2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

McDonagh, Theresa A.; Metra, Marco; Adamo, Marianna; Gardner, Roy S.; Baumbach, Andreas; Böhm, Michael; Burri, Haran; Butler, Javed; Čelutkienė, Jelena; Chioncel, Ovidiu; Cleland, John G.F.; Coats, Andrew J.S.; Crespo‐Leiro, María G.; Farmakis, Dimitrios; Gilard, Martine; Heymans, Stéphane; Hoes, Arno W.; Jaarsma, Tiny; Jankowska, Ewa A.; Lainščak, Mitja; Lam, Carolyn S.P.; Lyon, Alexander R.; McMurray, John J.V.; Mebazaa, Alexandre; Mindham, Richard; Muneretto, Claudio; Piepoli, Massimo F; Price, Susanna; Rosano, Giuseppe; Ruschitzka, Frank; Skibelund, Anne Kathrine

doi:10.1093/eurheartj/ehab368

Cited by 7,083 publications

(6,968 citation statements)

References 984 publications

Supporting

Mentioning

5,385

Contrasting

Unclassified

401

Order By: Relevance

“…Por otro lado, aproximadamente la mitad de pacientes con FC poseen fracción de eyección preservada (FCFEVIp), su diagnóstico está basado en el uso de parámetros no invasivos; sin embargo, según la nueva guía 2021 de FC de la ESC, la prueba confirmatoria diagnóstica consiste en la evaluación invasiva de la PCP al reposo( >15 mmHg) y al ejercicio(> 25 mmHg), aunque su uso es limitado y no posee una indicación rutinaria, el CAP ofrece un beneficio relevante cuando los marcadores no invasivos aportan una baja sensibilidad diagnóstica; además, cumple una función importante en el planteamiento de diagnósticos diferenciales, así como información adicional sobre las posibles entidades causantes de FCFEp (42,43) . El monitoreo hemodinámico al esfuerzo es útil ya que evalúa directamente la variabilidad de presiones, y aporta un valor predictivo al calcular la pendiente PCP/GC.…”

Section: Falla Cardiacaunclassified

“…Según la ESC el CAP es el gold standard para confirmar el diagnóstico de HTP pues permite definir el perfil hemodinámico, la severidad, clasificación y el planteamiento de diagnósticos diferenciales (43) . Así mismo, permite realizar evaluaciones adicionales como la prueba de vasorreactividad o el monitoreo hemodinámico al esfuerzo, parámetros con gran relevancia durante la valoración del pronóstico, la orientación terapéutica y la respuesta a la misma.…”

Section: Hipertensión Pulmonarunclassified

See 1 more Smart Citation

Monitoreo hemodinámico invasivo por catéter de arteria pulmonar Swan-Ganz: conceptos y utilidad

Rueda¹,

Gonzalez²,

Cachi³

et al. 2021

Arch Peru Cardiol Cir Cardiovasc

View full text Add to dashboard Cite

Desde sus inicios en el siglo pasado, el cateterismo de arteria pulmonar (CAP) ha ido evolucionando hasta ser una técnica de evaluación hemodinámica invasiva que puede realizarse en la cama del paciente a través de un catéter Swan-Ganz; este procedimiento ha mantenido un curso intermitente en cuanto a su uso; no obstante, actualmente ha demostrado relevancia en escenarios específicos. El CAP permite el acceso a la circulación venosa central, el corazón derecho y la arteria pulmonar; realiza el cálculo de variables hemodinámicas de manera directa o indirecta mediante fórmulas y métodos establecidos. Esto hace posible realizar una evaluación y clasificación hemodinámica adecuada, realizar pruebas específicas (p. ej. prueba de vasorreactividad), que ayudan a definir el diagnóstico, la conducta terapéutica, monitorizar la respuesta al tratamiento, la evaluación previa a terapias avanzadas (p. ej. el trasplante cardiaco o dispositivos de asistencia circulatoria mecánica), y el pronóstico en los pacientes. En este artículo profundizamos sobre los conceptos y la utilidad del cateter de arteria pulmonar.

show abstract

Section: Falla Cardiacaunclassified

Section: Hipertensión Pulmonarunclassified

Monitoreo hemodinámico invasivo por catéter de arteria pulmonar Swan-Ganz: conceptos y utilidad

Rueda¹,

Gonzalez²,

Cachi³

et al. 2021

Arch Peru Cardiol Cir Cardiovasc

View full text Add to dashboard Cite

show abstract

“…[1] In subjects with secondary prevention of SCD, where no reversible cause such as an acute myocardial infarction can be identified, an implantable cardioverter defibrillator (ICD) is recommended with a class IA indication according to European Society of Cardiology (ESC) guidelines. [2,3] The situation is more complex in patients with ICD therapy for the primary prevention of SCD. In the new 2021 ESC Heart Failure Guidelines, primary prevention of SCD in patients with symptomatic systolic non-ischemic heart failure was downgraded from a 1B recommendation class in the 2016 ESC Heart Failure Guidelines, to a IIaB recommendation, as opposed to the class 1A recommendation for patients with ischemic heart failure, which remained a constant indication.…”

Section: Introductionmentioning

confidence: 99%

“…In the new 2021 ESC Heart Failure Guidelines, primary prevention of SCD in patients with symptomatic systolic non-ischemic heart failure was downgraded from a 1B recommendation class in the 2016 ESC Heart Failure Guidelines, to a IIaB recommendation, as opposed to the class 1A recommendation for patients with ischemic heart failure, which remained a constant indication. [2,3] In the American Heart Association Guidelines, on the other hand, ICD implantation for primary prevention of SCD in patients with symptomatic systolic heart failure is a class 1A recommendation, with no differentiation between patients with ischemic and non-ischemic cardiomyopathy. [4] This difference arises from the trials on which the guidelines are based: while the American Heart Association Guidelines refer to the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) trial, the 2016 European Guidelines consider the Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE), while the latest ESC Guidelines version grounds its recommendations on DANISH study.…”

Section: Introductionmentioning

confidence: 99%

Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death

Ursaru¹,

Costache²,

Petris³

et al. 2021

Preprint

View full text Add to dashboard Cite

(1) Background: In patients suffering from heart failure, the main causes of death are either he-modynamic failure, or ventricular arrhythmias. The only tool to significantly reduce arrhythmic sudden death is the implantable cardioverter defibrillator (ICD), but not all patients benefit to the same extend of these devices. (2) Methods: The primary outcome of this single center study was defined as cardiovascular death in patients with ischemic and non-ischemic heart failure who have benefited from ICD therapy. The secondary outcomes were death from any cause, sudden cardiac death, ICD-related therapies (appropriate antitachycardia pacing or shock therapy for ventricular tachycardia or fi-brillation) and recurrences of ventricular tachyarrhythmias. (3) Results: A total of 403 consecutive ICD recipients – symptomatic heart failure patients with ICD for the primary prevention of sudden cardiac death – were included retrospectively: 59% is-chemic cardiomyopathy (ICMP) and 41% non-ischemic cardiomyopathy (NICMP). Within a median follow-up period of 36 months, the incidence of cardiovascular mortality was not signif-icantly different in patients with NICMP and ICMP: the primary outcome had occurred in 9 pa-tients (5.4%) in the NICMP group and in 14 patients (5.9%) in the ICMP group (hazard ratio 1; 95%confidence interval [CI] 0.45 to 2.28; p =0.97). All-cause mortality occurred in 14 of 166 pa-tients (8.4%) in NICMP group and 18 of 237 patients (7.6%) in ICMP group. Sudden cardiac death occurred in 2 patients (1.2%) in the NICMP group and in 4 patients (1.7%) in the ICMP group (hazard ratio 0.71; 95% CI, 0.13 to 3.88; P=0.69). The rate of appropriate device therapies was comparable in both groups. (4) Conclusion: In this study, ICD implantation for primary prevention of sudden cardiac death in patients with symptomatic systolic heart failure was associated with similar rates of cardiovas-cular and all-cause mortality in patients with ischemic heart disease, and in patients with heart failure from other causes. NICMP and ICMP showed comparable rates of recurrent ventricular tachyarrhythmias and appropriate ICD therapies.

show abstract

“…The percentage of population having HF in 2012 was 2.4% but it is assumed to increase to 3% in 2030. Guideline from European Society of Cardiology (ESC) for the diagnosis and treatment of acute and chronic HF was released recently (2). The prevention side of HF management was covered as providing a general advice.…”

mentioning

confidence: 99%

New in the diagnosis of heart failure and management of associated conditions in 2021 ESC guidelines

Baysan¹,

Akyıldız²,

Ivaniv³

2021

HVT

View full text Add to dashboard Cite

2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Cited by 7,083 publications

References 984 publications

Monitoreo hemodinámico invasivo por catéter de arteria pulmonar Swan-Ganz: conceptos y utilidad

Monitoreo hemodinámico invasivo por catéter de arteria pulmonar Swan-Ganz: conceptos y utilidad

Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death

New in the diagnosis of heart failure and management of associated conditions in 2021 ESC guidelines

Contact Info

Product

Resources

About