Heart Failure Society of America (Hfsa) Practice Guidelines

Adams, Kirkwood F.; Baughman, Kenneth L.; Dec, William G.; Elkayam, Uri; Forker, Alan D.; Gheorghiade, Mihai; Hermann, Denise D.; Konstam, Marvin A.; Liu, Peter; Massie, Barry M.; Patterson, J. Herbert; Silver, Marc A.; Stevenson, Lynne Warner; Cohn, Jay N.; Francis, Gary S.; Greenberg, Barry; Leier, Carl V.; Lorell, Beverly H.; Packer, Milton; Pitt, Bertram; Eh, Sonnenblick; Strobeck, John E.; Walsh, Richard A.; Yusuf, Salim

doi:10.1592/phco.20.6.495.35164

Cited by 78 publications

(20 citation statements)

References 122 publications

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“…weight of evidence from meta-analyses regarding the impact of such interventions on survival and hospitalization rates [11][12][13][14][15] has paved their way into current treatment guidelines, 7,8 although success has not been consistent throughout. 16 -18 Recommendations regarding basic elements of DMP have been published, 7,8,19 but prediction of efficacy has remained difficult.…”

Section: Clinical Perspective On P 35mentioning

confidence: 99%

“…16 -18 Recommendations regarding basic elements of DMP have been published, 7,8,19 but prediction of efficacy has remained difficult. Intervention details are usually not provided, which limits reproducibility, and performance characteristics of DMP in individual subjects have never been reported in detail.…”

Section: Clinical Perspective On P 35mentioning

confidence: 99%

“…Although multiple drug-and device-related therapies have improved outcomes, the prognosis of heart failure patients has remained grim. [1][2][3] Large surveys from Europe 4,5 and the United States 6 indicate that implementation of evidence-based therapies 7,8 is fragmentary, although guideline adherence improves survival. 9 Multidisciplinary disease management programs (DMP) may bridge the gap between existing therapeutic options and the realities of clinical practice.…”

mentioning

confidence: 99%

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Mode of Action and Effects of Standardized Collaborative Disease Management on Mortality and Morbidity in Patients With Systolic Heart Failure

Angermann

Störk²,

Gelbrich³

et al. 2012

Circ: Heart Failure

216

174

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Background— Trials investigating efficacy of disease management programs (DMP) in heart failure reported contradictory results. Features rendering specific interventions successful are often ill defined. We evaluated the mode of action and effects of a nurse-coordinated DMP (HeartNetCare-HF, HNC). Methods and Results— Patients hospitalized for systolic heart failure were randomly assigned to HNC or usual care (UC). Besides telephone-based monitoring and education, HNC addressed individual problems raised by patients, pursued networking of health care providers and provided training for caregivers. End points were time to death or rehospitalization (combined primary), heart failure symptoms, and quality of life (SF-36). Of 1007 consecutive patients, 715 were randomly assigned (HNC: n=352; UC: n=363; age, 69±12 years; 29% female; 40% New York Heart Association class III-IV). Within 180 days, 130 HNC and 137 UC patients reached the primary end point (hazard ratio, 1.02; 95% confidence interval, 0.81–1.30; P =0.89), since more HNC patients were readmitted. Overall, 32 HNC and 52 UC patients died (1 UC patient and 4 HNC patients after dropout); thus, uncensored hazard ratio was 0.62 (0.40–0.96; P =0.03). HNC patients improved more regarding New York Heart Association class ( P =0.05), physical functioning ( P =0.03), and physical health component ( P =0.03). Except for HNC, health care utilization was comparable between groups. However, HNC patients requested counseling for noncardiac problems even more frequently than for cardiovascular or heart-failure–related issues. Conclusions— The primary end point of this study was neutral. However, mortality risk and surrogates of well-being improved significantly. Quantitative assessment of patient requirements suggested that besides (tele)monitoring individualized care considering also noncardiac problems should be integrated in efforts to achieve more sustainable improvement in heart failure outcomes. Clinical Trial Registration— URL: http://www.controlled-trials.com . Unique identifier: ISRCTN23325295.

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Section: Clinical Perspective On P 35mentioning

confidence: 99%

Section: Clinical Perspective On P 35mentioning

confidence: 99%

mentioning

confidence: 99%

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Mode of Action and Effects of Standardized Collaborative Disease Management on Mortality and Morbidity in Patients With Systolic Heart Failure

Angermann

Störk²,

Gelbrich³

et al. 2012

Circ: Heart Failure

216

174

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“…4,6 Because she shows evidence of volume overload, diuretics will represent an important early component of treatment, and her acute exacerbation should push us toward initial use of a loop diuretic instead of a thiazide. An angiotensin-converting enzyme (ACE) inhibitor, however, should be initiated early, before excessive diuresis.…”

Section: Specific Drug Recommendationsmentioning

confidence: 99%

Contemporary Medical Options for Treating Patients With Heart Failure

Konstam

Mann²

2002

Circulation

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ase study: A 72-year-old woman presented with shortness of breath. Three months earlier, she had begun to notice dyspnea on exertion. This dyspnea progressed to the point that she noted dyspnea at rest in the 24 hours before presentation. She had a history of long-standing mild hypertension, treated with a calcium-channel antagonist, and type 2 diabetes. She denied chest pain, lightheadedness, and abdominal or ankle swelling, although she believed that she had gained between 5 and 10 pounds in recent weeks. On examination, she had a blood pressure of 150/90 mm Hg, a regular pulse at a rate of 90 min Ϫ1 , jugular venous pressure of about 8 cm water, faint bibasilar crackles, a prominent and displaced apical impulse, and a summation gallop, with no murmurs, no organomegaly, or ascites, but with 1ϩ ankle edema. Laboratory findings were notable for a creatinine level of 2.0 mg/dL, a random blood sugar level of 220 mg/dL, and proteinuria (protein:creatinineϭ400 mg/g). Her ECG showed sinus rhythm, left atrial enlargement, left ventricular hypertrophy (LVH), Q waves in the inferior leads, and inferolateral ST-and T-wave changes. The ECG findings were unchanged, except for a heart rate that had increased from a tracing taken 6 months earlier. Her chest x-ray showed a mildly enlarged cardiac silhouette and questionable evidence of pulmonary venous congestion. An echocardiogram showed a moderately dilated left ventricle with increased wall thickness, inferobasilar akinesis, and an ejection fraction estimated between 30% and 35%.

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“…The pharmacological therapy with beta-blockers in these patients is consensual 22 and it influences the VO 2 peak values. The correct use of the medicationsoptimizes drugs therapy prescribed by assistant physician directly interferes with the obtained results, considering that its adequate use decreases mortality in patients with LV failure.…”

Section: Apneia Mansfield Et Almentioning

confidence: 99%