Table 8

Recommendations for Treatment of Patients With Heart Failure and Normal Left Ventricular Ejection Fraction

RecommendationClassLevel of Evidence
Physicians should control systolic and diastolic hypertension, in accordance with published guidelines.IA
Physicians should control ventricular rate in patients with atrial fibrillation.IC
Physicians should use diuretics to control pulmonary congestion and peripheral edema.IC
Physicians might recommend coronary revascularization in patients with coronary artery disease in whom symptomatic or demonstrable myocardial ischemia is judged to be having an adverse effect on cardiac function.IIaC
Restoration and maintenance of sinus rhythm in patients with atrial fibrillation might be useful to improve symptoms.IIbC
The use of beta-adrenergic blocking agents, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, or calcium antagonists in patients with controlled hypertension might be effective to minimize symptoms of heart failure.IIbC
The use of digitalis to minimize symptoms of heart failure might be considered.IIbC