The European Society of Cardiology (ESC) recently released new guidelines for the diagnosis and treatment of acute and chronic heart failure. The new guidelines were developed in collaboration with the Heart Failure Association of the ESC and released during the Heart Failure Congress in Belgrade, Serbia, May 19-22. They update guidelines from 2008.
Highlights from the new guidelines include:
- Expansion of the indication for mineralocorticoid (aldosterone) receptor antagonists (MRAs);
- A new indication for the sinus node inhibitor ivabradine;
- Expansion of the indication for cardiac resynchronization therapy (CRT);
- New information on the role of coronary revascularization in heart failure; and
- Recognition of the growing use of ventricular assist devices.
The new guidelines also address the emergence of transcatheter valve interventions, and include overall changes to the structure and format of the guidelines to make them easier to understand and use. For example, therapeutic recommendations now state the treatment effect supported by the class and level of recommendation in tabular format. In the case of chronic heart failure due to left ventricular systolic dysfunction, the recommendations focus on mortality and morbidity outcomes.
Detailed summaries of the key evidence supporting generally recommended treatments are also available, and practical guidance is provided for the use of the more important disease-modifying drugs and diuretics.
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