University of Cambridge, Cambridge, United Kingdom.
Ann Intern Med. 2011 Aug 16;155(4):252-9. doi: 10.7326/0003-4819-155-4-201108160-00009.
The National Institute for Health and Clinical Excellence released its first clinical guideline on heart failure in 2003. This synopsis describes the update of that guideline, which was released in August 2010 and discusses the diagnosis, treatment, and monitoring of heart failure.
Guideline developers considered clinical evidence, health economic analyses, clinical expert opinion, and patient views. Systematic literature searches were performed, and an original decision model assessed the cost-effectiveness of serial measurement of serum natriuretic peptide to monitor patients with chronic heart failure.
First, this guideline update describes the role of serum natriuretic peptide measurement, echocardiography, and specialist assessment in the diagnosis of heart failure. Second, it presents a pathway for pharmacologic treatment, rehabilitation, and pacing therapy (including implantable cardioverter-defibrillator and cardiac resynchronization therapy) for patients with heart failure and left ventricular systolic dysfunction and patients with heart failure and preserved ejection fraction. Finally, it explains the recommendation to monitor patients with heart failure by using serial measurement of serum natriuretic peptide.
国家卫生与临床优化研究所于 2003 年发布了首个心力衰竭临床指南。该概要描述了 2010 年 8 月发布的该指南更新内容，并讨论了心力衰竭的诊断、治疗和监测。
指南制定者考虑了临床证据、健康经济学分析、临床专家意见和患者观点。进行了系统的文献检索，并使用原始决策模型评估了连续测量血清利钠肽监测慢性心力衰竭患者的成本效益。
首先，本指南更新描述了血清利钠肽测量、超声心动图和专科评估在心力衰竭诊断中的作用。其次，它为心力衰竭和左心室收缩功能障碍患者以及心力衰竭和射血分数保留患者的药物治疗、康复和起搏治疗（包括植入式心脏复律除颤器和心脏再同步治疗）提供了一个途径。最后，它解释了通过连续测量血清利钠肽监测心力衰竭患者的建议。
