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| bgcolor="LightGreen" |<nowiki>"</nowiki>'''4.''' In patients with a recent or remote history of MI or acute coronary syndrome (ACS) and LVEF ≤40%, evidence-based beta blockers should be used to reduce mortality ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen" |<nowiki>"</nowiki>'''4.''' In patients with a recent or remote history of MI or acute coronary syndrome (ACS) and LVEF ≤40%, evidence-based beta blockers should be used to reduce mortality ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
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|"'''5.''' In patients who are at least 40 days post-MI with LVEF ≤30% and NYHA class I symptoms while receiving GDMT and have reasonable expectation of meaningful survival for >1 year, an ICD is recommended for primary prevention of sudden cardiac death (SCD) to reduce total mortality ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen" |<nowiki>"</nowiki>"'''5.''' In patients who are at least 40 days post-MI with LVEF ≤30% and NYHA class I symptoms while receiving GDMT and have reasonable expectation of meaningful survival for >1 year, an ICD is recommended for primary prevention of sudden cardiac death (SCD) to reduce total mortality ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
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|"'''6.''' In patients with LVEF ≤40%, beta blockers should be used to prevent symptomatic HF. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen" |<nowiki>"</nowiki>"'''6.''' In patients with LVEF ≤40%, beta blockers should be used to prevent symptomatic HF. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki>
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Revision as of 14:25, 28 November 2022
Resident
Survival
Guide
Congestive Heart Failure Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

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

Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Cardiac MRI

Echocardiography

Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Other Imaging Studies

Other Diagnostic Studies

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

Congestive heart failure clinical assessment On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Congestive heart failure clinical assessment

CDC on Congestive heart failure clinical assessment

Congestive heart failure clinical assessment in the news

Blogs on Congestive heart failure clinical assessment

Directions to Hospitals Treating Congestive heart failure clinical assessment

Risk calculators and risk factors for Congestive heart failure clinical assessment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D. [2]

Overview

Clinical assessment of a patient based on a thorough history taking and physical examination is still the cornerstone in diagnosing heart failure. Based on the gathered data, patients can be assessed if he has an underlying heart condition which necessitates a disease-specific therapy such as amyloid heart disease, a cardiomyopathy, or a developing decompensated heart failure. It is important to investigate for presence of heart congestion so as to treat it the at the earliest stage to avoid deterioration in the quality of life and prognosis.

Diagnostic algorithm for heart failure

 
 
 
 
 
 
 
 
Suspected heart failure
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NT-proBNP ≥ 125 pg/mL or BNP ≥ 35 pg/mL

or if HF strongly suspected

or if NT-proBNP/BNP unavailable
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Echocardiography
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Abnormal findings
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hear failure unlikely, other dignosis shoulb be considered
 
NO
 
Yes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Heart failure confirmed based on LVEF
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LVEF≤ 40%
 
 
 
 
LVEF=41-49%
 
 
 
 
LVEF≥50%
The above table adopted from 2021 ESC Guideline

[1]

Diagnostic of HF and EF-Based Classification.

Diagnostic Algorithm for HF and EF-Based Classification

[2] [3]

Criteria for definition of advanced heart failure

1. Severe and persistent symptoms of heart failure NYHA class III-IV
2. Severe cardiac dysfunction is defined by at least one of the following:

3. Episodes of pulmonary or systemic congestion requiring high-dose i.v. diuretics (or diuretic combinations) or episodes of low output requiring inotropes or vasoactive drugs or malignant arrhythmias causing >1 unplanned visit or hospitalization in the last 12 months
4. Severe impairment of exercise capacity with inability to exercise or low 6MWT distance (<300 m) or pVO2 <12 mL/kg/min or <50% predicted value, estimated to be of cardiac origin[1]

Clinical Assessment

Framingham Criteria

Major Criteria

Minor Criteria

Boston Criteria of Congestive Heart Failure

Category I: History

Category II: Physical Examination

HFpEF

The [H2FPEF https://www.mdcalc.com/calc/10105/h2fpef-score-for-heart-failure-with-preserved-ejection-fraction] can help diagnose[3].

Category III: Chest Radiography

No more than 4 points are allowed from each of three categories; hence the composite score (the sum of the subtotal from each category) has a possible maximum of 12 points.

The diagnosis of heart failure is classified as "definite" at a score of 8 to 12 points, "possible" at a score of 5 to 7 points, and "unlikely" at a score of 4 points or less.

2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

INITIAL AND SERIAL EVALUATION (DO NOT EDIT) [2]

Clinical Assessment: History and Physical Examination (DO NOT EDIT) [2]

Class I
"1. In patients with HF, vital signs and evidence of clinical congestion should be assessed at each encounter to guide overall management, including adjustment of diuretics and other medications.[4][5][6][7][8][9] (Level of Evidence: B-NR) "
"2. In patients with symptomatic HF, clinical factors indicating the presence of advanced HF should be sought via the history and physical examination. [10][11][12][13][14][15] (Level of Evidence: B-NR) "
"3. In patients with cardiomyopathy, a 3-generation family history should be obtained or updated when assessing the cause of the cardiomyopathy to identify possible inherited disease. [16][17] (Level of Evidence: B-NR) "
"4. In patients presenting with HF, a thorough history and physical examination should direct diagnostic strategies to uncover specific causes that may warrant disease-specific management. [18][19] (Level of Evidence: B-NR) "
"4. In patients presenting with HF, a thorough history and physical examination should be obtained and performed to identify cardiac and noncardiac disorders, lifestyle and behavioral factors, and social determinants of health that might cause or accelerate the development or progression of HF. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-EO]) "

Initial Laboratory and Electrocardiographic Testing (DO NOT EDIT) [2]

Class I
"1. For patients presenting with HF, the specific cause of HF should be explored using additional laboratory testing for appropriate management. [20][21][22][23][24][25][26][27] (Level of Evidence: B-NR) "
"2. For patients who are diagnosed with HF, laboratory evaluation should include complete blood count, urinalysis, serum electrolytes, blood urea nitrogen, serum creatinine, glucose, lipid profile, liver function tests, iron studies, and thyroid-stimulating hormone to optimize management. (Level of Evidence: C-EO) "
"3. For all patients presenting with HF, a 12-lead ECG should be performed at the initial encounter to optimize management. (Level of Evidence: C-EO) "

Use of Biomarkers for Prevention, Initial Diagnosis, and Risk Stratification (DO NOT EDIT) [2]

Class I
"1. In patients presenting with dyspnea, measurement of B-type natriuretic peptide (BNP) or N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) is useful to support a diagnosis or exclusion of HF. [28][29][30][31][32][33][34][35][36][37][38][39] (Level of Evidence: A) "
"2.In patients with chronic HF, measurements of BNP or NT-proBNP levels are recommended for risk stratification. [38][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] (Level of Evidence: A) "
"3. In patients hospitalized for HF, measurement of BNP or NT-proBNP levels at admission is recommended to establish prognosis. [38][40][41][42][43][44][45][46] (Level of Evidence: A) "
Class IIa
"4. In patients at risk of developing HF, BNP or NT-proBNP-based screening followed by team-based care, including a cardiovascular specialist, can be useful to prevent the development of LV dysfunction or new-onset HF. [57][58] (Level of Evidence: B-R) "
"5.In patients hospitalized for HF, a predischarge BNP or NT-proBNP level can be useful to inform the trajectory of the patient and establish a postdischarge prognosis. [41][44][47][48][49][50][51][52][53][54][55][56] (Level of Evidence: B-NR) "

Genetic Evaluation and Testing 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class I
"1. In first-degree relatives of selected patients with genetic or inherited cardiomyopathies, genetic screening and counseling are recommended to detect cardiac disease and prompt consideration of treatments to decrease HF progression and sudden death. [16][17] (Level of Evidence: B-NR) "
Class IIa
"1. In select patients with nonischemic cardiomyopathy, referral for genetic counseling and testing is reasonable to identify conditions that could guide treatment for patients and family members.[59][60] (Level of Evidence: B-NR) "

Evaluation With Cardiac Imaging 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class I
"1. In patients with suspected or new-onset HF, or those presenting with acute decompensated HF, a chest X-ray should be performed to assess heart size and pulmonary congestion and to detect alternative cardiac, pulmonary, and other diseases that may cause or contribute to the patient's symptoms. [61][62](Level of Evidence: C-LD) "
"2. In patients with suspected or newly diagnosed HF, transthoracic echocardiography (TTE) should be performed during initial evaluation to assess cardiac structure and function. [63] (Level of Evidence: C-LD) "
"3. In patients with HF who have had a significant clinical change, or who have received GDMT and are being considered for invasive procedures or device therapy, repeat measurement of EF, degree of structural remodeling, and valvular function are useful to inform therapeutic interventions.[64][65][66][67] (Level of Evidence: C-LD) "
"4. In patients for whom echocardiography is inadequate, alternative imaging (eg, cardiac magnetic resonance [CMR], cardiac computed tomography [CT], radionuclide imaging) is recommended for assessment of LVEF.[68][69][70][71][72][73][74][75](Level of Evidence: C-LD) "
Class IIa
"5. In patients with HF or cardiomyopathy, CMR can be useful for diagnosis or management. [76][77][78][79][80][81][82][83] (Level of Evidence:B-NR) "
"6. In patients with HF, an evaluation for possible ischemic heart disease can be useful to identify the cause and guide management. [84][85][86][87] (Level of Evidence:B-NR) "
Class IIb
"7. In patients with HF and coronary artery disease (CAD) who are candidates for coronary revascularization, noninvasive stress imaging (stress echocardiography, single-photon emission CT [SPECT], CMR, or positron emission tomography [PET] may be considered for detection of myocardial ischemia to help guide coronary revascularization. [88][89][90][91][92] (Level of Evidence:B-NR) "
Class III (No Benefit)
"8. In patients with HF in the absence of 1) clinical status change, 2) treatment interventions that might have had a significant effect on cardiac function, or 3) candidacy for invasive procedures or device therapy, routine repeat assessment of LV function is not indicated. (Level of Evidence:C-EO) "

Invasive Evaluation 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class IIa
"1. In patients with HF, endomyocardial biopsy may be useful when a specific diagnosis is suspected that would influence therapy. [93][94] (Level of Evidence:B-NR) "
"2. In selected patients with HF with persistent or worsening symptoms, signs, diagnostic parameters, and in whom hemodynamics are uncertain, invasive hemodynamic monitoring can be useful to guide management. (Level of Evidence:C-EO) "
Class III (No Benefit)
"3. In patients with HF, routine use of invasive hemodynamic monitoring is not recommended. [95][96] (Level of Evidence:B-R) "
Class III (Harm)
"2. For patients undergoing routine evaluation of HF, endomyocardial biopsy should not be performed because of the risk of complications. [97][98](Level of Evidence:C-LD) "

Wearables and Remote Monitoring (Including Telemonitoring and Device Monitoring) 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class IIb
"1. In selected adult patients with NYHA class III HF and history of a HF hospitalization in the past year or elevated natriuretic peptide levels, on maximally tolerated stable doses of GDMT with optimal device therapy, the usefulness of wireless monitoring of PA pressure by an implanted hemodynamic monitor to reduce the risk of subsequent HF hospitalization is uncertain. [99][100][101][102] (Level of Evidence:B-R) "
Value Statement: Uncertain Value
"2. In patients with NYHA class III HF with a HF hospitalization within the previous year, wireless monitoring of the PA pressure by an implanted hemodynamic monitor provides uncertain value. [102][103][104][105] (Level of Evidence:B-NR) "

Exercise and Functional Capacity Testing 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class I
"1. In patients with HF, assessment and documentation of NYHA functional classification are recommended to determine eligibility for treatments. [106][107] (Level of Evidence: C-LD) "
"2. In selected ambulatory patients with HF, cardiopulmonary exercise testing (CPET) is recommended to determine appropriateness of advanced treatments (eg, LVAD, heart transplant). [108][109][110][111][112](Level of Evidence: C-LD) "
Class IIa
"3. In ambulatory patients with HF, performing a CPET or 6-minute walk test is reasonable to assess functional capacity. [108][109][113][114][115][116][117][118][119][120] (Level of Evidence: C-LD) "
"4. In ambulatory patients with unexplained dyspnea, CPET is reasonable to evaluate the cause of dyspnea. [121][122](Level of Evidence: C-LD) "

Initial and Serial Evaluation: Clinical Assessment: HF Risk Scoring 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class IIa
"1. In ambulatory or hospitalized patients with HF, validated multivariable risk scores can be useful to estimate subsequent risk of mortality. [123][124][125][126][127][128][129][130][131][132][133][134][135][48] (Level of Evidence: B-NR) "

Patients at risk for HF, Stage A. Primary prevention recommendations for patients at risk for HF. 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT)

Class I
"1. In patients with hypertension, blood pressure should be controlled in accordance with GDMT for hypertension to prevent symptomatic HF (Level of Evidence A).
"2. In patients with type 2 diabetes and either established CVD or at high cardiovascular risk, SGLT2i should be used to prevent hospitaliza-tions for HF (Level of Evidence A).
"3. In the general population, healthy lifestyle habits such as regular physical activity, maintaining normal weight, healthy dietary patterns, and avoiding smoking are helpful to reduce future risk of HF (Level of Evidence B-NR).
Class IIa
"1. For patients at risk of developing HF, natriuretic peptide biomarker-based screening followed by team-based care, including a cardiovascular specialist optimizing GDMT, can be useful to prevent the development of LV dysfunction (systolic or diastolic) or new-onset HF (Level of Evidence: B-R).
"2. In the general population, validated multivariable risk scores can be useful to estimate subsequent risk of incident HF (Level of Evidence: B-NR).

[2]

Patients with PRE- HF: Stage B.

Management of patients in stage B. Preventing heart failure in pre-HF patients.

Class I
"1. In patients with LVEF ≤40%, ACEi should be used to prevent symptomatic HF and reduce mortality (Level of Evidence: A) "
"2.   In patients with a recent or remote history of MI or ACS, statins should be used to prevent symptomatic HF and adverse cardiovascular events. (Level of Evidence: A) "
"3. In patients with a recent MI and LVEF ≤40% who are intolerant to ACEi, ARB should be used to prevent symptomatic HF and reduce mortality (Level of Evidence: B-R) "
"4. In patients with a recent or remote history of MI or acute coronary syndrome (ACS) and LVEF ≤40%, evidence-based beta blockers should be used to reduce mortality (Level of Evidence: B-R) "
""5. In patients who are at least 40 days post-MI with LVEF ≤30% and NYHA class I symptoms while receiving GDMT and have reasonable expectation of meaningful survival for >1 year, an ICD is recommended for primary prevention of sudden cardiac death (SCD) to reduce total mortality (Level of Evidence: B-R) "
""6. In patients with LVEF ≤40%, beta blockers should be used to prevent symptomatic HF. (Level of Evidence: C-LD) "



Source

References

  1. ↑ 1.0 1.1 McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano G, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". Eur Heart J. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check |pmid= value (help). Vancouver style error: initials (help)
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 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: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  3. ↑ 3.0 3.1 Reddy YNV, Kaye DM, Handoko ML, van de Bovenkamp AA, Tedford RJ, Keck C; et al. (2022). "Diagnosis of Heart Failure With Preserved Ejection Fraction Among Patients With Unexplained Dyspnea". JAMA Cardiol. 7 (9): 891–899. doi:10.1001/jamacardio.2022.1916. PMC 9280610 Check |pmc= value (help). PMID 35830183 Check |pmid= value (help).
  4. ↑ Ambrosy AP, Pang PS, Khan S, Konstam MA, Fonarow GC, Traver B; et al. (2013). "Clinical course and predictive value of congestion during hospitalization in patients admitted for worsening signs and symptoms of heart failure with reduced ejection fraction: findings from the EVEREST trial". Eur Heart J. 34 (11): 835–43. doi:10.1093/eurheartj/ehs444. PMID 23293303.
  5. ↑ Selvaraj S, Claggett B, Pozzi A, McMurray JJV, Jhund PS, Packer M; et al. (2019). "Prognostic Implications of Congestion on Physical Examination Among Contemporary Patients With Heart Failure and Reduced Ejection Fraction: PARADIGM-HF". Circulation. 140 (17): 1369–1379. doi:10.1161/CIRCULATIONAHA.119.039920. PMID 31510768.
  6. ↑ Selvaraj S, Claggett B, Shah SJ, Anand IS, Rouleau JL, Desai AS; et al. (2019). "Utility of the Cardiovascular Physical Examination and Impact of Spironolactone in Heart Failure With Preserved Ejection Fraction". Circ Heart Fail. 12 (7): e006125. doi:10.1161/CIRCHEARTFAILURE.119.006125. PMC 6686863 Check |pmc= value (help). PMID 31220936.
  7. ↑ Caldentey G, Khairy P, Roy D, Leduc H, Talajic M, Racine N; et al. (2014). "Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure)". JACC Heart Fail. 2 (1): 15–23. doi:10.1016/j.jchf.2013.10.004. PMID 24622114.
  8. ↑ Simonavičius J, Sanders van-Wijk S, Rickenbacher P, Maeder MT, Pfister O, Kaufmann BA; et al. (2019). "Prognostic Significance of Longitudinal Clinical Congestion Pattern in Chronic Heart Failure: Insights From TIME-CHF Trial". Am J Med. 132 (9): e679–e692. doi:10.1016/j.amjmed.2019.04.010. PMID 31051151.
  9. ↑ Fudim M, Parikh KS, Dunning A, DeVore AD, Mentz RJ, Schulte PJ; et al. (2018). "Relation of Volume Overload to Clinical Outcomes in Acute Heart Failure (From ASCEND-HF)". Am J Cardiol. 122 (9): 1506–1512. doi:10.1016/j.amjcard.2018.07.023. PMC 6924269 Check |pmc= value (help). PMID 30172362.
  10. ↑ Anker SD, Negassa A, Coats AJ, Afzal R, Poole-Wilson PA, Cohn JN; et al. (2003). "Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors: an observational study". Lancet. 361 (9363): 1077–83. doi:10.1016/S0140-6736(03)12892-9. PMID 12672310.
  11. ↑ Eshaghian S, Horwich TB, Fonarow GC (2006). "Relation of loop diuretic dose to mortality in advanced heart failure". Am J Cardiol. 97 (12): 1759–64. doi:10.1016/j.amjcard.2005.12.072. PMID 16765130.
  12. ↑ Gorodeski EZ, Chu EC, Reese JR, Shishehbor MH, Hsich E, Starling RC (2009). "Prognosis on chronic dobutamine or milrinone infusions for stage D heart failure". Circ Heart Fail. 2 (4): 320–4. doi:10.1161/CIRCHEARTFAILURE.108.839076. PMID 19808355.
  13. ↑ Kittleson M, Hurwitz S, Shah MR, Nohria A, Lewis E, Givertz M; et al. (2003). "Development of circulatory-renal limitations to angiotensin-converting enzyme inhibitors identifies patients with severe heart failure and early mortality". J Am Coll Cardiol. 41 (11): 2029–35. doi:10.1016/s0735-1097(03)00417-0. PMID 12798577.
  14. ↑ Poole JE, Johnson GW, Hellkamp AS, Anderson J, Callans DJ, Raitt MH; et al. (2008). "Prognostic importance of defibrillator shocks in patients with heart failure". N Engl J Med. 359 (10): 1009–17. doi:10.1056/NEJMoa071098. PMC 2922510. PMID 18768944.
  15. ↑ Setoguchi S, Stevenson LW, Schneeweiss S (2007). "Repeated hospitalizations predict mortality in the community population with heart failure". Am Heart J. 154 (2): 260–6. doi:10.1016/j.ahj.2007.01.041. PMID 17643574.
  16. ↑ 16.0 16.1 Marume K, Noguchi T, Tateishi E, Morita Y, Miura H, Nishimura K; et al. (2020). "Prognosis and Clinical Characteristics of Dilated Cardiomyopathy With Family History via Pedigree Analysis". Circ J. 84 (8): 1284–1293. doi:10.1253/circj.CJ-19-1176. PMID 32624524 Check |pmid= value (help).
  17. ↑ 17.0 17.1 Waddell-Smith KE, Donoghue T, Oates S, Graham A, Crawford J, Stiles MK; et al. (2016). "Inpatient detection of cardiac-inherited disease: the impact of improving family history taking". Open Heart. 3 (1): e000329. doi:10.1136/openhrt-2015-000329. PMC 4762189. PMID 26925241.
  18. ↑ González-López E, Gagliardi C, Dominguez F, Quarta CC, de Haro-Del Moral FJ, Milandri A; et al. (2017). "Clinical characteristics of wild-type transthyretin cardiac amyloidosis: disproving myths". Eur Heart J. 38 (24): 1895–1904. doi:10.1093/eurheartj/ehx043. PMID 28329248.
  19. ↑ Lousada I, Comenzo RL, Landau H, Guthrie S, Merlini G (2015). "Light Chain Amyloidosis: Patient Experience Survey from the Amyloidosis Research Consortium". Adv Ther. 32 (10): 920–8. doi:10.1007/s12325-015-0250-0. PMC 4635176. PMID 26498944.
  20. ↑ Cardinale D, Colombo A, Bacchiani G, Tedeschi I, Meroni CA, Veglia F; et al. (2015). "Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy". Circulation. 131 (22): 1981–8. doi:10.1161/CIRCULATIONAHA.114.013777. PMID 25948538 : 25948538 Check |pmid= value (help).
  21. ↑ Cardinale D, Sandri MT, Colombo A, Colombo N, Boeri M, Lamantia G; et al. (2004). "Prognostic value of troponin I in cardiac risk stratification of cancer patients undergoing high-dose chemotherapy". Circulation. 109 (22): 2749–54. doi:10.1161/01.CIR.0000130926.51766.CC. PMID 15148277.
  22. ↑ Castaño A, Narotsky DL, Hamid N, Khalique OK, Morgenstern R, DeLuca A; et al. (2017). "Unveiling transthyretin cardiac amyloidosis and its predictors among elderly patients with severe aortic stenosis undergoing transcatheter aortic valve replacement". Eur Heart J. 38 (38): 2879–2887. doi:10.1093/eurheartj/ehx350. PMC 5837725. PMID 29019612.
  23. ↑ Maurer MS, Hanna M, Grogan M, Dispenzieri A, Witteles R, Drachman B; et al. (2016). "Genotype and Phenotype of Transthyretin Cardiac Amyloidosis: THAOS (Transthyretin Amyloid Outcome Survey)". J Am Coll Cardiol. 68 (2): 161–72. doi:10.1016/j.jacc.2016.03.596. PMC 4940135. PMID 27386769.
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  25. ↑ Brown EE, Lee YZJ, Halushka MK, Steenbergen C, Johnson NM, Almansa J; et al. (2017). "Genetic testing improves identification of transthyretin amyloid (ATTR) subtype in cardiac amyloidosis". Amyloid. 24 (2): 92–95. doi:10.1080/13506129.2017.1324418. PMID 28494620.
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