Congestive heart failure AHA recommendations Quality Metrics/Performance Measures

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Congestive Heart Failure Microchapters

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Patient Information

Overview

Historical Perspective

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Pathophysiology

Systolic Dysfunction
Diastolic Dysfunction
HFpEF
HFrEF

Causes

Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

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History and Symptoms

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Cardiac Catheterization

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Treatment

Invasive Hemodynamic Monitoring

Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
Positive Inotropics
Anticoagulants
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [3], Edzel Lorraine Co, D.M.D., M.D. [4]

2022 AHA/ACC/HFSA Heart Failure Guideline/ 2013 ACCF/AHA Guideline/2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Heart Failure in the Adult (DO NOT EDIT) [1][2][3]

Quality Metrics/Performance Measures (DO NOT EDIT) [1][2][3]

Class I
"1. Performance measures based on professionally developed clinical practice guidelines should be used with the goal of improving quality of care for patients with HF.[4][5][6][7][8][9][10] (Level of Evidence: B) "
Class IIa
"1. Participation in quality improvement programs, including patient registries that provide benchmark feedback on nationally endorsed, clinical practice guideline-based quality and performance measures can be beneficial in improving the quality of care for patients with HF.[4][5][8][9] (Level of Evidence: B) "

Vote on and Suggest Revisions to the Current Guidelines

Sources

References

  1. 1.0 1.1 1.2 Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "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". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check |pmid= value (help).
  2. 2.0 2.1 2.2 Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
  3. 3.0 3.1 3.2 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016.DOI:10.1161/CIRCULATIONAHA.109.192064 PMID:19324967
  4. 4.0 4.1 Fonarow GC, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT; et al. (2010). "Improving evidence-based care for heart failure in outpatient cardiology practices: primary results of the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF)". Circulation. 122 (6): 585–96. doi:10.1161/CIRCULATIONAHA.109.934471. PMID 20660805.
  5. 5.0 5.1 Nakano A, Vinter N, Egstrup K, Svendsen ML, Schjødt I, Johnsen SP (2019). "Association between process performance measures and 1-year mortality among patients with incident heart failure: a Danish nationwide study". Eur Heart J Qual Care Clin Outcomes. 5 (1): 28–34. doi:10.1093/ehjqcco/qcy041. PMID 30204858.
  6. Patel DB, Shah RM, Bhatt DL, Liang L, Schulte PJ, DeVore AD; et al. (2016). "Guideline-Appropriate Care and In-Hospital Outcomes in Patients With Heart Failure in Teaching and Nonteaching Hospitals: Findings From Get With The Guidelines-Heart Failure". Circ Cardiovasc Qual Outcomes. 9 (6): 757–766. doi:10.1161/CIRCOUTCOMES.115.002542. PMID 27780849.
  7. Patel J, Sandhu A, Parizo J, Moayedi Y, Fonarow GC, Heidenreich PA (2018). "Validity of Performance and Outcome Measures for Heart Failure". Circ Heart Fail. 11 (9): e005035. doi:10.1161/CIRCHEARTFAILURE.118.005035. PMID 30354367.
  8. 8.0 8.1 Heidenreich PA, Hernandez AF, Yancy CW, Liang L, Peterson ED, Fonarow GC (2012). "Get With The Guidelines program participation, process of care, and outcome for Medicare patients hospitalized with heart failure". Circ Cardiovasc Qual Outcomes. 5 (1): 37–43. doi:10.1161/CIRCOUTCOMES.110.959122. PMID 22235067.
  9. 9.0 9.1 Heidenreich PA, Lewis WR, LaBresh KA, Schwamm LH, Fonarow GC (2009). "Hospital performance recognition with the Get With The Guidelines Program and mortality for acute myocardial infarction and heart failure". Am Heart J. 158 (4): 546–53. doi:10.1016/j.ahj.2009.07.031. PMID 19781413.
  10. Ivers NM, Grimshaw JM, Jamtvedt G, Flottorp S, O'Brien MA, French SD; et al. (2014). "Growing literature, stagnant science? Systematic review, meta-regression and cumulative analysis of audit and feedback interventions in health care". J Gen Intern Med. 29 (11): 1534–41. doi:10.1007/s11606-014-2913-y. PMC 4238192. PMID 24965281.
  11. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112 (12):e154-235. [1]PMID:16160202

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