outcomes, and tools for implementation.
Discussion
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Cite This Study
Paul A. Heidenreich (2023) studied this question.