/pdf/2021-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-4pqhe8c49t.pdf

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

/pdf/2021-esc-guidelines-on-cardiovascular-disease-prevention-in-14ygu7kat1.pdf

2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Aim: The “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure” replaces the “2013 ACCF/AHA Guideline for the Management of Heart Failure” and the “2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure.” The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. Methods: A comprehensive literature search was conducted from May 2020 to December 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (PubMed), EMBASE, the Cochrane Collaboration, the Agency for Healthcare Research and Quality, and other relevant databases. Additional relevant clinical trials and research studies, published through September 2021, were also considered. This guideline was harmonized with other American Heart Association/American College of Cardiology guidelines published through December 2021. Structure: Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients’ interests. Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses. 

https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000001063

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Document Reviewers: Rudolf A. de Boer (CPG Review Coordinator) (Netherlands), P. Christian Schulze (CPG Review Coordinator) (Germany), Magdy Abdelhamid (Egypt), Victor Aboyans (France), Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Elena Arbelo (Spain), Riccardo Asteggiano (Italy), Johann Bauersachs (Germany), Antoni Bayes‐Genis (Spain), Michael A. Borger (Germany), Werner Budts (Belgium), Maja Cikes (Croatia), Kevin Damman (Netherlands), Victoria Delgado (Netherlands), Paul Dendale (Belgium), Polychronis Dilaveris (Greece), Heinz Drexel (Austria), Justin Ezekowitz (Canada), Volkmar Falk (Germany), Laurent Fauchier (France), Gerasimos Filippatos (Greece), Alan Fraser (United Kingdom), Norbert Frey (Germany), Chris P. Gale (United Kingdom), Finn Gustafsson (Denmark), Julie Harris (United Kingdom), Bernard Iung (France), Stefan Janssens (Belgium), Mariell Jessup (United States of America), Aleksandra Konradi (Russia), Dipak Kotecha (United Kingdom), Ekaterini Lambrinou (Cyprus), Patrizio Lancellotti (Belgium), Ulf Landmesser (Germany), Christophe Leclercq (France), Basil S. Lewis (Israel), Francisco Leyva (United Kingdom), AleVs Linhart (Czech Republic), Maja‐Lisa Løchen (Norway), Lars H. Lund (Sweden), Donna Mancini (United States of America), Josep Masip (Spain), Davor Milicic (Croatia), Christian Mueller (Switzerland), Holger Nef (Germany), Jens‐Cosedis Nielsen (Denmark), Lis Neubeck (United Kingdom), Michel Noutsias (Germany), Steffen E. Petersen (United Kingdom), Anna Sonia Petronio (Italy), Piotr Ponikowski (Poland), Eva Prescott (Denmark), Amina Rakisheva (Kazakhstan), Dimitrios J. Richter (Greece), Evgeny Schlyakhto (Russia), Petar Seferovic (Serbia), Michele Senni (Italy), Marta Sitges (Spain), Miguel Sousa‐Uva (Portugal), Carlo G. Tocchetti (Italy), Rhian M. Touyz (United Kingdom), Carsten Tschoepe (Germany), Johannes Waltenberger (Germany/Switzerland)

/pdf/2021-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-1wzjkcdn.pdf

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

We read with great interest the protocol design of HEMOVAD pilot study proposed by Veenis and colleagues, in which the feasibility and implication of pulmonary artery pressure (PAP) guidance with CardioMEMS in patients with left ventricular assist device (LVAD) is prospectively investigated. Our team recently demonstrated the implications of hemodynamic optimization in LVAD patients, with the observed association of abnormal hemodynamics and heart failure (HF) readmissions along with hemocompatibility-related adverse events. We fully agree that the PAP-guided adjustment of LVAD speed and medications would likely result in a reduction in HF readmissions, given the strongly positive studies previously published on the use of CardioMEMS in general HF cohorts. If the CardioMEMS device can be mechanistically linked to LVADs, the promising future of a smart pump, which can automatically adjust pump settings based on feedback from the CardioMEMS, would be a welcomed innovation. Unique hemodynamic challenges remain nevertheless in estimating the degree of ventricular unloading, as approximately half of clinically stable LVAD patients have decoupling between diastolic PAP and pulmonary capillary wedge pressure. Second, the assessment of right ventricular failure (RVF) by PAP monitoring alone might be challenging to accurately quantify. In patients with HF with reduced ejection fraction, out-of-proportion RVF can result from longstanding left-sided failure. However, the physiology of RVF during LVAD support is unique and complex. Increased right ventricular preload and anatomical changes experienced by the RV due to leftward shifting of the intraventricular septum both contribute maladaptive structure and function. Therefore, in patients with LVADs, RVF often exists in the absence of elevated left-sided filling pressures, and as a result, PAP monitoring alone might not be an appropriate method to assess for the presence of RVF. Central venous pressure monitoring in the context of PAP measurements would be the most optimal method to hemodynamically assess for RVF, although technology to accurately assess central venous pressure through minimally invasive yet durable means has yet to be developed. Using a combination of these assessments may also be useful in predicting potential LVAD-related adverse events, specifically gastrointestinal bleeding, which is known to be associated with RVF.

Comment on: Implication of pulmonary artery pressure monitoring during left ventricular assist device supports.

(525) - Consequence of Retained Defibrillator and Pacemaker Leads Following Heart Transplantation - An Under-Sensed Problem?

LATE BREAKING CLINICAL TRIAL (JCS 2016) : Waon Therapy for Managing Chronic Heart Failure : Results From a Multicenter Prospective Randomized WAON-CHF Study

Use of mechanical ventilation represents the sickest population before left ventricular assist device implantation

Normal Serum Lactic Acid is Discordant with Shock in Advanced Heart Failure Patients

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