Heart failure with reduced ejection fraction: A systematic review of clinical practice guidelines and recommendations - PubMed
4 hours ago
- #Heart Failure Management
- #Clinical Guidelines
- #HFrEF
- Heart failure with reduced ejection fraction (HFrEF) accounts for over half of heart failure cases.
- A systematic review of 12 guidelines identified 7 meeting AGREE II criteria for methodological rigor.
- Broad consensus exists on HFrEF prevention, definition, and initial diagnostic approach.
- Recommended investigations include coronary CT angiography, cardiac MRI, and invasive coronary angiography for selected patients.
- Pharmacological management consistently endorses RAAS inhibitors, beta-blockers, MRAs, and SGLT2 inhibitors.
- Key differences exist in natriuretic peptide thresholds, RAAS inhibitor sequencing, and device-based therapies.
- Variability noted in staging, particularly for stage A (at-risk) and stage B (pre-heart failure).
- Few guidelines address comorbidities like iron deficiency, atrial fibrillation, obesity, and sleep-disordered breathing.
- Findings highlight the need for greater harmonization to standardize HFrEF care globally.