2012年ESC急慢性心衰的指南

The aim of this document is to provide practical, evidence-based guidelines for the diagnosis and treatment of heart failure (HF). The principal changes from the 2008 guidelines1 relate to:

(i) an expansion of the indication for mineralocorticoid (aldosterone) receptor antagonists (MRAs);

(ii) a new indication for the sinus node inhibitor ivabradine;

(iii) an expanded indication for cardiac resynchronization therapy (CRT);

(iv) new information on the role of coronary revascularization in HF;

(v) recognition of the growing use of ventricular assist devices; and

(vi) the emergence of transcatheter valve interventions.

There are also changes to the structure and format of the guidelines. Therapeutic recommendations now state the treatment effect supported by the class and level of recommendation in tabular format; in the case of chronic heart failure due to left ventricular (LV) systolic dysfunction, the recommendations focus on mortality and morbidity outcomes. Detailed summaries of the key evidence supporting generally recommended treatments have been provided. Practical guidance is provided for the use of the more important disease-modifying drugs and diuretics. When possible, other relevant guidelines, consensus statements, and position papers have been cited to avoid unduly lengthy text. All tables should be read in conjunction with their accompanying text and not read in isolation.