ESC Heart Failure Guidelines feature new recommendations on devices, drugs and diagnosis

May 19, 2012, European Society of Cardiology

New recommendations on devices, drugs and diagnosis in heart failure were launched at the Heart Failure Congress 2012, 19-22 May, in Belgrade, Serbia, and published in the European Heart Journal.

The ESC Guidelines for the Diagnosis and Treatment of Acute and 2012 were developed by the European Society of Cardiology (ESC) in collaboration with the Heart Failure Association (HFA) of the ESC. The Congress is the HFA's main annual meeting.

An analysis of the most up to date in the field of heart failure by the ESC Guidelines task force led to several major updates since the previous ESC Guidelines were published in 2008.

In devices, left (LVADs) were hailed as a step change in the management of heart failure. LVADs are more reliable and lead to fewer complications than in 2008. Until now, LVADs have been used as a temporary measure in patients awaiting a . But Professor John McMurray (Glasgow, UK), chairperson of the ESC Clinical Practice Guidelines Task Force, says: "LVADs will increasingly be used as a treatment in their own right, not just as a temporary support while awaiting transplantation."

A new indication for cardiac resynchronisation therapy (CRT) in patients with mild symptoms is given in the guidelines. More evidence from new trials and further analysis of existing trials also enabled the task force to provide more clarity about the effects of CRT. It is clear that patients with left bundle branch block QRS morphology and those who are in sinus rhythm have the greatest benefit from CRT. Conversely, those who have a non-left bundle branch block QRS morphology and patients in have less certain benefit.

Also in the device arena, new transcatheter valve interventions are discussed. "These interventions offer the possibility of treating aortic in patients who are unsuitable for surgery," says Professor McMurray.

In pharmacological treatments, two new indications are highlighted. The guidelines stress that when attempting to reduce heart rate, the dose of beta blocker should be maximised before giving additional medications to reduce heart rate. "Beta blockers are more established, more effective and less expensive, and should be given first," says Professor McMurray.

New evidence has extended the indication for mineralocorticoid receptor antagonists. This means that for many patients, standard therapy should include three neurohumoral antagonists – an angiotensin converting enzyme inhibitor (or angiotensin receptor blocker), a beta blocker and, if symptoms persist, now a mineralocorticoid receptor antagonist as well.

In the area of diagnostics, a new biomarker called mid-regional pro-A-type natriuretic peptide is mentioned for the first time.

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

Explore further: HFSA updates recommendations for use of cardiac resynchronization therapy

More information: For practical information about heart failure aimed at patients, families and caregivers, visit the HFA's Heart Failure Matters website at www.heartfailurematters.org/EN/Pages/index.aspx

Related Stories

HFSA updates recommendations for use of cardiac resynchronization therapy

February 27, 2012
Based on a review of the latest evidence, the Guidelines Committee of the Heart Failure Society of America now recommends that the use of cardiac resynchronization therapy (CRT) be expanded to a larger group of patients with ...

The benefits of cardiac resynchronisation therapy in heart failure

December 19, 2011
However, large-scale clinical trials have highlighted the beneficial effect of cardiac resynchronisation therapy (CRT) in the improvement of symptoms and reduction of mortality, and CRT is now recommended in the major European ...

New patient guidelines for heart devices

April 17, 2011
A series of new guidelines for cardiac specialists has been developed to determine when heart failure patients should receive a mechanical heart-pumping device.

Heart Failure: Targeting the right patients for CRT-D

May 22, 2011
Patients with dyssynchronous yet viable ventricles are most likely to benefit from cardiac resynchronization therapy combined with defibrillation, concludes the latest analysis of the MADIT CRT trial. The CRT-MADIT-CRT trial ...

Recommended for you

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.