By América Torres
The “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure”), by The American Heart Association (AHA), The American College of Cardiology (ACC) and The Heart Failure Society of America (HFSA) contains substantial changes to prevent, diagnose and manage patients with heart failure (HF).
This document replaces the “2013 ACCF/AHA Guideline for the Management of Heart Failure” and the “ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure”, published in 2017.
In this article we have condensed some of the most important topics to help you get a general idea of its contents in a few minutes. We hope you find it useful.
Some novelties and changes 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
Some novelties and changes 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
HF is one of the leading causes of morbidity and mortality worldwide.The new document offers recommendations to manage those patients, based on the latest scientific and medical evidence. The objective of this arduous research (which took place from May to December 2020) is to offer them better care that positively impacts their quality of life.These are the most outstanding topics.
- Prevention plays a major role in patients who are at risk for heart failure (stage A) or pre-HF (stage B).The 2022 Guideline contains new definitios of what "at risk" means for stage A heart failure and stage B pre-HF.
- Medical therapy to treat HFrEF HF considers now four kinds of medications:
1 ReninAngiotensin System Inhibition With ACEi or ARB or ARNi. Recommendations for ReninAngiotensin System Inhibition With ACEi or ARB or ARNi
2 Beta Blockers.
3 Mineralocorticoid Receptor Antagonists (MRAs).
4 A new group of medication is added: Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i).
- SGLT2i have a Class 2a recommendation for patients with HfmrEF. On the other hand, ARNi, ACEi, ARB, MRA, and beta-blockers have a recommendation Class 2b.
- The term Improved Left Ventricular Ejection Fraction (LVEF) will be used to refer to patients with HF with Reduced Ejection Fraction (HfrEF) who now have a LVEF >40%.However, such patients should continue their treatment for HfrEF.
- The 2022 Guideline for the Management of HF includes new recommendations for treating amyloid heart disease, such as: genetic sequencing, serum and urine monoclonal light chain screening, bone scintigraphy, tetramer stabilization therapy (e.g., tadamidis), and anticoagulation.
- Special recommendations are included for patients with HF with the following comorbidities:
Iron deficiency
Anemia
Cancer
Sleep disorders
Type 2 diabetes
Coronary artery disease (arteriosclerosis)
Atrial fibrillation
Hypertension
* Patients with advanced HF who wish to prolong their survival should be referred to a specialized team. This team will be responsible for managing HF, defining the most appropriate advanced therapies and palliative care (including palliative inotropes), according to the patient's wishes.
If you´d like to check the full document, click here.
