Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology
Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology
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DOI：
10.1002/ejhf.1531
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发表时间：
2019-08-30
影响因子：
18.2
通讯作者：
Coats, Andrew J. S.
中科院分区：
文献类型：
--
作者：
Seferovic, Petar M.;Ponikowski, Piotr;Coats, Andrew J. S.
欧洲心脏病学会（ESC）在过去25年中发布了一系列心力衰竭（HF）指南，最近一次是在2016年。鉴于自那时以来获得的大量新信息，ESC的心力衰竭协会（HFA）认识到有必要在共识文件中回顾和总结最近的进展。以下是2019年1月在德国法兰克福举行的HFA研讨会的报道。这份专家共识报告既不是指南的更新，也不是立场声明，而是以共识建议的形式总结和一致意见。该报告描述了这些指导声明是如何得到证据支持的，它提出了一些实用的评论，并强调了新的研究领域以及进展如何可能改变心衰的临床管理。我们避免重新解释2016年ESC/HFA指南中已经考虑的信息。根据2016年以来发表的主要试验的证据，提出了具体的新建议，包括治疗2型糖尿病的钠-葡萄糖共转运蛋白2抑制剂、治疗功能性二尖瓣反流的米特拉普、治疗心衰的房颤消融、治疗经甲状腺蛋白淀粉样变性的他非他胺类药物、治疗心衰的利伐沙班、治疗非缺血性心衰的植入式心律转复除颤器以及远程医疗。此外，来自小型试验的新试验证据和更新的荟萃分析使我们有机会在选定的其他领域提供完善的建议。此外，在未来两年内，这些领域和其他领域将有新的试验证据，以赶上计划中的2021年ESC急性和慢性心力衰竭诊断和治疗指南。
The European Society of Cardiology (ESC) has published a series of guidelines on heart failure (HF) over the last 25 years, most recently in 2016. Given the amount of new information that has become available since then, the Heart Failure Association (HFA) of the ESC recognized the need to review and summarise recent developments in a consensus document. Here we report from the HFA workshop that was held in January 2019 in Frankfurt, Germany. This expert consensus report is neither a guideline update nor a position statement, but rather a summary and consensus view in the form of consensus recommendations. The report describes how these guidance statements are supported by evidence, it makes some practical comments, and it highlights new research areas and how progress might change the clinical management of HF. We have avoided re-interpretation of information already considered in the 2016 ESC/HFA guidelines. Specific new recommendations have been made based on the evidence from major trials published since 2016, including sodium-glucose co-transporter 2 inhibitors in type 2 diabetes mellitus, MitraClip for functional mitral regurgitation, atrial fibrillation ablation in HF, tafamidis in cardiac transthyretin amyloidosis, rivaroxaban in HF, implantable cardioverter-defibrillators in non-ischaemic HF, and telemedicine for HF. In addition, new trial evidence from smaller trials and updated meta-analyses have given us the chance to provide refined recommendations in selected other areas. Further, new trial evidence is due in many of these areas and others over the next 2 years, in time for the planned 2021 ESC guidelines on the diagnosis and treatment of acute and chronic heart failure.