ESC guidelines feature new recommendations for diagnosis, treatment of HF

The European Society of Cardiology, in collaboration with the Heart Failure Association, recently released new recommendations on diagnosis, drugs and devices for HF.

Launched at the Heart Failure Congress 2012, the “ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012” serves as an update to the 2008 guidelines.

New updates in the area of diagnostics include the first-time mention of the midregional pro-A-type natriuretic peptide biomarker.

The guidelines task force also highlighted two new indications for pharmacological treatment. It is now recommended that, when attempting to reduce heart rate, the dose of beta-blocker should be maximized before giving additional medications to reduce heart.

“Beta-blockers are more established, more effective and less expensive, and should be given first,” John J.V. McMurray, MD, of the University of Glasgow, Scotland, and chairman of the ESC Clinical Practice Guidelines Task Force, said in a press release.

In addition, indications for mineralocorticoid receptor antagonosis were extended to include use with standard therapy.

For devices, more emphasis has been placed on left ventricular assist devices for the management of HF, based on recent research showing that LVADs are more reliable and lead to fewer complications than in past years.

“LVADs will increasingly be used as a treatment in their own right, not just as a temporary support while awaiting transplantation,” McMurray said.

A new indication for cardiac resynchronization therapy (CRT) in patients with mild symptoms is a focus in the guidelines. Data from new trials and further analysis of existing trials since the last guideline update demonstrate that CRT is most beneficial in patients with left bundle branch block QRS morphology and those who are in sinus rhythm. Additionally, new transcatheter valve interventions are also discussed for the treatment of aortic stenosis in patients who are not suitable for surgery.

“These guidelines make recommendations based upon evidence for established and new diagnostic tests and therapies for HF,” McMurray said. “If implemented, they offer a real opportunity to improve the outcome of patients with this condition.”

For more information:

McMurray JJV. Eur Heart J. 2012;doi:10.1093/eurheartj/ehs104.

Disclosure: Dr. McMurray reports no relevant financial disclosures.