Author + information
- Received October 24, 2018
- Revision received February 6, 2019
- Accepted March 7, 2019
- Published online May 27, 2019.
- Peter van der Meer, MD, PhDa,∗,
- Hanna K. Gaggin, MD, MPHb,∗@HannaGaggin and
- G. William Dec, MDb,∗ (, )@MassGeneralNews
- aDepartment of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
- bCardiology Division, Massachusetts General Hospital, Boston, Massachusetts
- ↵∗Address for correspondence:
Dr. G. William Dec, Cardiology Division, Massachusetts General Hospital, Yawkey 5B, Boston, Massachusetts 02114.
• HF is a highly prevalent, progressive condition associated with substantial morbidity and mortality.
• Practice HF guidelines provide a contemporary, evidence-based approach to its diagnosis and management.
• Guideline recommendations from the American College of Cardiology and European Society of Cardiology for differing HF phenotypes have similarities and discordances.
• Although effective treatment options exist for HF with reduced ejection fraction, new therapies for HF with preserved ejection fraction and AHF are urgently needed.
The 2013 (with updates in 2016 and 2017) American College of Cardiology/American Heart Association and 2016 European Society of Cardiology guidelines provide practical evidence-based clinical guidelines for the diagnosis and treatment of both acute and chronic heart failure (HF). Both guidelines address noninvasive and invasive testing to establish the diagnosis of HF with reduced ejection fraction and HF with preserved ejection fraction. Extensive trial evidence supports the use of guideline-directed medical therapy and device-based therapies for the optimal management of patients with HF with reduced ejection fraction. Specific recommendations are also provided for HF with preserved ejection fraction although the evidence is substantially weaker. Management of medical comorbidities is now addressed in both guidelines. Acute HF and end-stage disease requiring advanced therapies are also discussed. This review compares specific recommendations across the spectrum of HF phenotypes and disease severity, highlights areas where differences exist, and lists consequential studies published since the latest guidelines.
↵∗ Drs. van der Meer and Gaggin contributed equally to this work.
Dr. Gaggin is supported in part by the Clark Fund for Cardiac Research Innovation. Dr. van der Meer has served on the Speakers Bureau for Novartis, Vifor Pharma, Boston Scientific, and AstraZeneca; and has received research grant support from AstraZeneca, Corvidia, Ionis, and Vifor Pharma. Dr. Gaggin has received research grant support from Roche Diagnostics, Jana Care, Novartis, and Ortho Clinical; has received consulting income from Roche Diagnostics and Merck; and has received research payments for clinical endpoint committees from Radiometer. Dr. Dec has reported that he has no relationships relevant to the contents of this paper to disclose. Michele Hamilton, MD, served as Guest Associate Editor and P.K. Shah, MD, served as Guest Editor-in-Chief for this paper.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received October 24, 2018.
- Revision received February 6, 2019.
- Accepted March 7, 2019.
- 2019 American College of Cardiology Foundation
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