27 Ago EU: chronic and Acute heart failure (2017)
EU: chronic and Acute heart failure (2017)
What can we learn from recent european recommendations on the”chronic heart failure and acute heart failure ?
The main new features of the latest series of European guidelines for the management of heart failure
The heart failure (hf) is the leading chronic disease in cardiology. If the son’s prognosis remains extremely serious, the progress in its support of the police that the patients live longer with this disease, whose evolution will be punctuated by décompensations requiring hospitalization.
The recommendations, with regular updates make it possible to integrate the results of the studies whether they are positive or negative, in the practice of care and to indicate the level of recommendation and level of evidence. It is important to summarize these recommendations to make them accessible to the greatest number of practitioners, and to promote their application.
Among the important points to remember the past recommendations, there is the proposal of a new classification with the”individualization of the IC to the fraction of the left ventricle (LVEF) is moderately reduced (LVEF of 40% to 50%), new algorithms for the diagnosis and treatment, including the diagnosis of l”IC-to-LVEF preserved, place and means of preventive treatment, the support of co-morbidities, in particular of iron deficiency, a simplification of the indications for resynchronization, and finally a growing place given to the patient’s journey and management of the output of hospitalization.
It is important that the doctor make the choice of the right order, but it is also important that the patient has well understood the challenges of his illness to be un important actor in this support, and it passes through therapeutic education, whose development is still insufficient in France.
Heart failure (heart failure 101) is the leading chronic disease in cardiology. Its prognosis remains poor despite improvement of its management that allow patients to live longer with this disease, alternating periods of stability and episodes of decompensation. The treatment guidelines are regularly updated to incorporate new results of recent trials that are likely to impact on the care routine. These guidelines are proposed with different categories of recommendations and the difference of the levels of evidence. It is of paramount importance to summarize the guidelines to make them accessible to the great majority of cardiologists and easy to read and to promote their application.
Among the main novelties of the last set of European guidelines for the management of heart failure, we take note of the proposal of a new classification based on the level of the left ventricular ejection fraction (LVEF) with a new class, called heart failure with mid-range ejection fraction (LVEF of 40% to 50%), new algorithms for the diagnosis and treatment, including the diagnosis of heart failure with preserved ejection fraction, a particular focus on prevention strategies, management of comorbidities, including iron deficiency, simplification of the indications for cardiac resynchronization therapy, and finally, a growing attention to patient pathways and the management of the exit of the hospital.
According to these guidelines, it is important for the doctor to choose the proper medicines; but it is also important that the patient understands the disease, and acquired self-care skills necessary to become a real actor in its management. This requires education of the patient, who is under-developed in France.