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Heart failure with preserved ejection fraction management : a systematic review of clinical practice guidelines and recommendations

Mahmood, Adil ; Dhall, Eamon ; Primus, Christopher P. ; Gallagher, Angela ; Zakeri, Rosita ; Mohammed, Selma F. ; Chahal, Anwar A. ; Ricci, Fabrizio LU ; Aung, Nay and Khanji, Mohammed Y. (2024) In European Heart Journal - Quality of Care and Clinical Outcomes 10(7). p.571-589
Abstract

Multiple guidelines exist for the diagnosis and management of heart failure with preserved ejection fraction (HFpEF). We systematically reviewed current guidelines and recommendations, developed by national and international medical organizations, on the management of HFpEF in adults to aid clinical decision-making. We searched MEDLINE and EMBASE on 28 February 2024 for publications over the last 10 years as well as websites of organizations relevant to guideline development. Of the 10 guidelines and recommendations retrieved, 7 showed considerable rigour of development and were subsequently retained for analysis. There was consensus on the definition of HFpEF and the diagnostic role of serum natriuretic peptides and resting... (More)

Multiple guidelines exist for the diagnosis and management of heart failure with preserved ejection fraction (HFpEF). We systematically reviewed current guidelines and recommendations, developed by national and international medical organizations, on the management of HFpEF in adults to aid clinical decision-making. We searched MEDLINE and EMBASE on 28 February 2024 for publications over the last 10 years as well as websites of organizations relevant to guideline development. Of the 10 guidelines and recommendations retrieved, 7 showed considerable rigour of development and were subsequently retained for analysis. There was consensus on the definition of HFpEF and the diagnostic role of serum natriuretic peptides and resting transthoracic echocardiography. Discrepancies were identified in the thresholds of serum natriuretic peptides and transthoracic echocardiography parameters used to diagnose HFpEF. There was agreement on the general pharmacological and supportive management of acute and chronic HFpEF. However, differences exist in strategies to identify and address specific phenotypes. Contemporary guidelines for HFpEF management agree on measures to avoid its development and the consideration of cardiac transplantation in advanced diseases. There were discrepancies in recommended frequency of surveillance for patients with HFpEF and sparse recommendations on screening for HFpEF in the general population, use of diagnostic scoring systems, and the role of newly emerging therapies.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Diastolic dysfunction, Guideline, Heart failure, Heart failure with preserved ejection fraction, recommendations, Systematic review
in
European Heart Journal - Quality of Care and Clinical Outcomes
volume
10
issue
7
pages
19 pages
publisher
Oxford University Press
external identifiers
  • scopus:85206350019
  • pmid:38918060
ISSN
2058-5225
DOI
10.1093/ehjqcco/qcae053
language
English
LU publication?
yes
id
6e07272d-f91f-4c14-a0e0-f1f35cace2a7
date added to LUP
2025-01-09 12:20:58
date last changed
2025-02-06 15:01:19
@article{6e07272d-f91f-4c14-a0e0-f1f35cace2a7,
  abstract     = {{<p>Multiple guidelines exist for the diagnosis and management of heart failure with preserved ejection fraction (HFpEF). We systematically reviewed current guidelines and recommendations, developed by national and international medical organizations, on the management of HFpEF in adults to aid clinical decision-making. We searched MEDLINE and EMBASE on 28 February 2024 for publications over the last 10 years as well as websites of organizations relevant to guideline development. Of the 10 guidelines and recommendations retrieved, 7 showed considerable rigour of development and were subsequently retained for analysis. There was consensus on the definition of HFpEF and the diagnostic role of serum natriuretic peptides and resting transthoracic echocardiography. Discrepancies were identified in the thresholds of serum natriuretic peptides and transthoracic echocardiography parameters used to diagnose HFpEF. There was agreement on the general pharmacological and supportive management of acute and chronic HFpEF. However, differences exist in strategies to identify and address specific phenotypes. Contemporary guidelines for HFpEF management agree on measures to avoid its development and the consideration of cardiac transplantation in advanced diseases. There were discrepancies in recommended frequency of surveillance for patients with HFpEF and sparse recommendations on screening for HFpEF in the general population, use of diagnostic scoring systems, and the role of newly emerging therapies.</p>}},
  author       = {{Mahmood, Adil and Dhall, Eamon and Primus, Christopher P. and Gallagher, Angela and Zakeri, Rosita and Mohammed, Selma F. and Chahal, Anwar A. and Ricci, Fabrizio and Aung, Nay and Khanji, Mohammed Y.}},
  issn         = {{2058-5225}},
  keywords     = {{Diastolic dysfunction; Guideline; Heart failure; Heart failure with preserved ejection fraction; recommendations; Systematic review}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{571--589}},
  publisher    = {{Oxford University Press}},
  series       = {{European Heart Journal - Quality of Care and Clinical Outcomes}},
  title        = {{Heart failure with preserved ejection fraction management : a systematic review of clinical practice guidelines and recommendations}},
  url          = {{http://dx.doi.org/10.1093/ehjqcco/qcae053}},
  doi          = {{10.1093/ehjqcco/qcae053}},
  volume       = {{10}},
  year         = {{2024}},
}