|1. New onset HF (regardless of EF) for evaluation of etiology, guideline-directed evaluation and management of recommended therapies, and assistance in disease management.|
|2. Chronic HF with high-risk features, such as development of 1 or more of the following risk factors:|
|3. To assist with management of GDMT, including replacement of ACEI or ARB therapy with ARNI for eligible patients, or to address comorbid conditions such as chronic renal disease or hyperkalemia, which may complicate treatment.|
|4. Persistently reduced LVEF ≤35% despite GDMT for ≥3 months for consideration of device therapy in those patients without prior placement of ICD or CRT, unless device therapy contraindicated.|
|5. Second opinion regarding etiology of HF; for example:|
|6. Annual review for patients with established advanced HF in which patients/caregivers and clinicians discuss current and potential therapies for both anticipated and unanticipated events, possible HF disease trajectory and prognosis, patient preferences, and advanced care planning.|
|7. Assess the possibility of participation in a clinical trial.|
ACEI = angiotensin converting enzyme inhibitors; ARB = angiotensin receptor blockers; ARNI = angiotensin receptor-neprilysin inhibitor; BNP = B-type natriuretic peptide; BUN = blood urea nitrogen; CRT = cardiac resynchronization therapy; EF = ejection fraction; GDMT = guideline-directed medical therapy; HF = heart failure; ICD = implantable cardioverter-defibrillator; LVEF = left ventricular ejection fraction; NT-proBNP = N-terminal pro–B-type natriuretic peptide; NYHA = New York Heart Association.