Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.
Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: https://twitter.com/HannaGaggin.
J Am Coll Cardiol. 2019 Jun 4;73(21):2756-2768. doi: 10.1016/j.jacc.2019.03.478.
The 2013 (with updates in 2016 and 2017) American College of Cardiology/American Heart Association and 2016 European Society of Cardiology guidelines provide practical evidence-based clinical guidelines for the diagnosis and treatment of both acute and chronic heart failure (HF). Both guidelines address noninvasive and invasive testing to establish the diagnosis of HF with reduced ejection fraction and HF with preserved ejection fraction. Extensive trial evidence supports the use of guideline-directed medical therapy and device-based therapies for the optimal management of patients with HF with reduced ejection fraction. Specific recommendations are also provided for HF with preserved ejection fraction although the evidence is substantially weaker. Management of medical comorbidities is now addressed in both guidelines. Acute HF and end-stage disease requiring advanced therapies are also discussed. This review compares specific recommendations across the spectrum of HF phenotypes and disease severity, highlights areas where differences exist, and lists consequential studies published since the latest guidelines.
2013 年（并在 2016 年和 2017 年进行了更新）美国心脏病学会/美国心脏协会和 2016 年欧洲心脏病学会指南为急性和慢性心力衰竭（HF）的诊断和治疗提供了实用的循证临床指南。这两个指南都涉及到无创和有创检查，以确定射血分数降低的心力衰竭和射血分数保留的心力衰竭的诊断。大量临床试验证据支持使用指南指导的药物治疗和基于器械的治疗，以优化射血分数降低的心力衰竭患者的管理。尽管证据较弱，但也为射血分数保留的心力衰竭提供了具体建议。现在，这两个指南都解决了医疗合并症的管理问题。急性心力衰竭和需要高级治疗的终末期疾病也在讨论中。这篇综述比较了心力衰竭表型和疾病严重程度谱中的具体建议，突出了存在差异的领域，并列出了自最新指南发布以来发表的相关研究。
