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Management of chronic heart failure in adults: synopsis of the National Institute For Health and clinical excellence
Jonathan Mant1, Abdallah Al-Mohammad, Sharon Swain
1University of Cambridge, Cambridge, United Kingdom. jm677@medschl.cam.ac.uk
Annals of Internal Medicine
|August 17, 2011
Summary
This updated heart failure guideline emphasizes using serum natriuretic peptide measurements for diagnosis and monitoring. It also outlines treatment pathways for various heart failure types, including those with preserved ejection fraction.
Area of Science:
- Cardiology
- Clinical Practice Guidelines
- Public Health
Background:
- The National Institute for Health and Clinical Excellence (NICE) first issued a heart failure guideline in 2003.
- This synopsis details the 2010 update, incorporating new evidence and recommendations.
Purpose of the Study:
- To summarize the updated NICE guideline on heart failure diagnosis, treatment, and monitoring.
- To highlight key changes and recommendations from the 2010 guideline update.
Main Methods:
- Systematic literature searches were conducted to gather clinical evidence.
- Health economic analyses and patient views were incorporated.
- A decision model evaluated the cost-effectiveness of serum natriuretic peptide monitoring.
Main Results:
- The guideline update details the use of serum natriuretic peptide, echocardiography, and specialist assessment for heart failure diagnosis.
- Treatment pathways are presented for heart failure with systolic dysfunction and preserved ejection fraction.
- Serial serum natriuretic peptide measurement is recommended for monitoring chronic heart failure patients.
Conclusions:
- The updated guideline provides comprehensive recommendations for heart failure management.
- Serum natriuretic peptide measurement is a key tool for both diagnosis and monitoring.
- The guideline addresses pharmacologic treatment, rehabilitation, and advanced pacing therapies.
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