ESC/HFA Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2016

      ESC/HFA Guidelines for the diagnosis and treatment of acute and chronic heart failure (HF) 2016 summarize the state-of-the-art in management of heart failure. There are several new approaches in both diagnostic and therapeutic strategies in recognizing the most important practical issues relevant for long term outcome. These can be listed as follows: 1. New diagnostic algorithm allowing non-cardiologists (internal medicine specialist, or even general practitioner) to get closer to timely and proper HF diagnosis (the role of natriuretic peptides stressed for ruling out HF); 2. The role of echocardiography in defining the new entity, heart failure with mid-ranged ejection fraction (40–50%) (applies to 10–20% of HF patients, with potentially different treatment approaches); 3. Prevention/delaying HF onset strategies (treatment of arterial hypertension, hyperlipidemia, obesity, dysglicemia may have essential influence); 4. Pharmacological treatment of chronic HF with new therapeutic algorithm (the importance of angiotensin receptor neprilysin inhibitors highlighted); 5. The indications for use of implantable cardioverter defibrillators was reviewed and clear guidance regarding the implantation was defined; 6. The use of cardiac resynchronization therapy was clearly outlined in relation to LVEF, left bundle branch block and QRS duration. Other topics with new approaches include: 7. Treatment of heart failure with reduced ejection fraction (new treatment algorithm stressing the role of ARNI); 8. HF co-morbidities (the recent therapeutic benefits in area of diabetes, sleep apnea, anemia and iron deficiency and renal dyfunction); 9. Acute heart failure (introducing the concept of stratifying patients and CHAMP algorithm); 10. Multidisciplinary care.
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