European Heart Journal Advance Access originally published online on May 18, 2005
European Heart Journal 2005 26(11):1115-1140; doi:10.1093/eurheartj/ehi204
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org
Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005)
The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology
Authors/Task Force Members,* Corresponding author. Chairperson: Karl Swedberg, Sahlgrenska Academy at the Göteborg University, Department of Medicine, Sahlgrenska University Hospital Östra, SE-416 85 Göteborg, Sweden. Tel.: +46 31 3434078; fax: +46 31 258933. E-mail address: karl.swedberg@hjl.gu.se
ESC Committee for Practice Guidelines (CPG), Silvia G. Priori (Chairperson) (Italy), Jean-Jacques Blanc (France), Andrzej Budaj (Poland), John Camm (UK), Veronica Dean (France), Jaap Deckers (The Netherlands), Kenneth Dickstein (Norway), John Lekakis (Greece), Keith McGregor (France), Marco Metra (Italy), João Morais (Portugal), Ady Osterspey (Germany), Juan Tamargo (Spain), José Luis Zamorano (Spain)
Document Reviewers, Marco Metra (CPG Review Coordinator) (Italy), Michael Böhm (Germany), Alain Cohen-Solal (France), Martin Cowie (UK), Ulf Dahlström (Sweden), Kenneth Dickstein (Norway), Gerasimos S. Filippatos (Greece), Edoardo Gronda (Italy), Richard Hobbs (UK), John K. Kjekshus (Norway), John McMurray (UK), Lars Rydén (Sweden), Gianfranco Sinagra (Italy), Juan Tamargo (Spain), Michal Tendera (Poland), Dirk van Veldhuisen (The Netherlands), Faiez Zannad (France)
| The first 150 words of the full text of this article appear below. |
Preamble
Guidelines and Expert Consensus Documents aim to present all the relevant evidence on a particular issue in order to help physicians to weigh the benefits and risks of a particular diagnostic or therapeutic procedure. They should be helpful in everyday clinical decision-making.
A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) and by different organizations and other related societies. This profusion can put at stake the authority and validity of guidelines, which can only be guaranteed if they have been developed by an unquestionable decision-making process. This is one of the reasons why the ESC and others have issued recommendations for formulating and issuing Guidelines and Expert Consensus Documents.
In spite of the fact that standards for issuing good quality Guidelines and Expert Consensus Documents are well defined, recent surveys of Guidelines and Expert Consensus Documents published
Diagnosis of chronic heart failure
Introduction
Methodology
Epidemiology
Descriptive terms in heart failure
Acute vs. chronic heart failure
Systolic vs. diastolic heart failure
Other descriptive terms in heart failure
Definition of chronic heart failure
Aspects of the pathophysiology of the symptoms of heart failure relevant to diagnosis
Possible methods for the diagnosis of heart failure in clinical practice
Symptoms and signs in the diagnosis of heart failure
Symptoms and the severity of heart failure
Electrocardiogram
The chest X-ray
Haematology and biochemistry
Natriuretic peptides
Echocardiography
Assessment of LV diastolic function
Diagnostic criteria of diastolic dysfunction
Additional non-invasive tests to be considered
Cardiac magnetic resonance imaging (CMR)
Pulmonary function
Exercise testing
Invasive investigation
Cardiac catheterization
Tests of neuroendocrine evaluations other than natriuretic peptides
Holter electrocardiography: ambulatory ECG and long-time ECG recording (LTER)
Requirements for the diagnosis of heart failure in clinical practice
Prognostication
Treatment of heart failure
Aims of treatment in heart failure
Prevention of heart failure
Management of chronic heart failure
Non-pharmacological management
General advice and measures
Educating patients and family
Weight monitoring
Dietary measures
Sodium
Fluids
Alcohol
Obesity
Abnormal weight loss
Smoking
Travelling
Sexual activity
Advice on immunizations
Drug counselling
Drugs to avoid or beware
Rest, exercise, and exercise training
Rest
Exercise
Pharmacological therapy
Angiotensin-converting enzyme inhibitors
ACE-inhibitors in asymptomatic left ventricular dysfunction
ACE-inhibitors in symptomatic heart failure
Diuretics
Loop diuretics, thiazides, and metolazone
Potassium-sparing diuretics
Beta-adrenoceptor antagonists
Initiation of therapy
Aldosterone receptor antagonists
Angiotensin II receptor blockers
Dosing
Cardiac glycosides
Digoxin
Vasodilator agents in chronic heart failure
Hydralazine-isosorbide dinitrate
Nitrates
Alpha-adrenergic blocking drugs
Calcium antagonists
Nesiritide
Positive inotropic therapy
Anti-thrombotic agents
Anti-arrhythmics
Class I anti-arrhythmics
Class II anti-arrhythmics
Class III anti-arrhythmics
Oxygen therapy
Surgery and devices
Revascularization procedures, mitral valve surgery, and ventricular restoration
Revascularization
Mitral valve surgery
Left ventricular restoration
LV aneurysmectomy
Cardiomyoplasty
Partial left ventriculectomy (Batista operation)
External ventricular restoration
Pacemakers
Implantable cardioverter defibrillators
Heart replacement therapies: heart transplantation, ventricular assist devices, and artificial heart
Heart transplantation
Ventricular assist devices and artificial heart
Ultrafiltration
Choice and timing of pharmacological therapy
Asymptomatic left ventricular systolic dysfunction
Symptomatic left ventricular systolic dysfunction: heart failure NYHA class II (Figure 4)
Without signs of fluid retention
With signs of fluid retention
Worsening heart failure (Figure 3)
End-stage heart failure (patients who persist in NYHA IV despite optimal treatment and proper diagnosis (Figure 4)
Management of heart failure with preserved left ventricular ejection fraction
Pharmacological therapy of heart failure with PLVEF or diastolic dysfunction
Heart failure treatment in the elderly
ACE-inhibitors and ARBs
Diuretic therapy
Beta-blockers
Cardiac glycosides
Vasodilator agents
Arrhythmias
Ventricular arrhythmias
Atrial fibrillation
Symptomatic systolic left ventricular dysfunction and concomitant angina or hypertension
Care and follow-up
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. M. Ferreira, P. Adragao, D. M. Cavaco, R. Candeias, F. B. Morgado, K. R. Santos, E. Santos, and J. A. Silva Benefit of cardiac resynchronization therapy in atrial fibrillation patients vs. patients in sinus rhythm: the role of atrioventricular junction ablation Europace, July 1, 2008; 10(7): 809 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Mandysova, T. Mraz, M. Taborsky, and P. Niederle Reproducibility of tissue Doppler parameters of asynchrony in patients with advanced LV dysfunction Eur J Echocardiogr, July 1, 2008; 9(4): 509 - 515. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Donal, C. De Place, G. Kervio, F. Bauer, R. Gervais, C. Leclercq, P. Mabo, and J.-C. Daubert Mitral regurgitation in dilated cardiomyopathy: value of both regional left ventricular contractility and dyssynchrony Eur J Echocardiogr, June 26, 2008; (2008) jen188v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Suskin, A. Pipe, and P. Prior Smokers paradox or not in heart failure. Just quit Eur. Heart J., June 12, 2008; (2008) ehn275v1. [Full Text] [PDF]
|
|
|
|
|
|
A. Ciszewski, Z. T. Bilinska, L. B. Brydak, C. Kepka, M. Kruk, M. Romanowska, E. Ksiezycka, J. Przyluski, W. Piotrowski, R. Maczynska, et al. Influenza vaccination in secondary prevention from coronary ischaemic events in coronary artery disease: FLUCAD study Eur. Heart J., June 1, 2008; 29(11): 1350 - 1358. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Chung, A. R. Leon, L. Tavazzi, J.-P. Sun, P. Nihoyannopoulos, J. Merlino, W. T. Abraham, S. Ghio, C. Leclercq, J. J. Bax, et al. Results of the Predictors of Response to CRT (PROSPECT) Trial Circulation, May 20, 2008; 117(20): 2608 - 2616. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. C. Fonarow, W. T. Abraham, N. M. Albert, W. G. Stough, M. Gheorghiade, B. H. Greenberg, C. M. O'Connor, E. Nunez, C. W. Yancy, and J. B. Young A smoker's paradox in patients hospitalized for heart failure: findings from OPTIMIZE-HF Eur. Heart J., May 15, 2008; (2008) ehn210v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. J. Verberne, L. M. Brewster, G. A. Somsen, and B. L.F. van Eck-Smit Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: a systematic review Eur. Heart J., May 1, 2008; 29(9): 1147 - 1159. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hammerer-Lercher, B. Halfinger, B. Sarg, J. Mair, B. Puschendorf, A. Griesmacher, N. A. Guzman, and H. H. Lindner Analysis of Circulating Forms of proBNP and NT-proBNP in Patients with Severe Heart Failure Clin. Chem., May 1, 2008; 54(5): 858 - 865. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Westermann, M. Kasner, P. Steendijk, F. Spillmann, A. Riad, K. Weitmann, W. Hoffmann, W. Poller, M. Pauschinger, H.-P. Schultheiss, et al. Role of Left Ventricular Stiffness in Heart Failure With Normal Ejection Fraction Circulation, April 22, 2008; 117(16): 2051 - 2060. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Anderson, C. Miyazaki, G. R. Sutherland, and J. K. Oh Patient Selection and Echocardiographic Assessment of Dyssynchrony in Cardiac Resynchronization Therapy Circulation, April 15, 2008; 117(15): 2009 - 2023. [Full Text] [PDF]
|
|
|
|
|
|
I. Squire Assessing prognosis in heart failure: you can see a lot if you look, but more if you look again ... ... ... Eur. Heart J., April 2, 2008; 29(8): 959 - 960. [Full Text] [PDF]
|
|
|
|
|
|
I. Garcia-Bolao, B. Lopez, A. Macias, J. J. Gavira, P. Azcarate, and J. Diez Impact of collagen type I turnover on the long-term response to cardiac resynchronization therapy Eur. Heart J., April 1, 2008; 29(7): 898 - 906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Torabi, J. G.F. Cleland, N. K. Khan, P. H. Loh, A. L. Clark, F. Alamgir, J. L. Caplin, A. S. Rigby, and K. Goode The timing of development and subsequent clinical course of heart failure after a myocardial infarction Eur. Heart J., April 1, 2008; 29(7): 859 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Brunner-La Rocca Do we understand why the heart fails? Eur. Heart J., March 2, 2008; 29(6): 698 - 700. [Full Text] [PDF]
|
|
|
|
|
|
J. Abdulla, L. Kober, S. Z. Abildstrom, E. Christensen, W. P. T. James, and C. Torp-Pedersen Impact of obesity as a mortality predictor in high-risk patients with myocardial infarction or chronic heart failure: a pooled analysis of five registries Eur. Heart J., March 1, 2008; 29(5): 594 - 601. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Quesada, G. Botto, A. Erdogan, M. Kozak, P. Lercher, J. C. Nielsen, O. Piot, R. Ricci, C. Weiss, D. Becker, et al. Managed ventricular pacing vs. conventional dual-chamber pacing for elective replacements: the PreFER MVP study: clinical background, rationale, and design Europace, March 1, 2008; 10(3): 321 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M J Lenzen, A Rosengren, W J M S. op Reimer, F Follath, E Boersma, M L Simoons, J G F Cleland, and M Komajda Management of patients with heart failure in clinical practice: differences between men and women Heart, March 1, 2008; 94(3): e10 - e10. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J G F Cleland, N Freemantle, J-C Daubert, W D Toff, F Leisch, and L Tavazzi Long-term effect of cardiac resynchronisation in patients reporting mild symptoms of heart failure: a report from the CARE-HF study Heart, March 1, 2008; 94(3): 278 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-M. Tartiere, D. Logeart, L. Tartiere-Kesri, and A. Cohen-Solal Colour tissue Doppler underestimates myocardial velocity as compared to spectral tissue Doppler: Poor reliability between both methods Eur J Echocardiogr, March 1, 2008; 9(2): 268 - 272. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Jaarsma, M. H. L. van der Wal, I. Lesman-Leegte, M.-L. Luttik, J. Hogenhuis, N. J. Veeger, R. Sanderman, A. W. Hoes, W. H. van Gilst, D. J. A. Lok, et al. Effect of Moderate or Intensive Disease Management Program on Outcome in Patients With Heart Failure: Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) Arch Intern Med, February 11, 2008; 168(3): 316 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Marcassa, J. J. Bax, F. Bengel, B. Hesse, C. L. Petersen, E. Reyes, R. Underwood, and on behalf of the European Council of Nuclear Cardi Clinical value, cost-effectiveness, and safety of myocardial perfusion scintigraphy: a position statement Eur. Heart J., February 2, 2008; 29(4): 557 - 563. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B. Young, W. T. Abraham, R. C. Bourge, M. A. Konstam, and L. W. Stevenson Task Force 8: Training in Heart Failure: Endorsed by the Heart Failure Society of America J. Am. Coll. Cardiol., January 22, 2008; 51(3): 383 - 389. [Full Text] [PDF]
|
|
|
|
 |
|
 L. M. Fabbri, F. Luppi, B. Beghe, and K. F. Rabe Complex chronic comorbidities of COPD Eur. Respir. J., January 1, 2008; 31(1): 204 - 212. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Leclercq Upgrading from right ventricular pacing to biventricular pacing in pacemaker patients with chronic heart failure Heart, January 1, 2008; 94(1): 102 - 107. [Full Text] [PDF]
|
|
|
|
|
|
M. Stockburger, S. Fateh-Moghadam, A. Nitardy, O. Celebi, A. Krebs, D. Habedank, and R. Dietz Baseline Doppler parameters are useful predictors of chronic left ventricular reduction in size by cardiac resynchronization therapy Europace, January 1, 2008; 10(1): 69 - 74. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. G. Camici, S. K. Prasad, and O. E. Rimoldi Stunning, Hibernation, and Assessment of Myocardial Viability Circulation, January 1, 2008; 117(1): 103 - 114. [Full Text] [PDF]
|
|
|
|
|
|
L. T. Cooper, K. L. Baughman, A. M. Feldman, A. Frustaci, M. Jessup, U. Kuhl, G. N. Levine, J. Narula, R. C. Starling, J. Towbin, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: A Scientific Statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology Eur. Heart J., December 2, 2007; 28(24): 3076 - 3093. [Full Text] [PDF]
|
|
|
|
|
|
F. Frassi, L. Gargani, S. Gligorova, Q. Ciampi, G. Mottola, and E. Picano Clinical and echocardiographic determinants of ultrasound lung comets Eur J Echocardiogr, December 1, 2007; 8(6): 474 - 479. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Boriani, C. Linde, and R. Sutton Celebrating 50 years of electrical therapies for the heart Eur. Heart J. Suppl., December 1, 2007; 9(suppl_I): I1 - I2. [Full Text] [PDF]
|
|
|
|
|
|
T. Rossenbacker, S. G. Priori, and D. P. Zipes The fight against sudden cardiac death: consensus guidelines as a reference Eur. Heart J. Suppl., December 1, 2007; 9(suppl_I): I50 - I58. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Padeletti, P. Pieragnoli, V. Jentzen, and A. Schuchert The comorbidity of atrial fibrillation and heart failure: a challenge for electrical therapies Eur. Heart J. Suppl., December 1, 2007; 9(suppl_I): I81 - I86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Leclercq, G. B. Bleeker, C. Linde, E. Donal, J. J. Bax, M. J. Schalij, and C. Daubert Cardiac resynchronization therapy: clinical results and evolution of candidate selection Eur. Heart J. Suppl., December 1, 2007; 9(suppl_I): I94 - I106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Jourdain, G. Jondeau, and Y. Juilliere Reply J. Am. Coll. Cardiol., November 20, 2007; 50(21): 2098 - 2099. [Full Text] [PDF]
|
|
|
|
|
|
U. C. Hoppe Plasma Brain Natriuretic Peptide-Guided Therapy Not Yet Justified J. Am. Coll. Cardiol., November 20, 2007; 50(21): 2097 - 2098. [Full Text] [PDF]
|
|
|
|
|
|
S. von Haehling, E. A. Jankowska, N. G. Morgenthaler, C. Vassanelli, L. Zanolla, P. Rozentryt, G. S. Filippatos, W. Doehner, F. Koehler, J. Papassotiriou, et al. Comparison of Midregional Pro-Atrial Natriuretic Peptide With N-Terminal Pro-B-Type Natriuretic Peptide in Predicting Survival in Patients With Chronic Heart Failure J. Am. Coll. Cardiol., November 13, 2007; 50(20): 1973 - 1980. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. T. Cooper, K. L. Baughman, A. M. Feldman, A. Frustaci, M. Jessup, U. Kuhl, G. N. Levine, J. Narula, R. C. Starling, J. Towbin, et al. The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease: A Scientific Statement From the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology J. Am. Coll. Cardiol., November 6, 2007; 50(19): 1914 - 1931. [Full Text] [PDF]
|
|
|
|
|
|
L. T. Cooper, K. L. Baughman, A. M. Feldman, A. Frustaci, M. Jessup, U. Kuhl, G. N. Levine, J. Narula, R. C. Starling, J. Towbin, et al. The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease: A Scientific Statement From the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Circulation, November 6, 2007; 116(19): 2216 - 2233. [Full Text] [PDF]
|
|
|
|
 |
|
 S. K H Lam and A. Owen Combined resynchronisation and implantable defibrillator therapy in left ventricular dysfunction: Bayesian network meta-analysis of randomised controlled trials BMJ, November 3, 2007; 335(7626): 925 - 925. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-R. Neuberger, C. Mewis, D. J. van Veldhuisen, U. Schotten, I. C. van Gelder, M. A. Allessie, and M. Bohm Management of atrial fibrillation in patients with heart failure Eur. Heart J., November 1, 2007; 28(21): 2568 - 2577. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Khunti, M. Stone, S. Paul, J. Baines, L. Gisborne, A. Farooqi, X. Luan, and I. Squire Disease management programme for secondary prevention of coronary heart disease and heart failure in primary care: a cluster randomised controlled trial Heart, November 1, 2007; 93(11): 1398 - 1405. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sandek, J. Bauditz, A. Swidsinski, S. Buhner, J. Weber-Eibel, S. von Haehling, W. Schroedl, T. Karhausen, W. Doehner, M. Rauchhaus, et al. Altered Intestinal Function in Patients With Chronic Heart Failure J. Am. Coll. Cardiol., October 16, 2007; 50(16): 1561 - 1569. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Paulus, C. Tschope, J. E. Sanderson, C. Rusconi, F. A. Flachskampf, F. E. Rademakers, P. Marino, O. A. Smiseth, G. De Keulenaer, A. F. Leite-Moreira, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology Eur. Heart J., October 2, 2007; 28(20): 2539 - 2550. [Abstract] [Full Text] [PDF]
|
|
|
|
|