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Amanda Jekowsky , American College of
Cardiology, 202-375-6645, ajekowsk@acc.org
March
26, 2009
Updated Heart Failure Guidelines Focus
on Key Research Findings, Clinical Advances
New section offers recommendations on hospitalized
patients with acute heart failure
Updated guidelines on the diagnosis and management of heart
failure will help physicians incorporate the latest research
findings into the treatment of patients with this complex
and disabling disease.
The guidelines update was a joint effort of the American
College of Cardiology (ACC) and the American Heart Association
(AHA), and was accomplished in collaboration with the International
Society for Heart and Lung Transplantation. The new document,
a focused revision of guidelines released in 2005, publishes
online today in the Journal of the American College of
Cardiology (JACC) and Circulation: Journal of the American
Heart Association.
“Heart failure is the number one reason patients over
the age of 65 are hospitalized, and is responsible for a huge
portion of the costs associated with cardiovascular disease,”
said Mariell Jessup, M.D., chair of the guidelines writing
group and a professor of medicine at the University of Pennsylvania
School of Medicine in Philadelphia. “We want to be sure
the guidelines are current and timely, and reflect the latest
data on the management of this important condition.”
In heart failure, the heart does not do an adequate job circulating
blood throughout the body. In one type of heart failure, the
heart is enlarged and weak. It is therefore unable to squeeze
enough blood out into the blood vessels with each beat. In
another form of heart failure, the walls of the heart become
stiff so that the heart is unable to relax and fill with enough
blood between beats. In either case, fluid backs up into the
lungs and the rest of the body, causing shortness of breath,
swelling of the limbs and other symptoms.
Some 5.7 million Americans have heart failure, a condition
that accounts for more than 1.1 million hospitalizations each
year. One in five people die within a year of being diagnosed
with heart failure. In 2009, it is estimated that total costs
associated with heart failure will reach $37.2 billion.
The new document includes several key updates, including
the following:
- An entirely new section on managing patients who are hospitalized
with acute heart failure, including how to establish the
cause of heart failure; the types of assessments to perform
throughout the hospitalization; and how to help patients
successfully transition to home care, including a new medication
regimen and an action plan for detecting signs of trouble
and seeking medical attention right away
- Strengthened recommendations on two medications, hydralazine
and isosorbide dinitrate, which relieve pressure on the
heart by relaxing blood vessels and are particularly effective
in African Americans
- Streamlined information on the use of implantable cardioverter-defibrillators
(ICDs)—which prevent sudden cardiac death—and
cardiac resynchronization devices—which improve symptoms
and outcomes in some patients with heart failure by helping
the two sides of the heart to beat in a more coordinated
fashion
- Clarification of treatment goals in patients with both
heart failure and atrial fibrillation, a common heart rhythm
disorder
“These guidelines strive to reflect the most recent
information coming out of clinical trials on heart failure,”
said Dr. Jessup, who is also director of the Heart Failure
and Transplant Program of the University of Pennsylvania Health
System in Philadelphia. “They also bring a new focus
to patients hospitalized with heart failure. We look forward
to continued research developments, so that the next update
will be even more useful for guiding physicians.”
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The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The College is
a 36,000-member nonprofit medical society and bestows the
credential Fellow of the American College of Cardiology upon
physicians who meet its stringent qualifications. The College
is a leader in the formulation of health policy, standards
and guidelines, and is a staunch supporter of cardiovascular
research. The ACC provides professional education and operates
national registries for the measurement and improvement of
quality care. More information about the association is available
online at www.acc.org .
The American College of Cardiology (ACC) provides these news
reports of clinical studies published in the Journal of
the American College of Cardiology as a service to physicians,
the media, the public and other interested parties. However,
statements or opinions expressed in these reports reflect
the view of the author(s) and do not represent official policy
of the ACC unless stated so.
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