National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heart failure 2018

John Atherton, Andrew Sindone, Carmine de Pasquale, Andrea Driscoll, Peter Simon Macdonald, Ingrid Hopper, Peter Kistler, Tom G Briffa, James Wong, Walter Abhayaratna, Liza Thomas, Ralph Audehm, Phillip J Newton, O'Loughlin Joan, Connell Cia, Maree G Branagan

Research output: Contribution to journalArticleOtherpeer-review

Abstract

Introduction: Heart failure (HF) is a clinical syndrome that is secondary to an abnormality of cardiac structure or function. These clinical practice guidelines focus on the diagnosis and management of HF with recommendations that have been graded on the strength of evidence and the likely absolute benefit versus harm. Additional considerations are presented as practice points.

Main recommendations:
Blood pressure and lipid lowering decrease the risk of developing HF. Sodium–glucose cotransporter 2 inhibitors decrease the risk of HF hospitalisation in patients with type 2 diabetes and cardiovascular disease.
An echocardiogram is recommended if HF is suspected or newly diagnosed.
If an echocardiogram cannot be arranged in a timely fashion, measurement of plasma B-type natriuretic peptides improves diagnostic accuracy.
Angiotensin-converting enzyme inhibitors, β-blockers and mineralocorticoid receptor antagonists improve outcomes in patients with HF associated with a reduced left ventricular ejection fraction. Additional treatment options in selected patients with persistent HF associated with reduced left ventricular ejection fraction include switching the angiotensin-converting enzyme inhibitor to an angiotensin receptor neprilysin inhibitor; ivabradine; implantable cardioverter defibrillators; cardiac resynchronisation therapy; and atrial fibrillation ablation.
Multidisciplinary HF disease management facilitates the implementation of evidence-based HF therapies. Clinicians should also consider models of care that optimise medication titration (eg, nurse-led titration).
Changes in management as a result of the guideline: These guidelines have been designed to facilitate the systematic integration of recommendations into HF care. This should include ongoing audit and feedback systems integrated into work practices in order to improve the quality of care and outcomes of patients with HF.
Original languageEnglish
Pages (from-to)363-369
Number of pages7
JournalMedical Journal of Australia
Volume209
Issue number8
DOIs
Publication statusPublished - 2 Aug 2018

Cite this

Atherton, John ; Sindone, Andrew ; de Pasquale, Carmine ; Driscoll, Andrea ; Macdonald, Peter Simon ; Hopper, Ingrid ; Kistler, Peter ; Briffa, Tom G ; Wong, James ; Abhayaratna, Walter ; Thomas, Liza ; Audehm, Ralph ; Newton, Phillip J ; Joan, O'Loughlin ; Cia, Connell ; Branagan, Maree G. / National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heart failure 2018. In: Medical Journal of Australia. 2018 ; Vol. 209, No. 8. pp. 363-369.
@article{b651bb982b374866887b869150688ed5,
title = "National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heart failure 2018",
abstract = "Introduction: Heart failure (HF) is a clinical syndrome that is secondary to an abnormality of cardiac structure or function. These clinical practice guidelines focus on the diagnosis and management of HF with recommendations that have been graded on the strength of evidence and the likely absolute benefit versus harm. Additional considerations are presented as practice points.Main recommendations:Blood pressure and lipid lowering decrease the risk of developing HF. Sodium–glucose cotransporter 2 inhibitors decrease the risk of HF hospitalisation in patients with type 2 diabetes and cardiovascular disease.An echocardiogram is recommended if HF is suspected or newly diagnosed.If an echocardiogram cannot be arranged in a timely fashion, measurement of plasma B-type natriuretic peptides improves diagnostic accuracy.Angiotensin-converting enzyme inhibitors, β-blockers and mineralocorticoid receptor antagonists improve outcomes in patients with HF associated with a reduced left ventricular ejection fraction. Additional treatment options in selected patients with persistent HF associated with reduced left ventricular ejection fraction include switching the angiotensin-converting enzyme inhibitor to an angiotensin receptor neprilysin inhibitor; ivabradine; implantable cardioverter defibrillators; cardiac resynchronisation therapy; and atrial fibrillation ablation.Multidisciplinary HF disease management facilitates the implementation of evidence-based HF therapies. Clinicians should also consider models of care that optimise medication titration (eg, nurse-led titration).Changes in management as a result of the guideline: These guidelines have been designed to facilitate the systematic integration of recommendations into HF care. This should include ongoing audit and feedback systems integrated into work practices in order to improve the quality of care and outcomes of patients with HF.",
author = "John Atherton and Andrew Sindone and {de Pasquale}, Carmine and Andrea Driscoll and Macdonald, {Peter Simon} and Ingrid Hopper and Peter Kistler and Briffa, {Tom G} and James Wong and Walter Abhayaratna and Liza Thomas and Ralph Audehm and Newton, {Phillip J} and O'Loughlin Joan and Connell Cia and Branagan, {Maree G}",
year = "2018",
month = "8",
day = "2",
doi = "10.5694/mja18.00647",
language = "English",
volume = "209",
pages = "363--369",
journal = "Medical Journal of Australia",
issn = "0025-729X",
publisher = "AMPCo",
number = "8",

}

Atherton, J, Sindone, A, de Pasquale, C, Driscoll, A, Macdonald, PS, Hopper, I, Kistler, P, Briffa, TG, Wong, J, Abhayaratna, W, Thomas, L, Audehm, R, Newton, PJ, Joan, OL, Cia, C & Branagan, MG 2018, 'National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heart failure 2018', Medical Journal of Australia, vol. 209, no. 8, pp. 363-369. https://doi.org/10.5694/mja18.00647

National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heart failure 2018. / Atherton, John; Sindone, Andrew; de Pasquale, Carmine; Driscoll, Andrea; Macdonald, Peter Simon; Hopper, Ingrid; Kistler, Peter; Briffa, Tom G; Wong, James; Abhayaratna, Walter; Thomas, Liza; Audehm, Ralph; Newton, Phillip J; Joan, O'Loughlin; Cia, Connell; Branagan, Maree G.

In: Medical Journal of Australia, Vol. 209, No. 8, 02.08.2018, p. 363-369.

Research output: Contribution to journalArticleOtherpeer-review

TY - JOUR

T1 - National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heart failure 2018

AU - Atherton, John

AU - Sindone, Andrew

AU - de Pasquale, Carmine

AU - Driscoll, Andrea

AU - Macdonald, Peter Simon

AU - Hopper, Ingrid

AU - Kistler, Peter

AU - Briffa, Tom G

AU - Wong, James

AU - Abhayaratna, Walter

AU - Thomas, Liza

AU - Audehm, Ralph

AU - Newton, Phillip J

AU - Joan, O'Loughlin

AU - Cia, Connell

AU - Branagan, Maree G

PY - 2018/8/2

Y1 - 2018/8/2

N2 - Introduction: Heart failure (HF) is a clinical syndrome that is secondary to an abnormality of cardiac structure or function. These clinical practice guidelines focus on the diagnosis and management of HF with recommendations that have been graded on the strength of evidence and the likely absolute benefit versus harm. Additional considerations are presented as practice points.Main recommendations:Blood pressure and lipid lowering decrease the risk of developing HF. Sodium–glucose cotransporter 2 inhibitors decrease the risk of HF hospitalisation in patients with type 2 diabetes and cardiovascular disease.An echocardiogram is recommended if HF is suspected or newly diagnosed.If an echocardiogram cannot be arranged in a timely fashion, measurement of plasma B-type natriuretic peptides improves diagnostic accuracy.Angiotensin-converting enzyme inhibitors, β-blockers and mineralocorticoid receptor antagonists improve outcomes in patients with HF associated with a reduced left ventricular ejection fraction. Additional treatment options in selected patients with persistent HF associated with reduced left ventricular ejection fraction include switching the angiotensin-converting enzyme inhibitor to an angiotensin receptor neprilysin inhibitor; ivabradine; implantable cardioverter defibrillators; cardiac resynchronisation therapy; and atrial fibrillation ablation.Multidisciplinary HF disease management facilitates the implementation of evidence-based HF therapies. Clinicians should also consider models of care that optimise medication titration (eg, nurse-led titration).Changes in management as a result of the guideline: These guidelines have been designed to facilitate the systematic integration of recommendations into HF care. This should include ongoing audit and feedback systems integrated into work practices in order to improve the quality of care and outcomes of patients with HF.

AB - Introduction: Heart failure (HF) is a clinical syndrome that is secondary to an abnormality of cardiac structure or function. These clinical practice guidelines focus on the diagnosis and management of HF with recommendations that have been graded on the strength of evidence and the likely absolute benefit versus harm. Additional considerations are presented as practice points.Main recommendations:Blood pressure and lipid lowering decrease the risk of developing HF. Sodium–glucose cotransporter 2 inhibitors decrease the risk of HF hospitalisation in patients with type 2 diabetes and cardiovascular disease.An echocardiogram is recommended if HF is suspected or newly diagnosed.If an echocardiogram cannot be arranged in a timely fashion, measurement of plasma B-type natriuretic peptides improves diagnostic accuracy.Angiotensin-converting enzyme inhibitors, β-blockers and mineralocorticoid receptor antagonists improve outcomes in patients with HF associated with a reduced left ventricular ejection fraction. Additional treatment options in selected patients with persistent HF associated with reduced left ventricular ejection fraction include switching the angiotensin-converting enzyme inhibitor to an angiotensin receptor neprilysin inhibitor; ivabradine; implantable cardioverter defibrillators; cardiac resynchronisation therapy; and atrial fibrillation ablation.Multidisciplinary HF disease management facilitates the implementation of evidence-based HF therapies. Clinicians should also consider models of care that optimise medication titration (eg, nurse-led titration).Changes in management as a result of the guideline: These guidelines have been designed to facilitate the systematic integration of recommendations into HF care. This should include ongoing audit and feedback systems integrated into work practices in order to improve the quality of care and outcomes of patients with HF.

U2 - 10.5694/mja18.00647

DO - 10.5694/mja18.00647

M3 - Article

VL - 209

SP - 363

EP - 369

JO - Medical Journal of Australia

JF - Medical Journal of Australia

SN - 0025-729X

IS - 8

ER -