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Can J Cardiol. 2017 Nov;33(11):1342-1433. doi: 10.1016/j.cjca.2017.08.022. Epub 2017 Sep 6.

2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure.

Author information

1
University of Alberta, Edmonton, Alberta, Canada. Electronic address: jae2@ualberta.ca.
2
Institut de Cardiologie de Montréal, Université de Montréal, Montréal, Québec, Canada.
3
University Health Network, Toronto, Ontario, Canada.
4
Edmonton Cardiology Consultants, Edmonton, Alberta, Canada.
5
McGill University, Montréal, Québec, Canada.
6
Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
7
University of Alberta, Edmonton, Alberta, Canada.
8
University of Waterloo, Waterloo, Ontario, Canada.
9
University of Calgary, Calgary, Alberta, Canada.
10
Université de Sherbrooke, Sherbrooke, Québec, Canada.
11
London Health Sciences, Western University, London, Ontario, Canada.
12
St Michael's Hospital, Toronto, Ontario, Canada.
13
QEII Health Sciences Centre, Halifax, Nova Scotia, Canada.
14
Royal Jubilee Hospital, Victoria, British Columbia, Canada.
15
University of British Columbia, Vancouver, British Columbia, Canada.
16
St Boniface General Hospital, Winnipeg, Manitoba, Canada.
17
Hôpital Lariboisière, Paris, France.
18
Université du Moncton, Moncton, New Brunswick, Canada.
19
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
20
University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
21
Duke Clinical Research Institute, Durham, North Carolina, USA.
22
Centre Hospitalier Régional de Lanaudière, Joliette, Québec, Canada.
23
Hôpital Laval, Université Laval, Québec, Québec, Canada.
24
University of Colorado, Aurora, Colorado, USA.
25
Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
26
Memorial University, St John's, Newfoundland, Canada.

Abstract

Since the inception of the Canadian Cardiovascular Society heart failure (HF) guidelines in 2006, much has changed in the care for patients with HF. Over the past decade, the HF Guidelines Committee has published regular updates. However, because of the major changes that have occurred, the Guidelines Committee believes that a comprehensive reassessment of the HF management recommendations is presently needed, with a view to producing a full and complete set of updated guidelines. The primary and secondary Canadian Cardiovascular Society HF panel members as well as external experts have reviewed clinically relevant literature to provide guidance for the practicing clinician. The 2017 HF guidelines provide updated guidance on the diagnosis and management (self-care, pharmacologic, nonpharmacologic, device, and referral) that should aid in day-to-day decisions for caring for patients with HF. Among specific issues covered are risk scores, the differences in management for HF with preserved vs reduced ejection fraction, exercise and rehabilitation, implantable devices, revascularization, right ventricular dysfunction, anemia, and iron deficiency, cardiorenal syndrome, sleep apnea, cardiomyopathies, HF in pregnancy, cardio-oncology, and myocarditis. We devoted attention to strategies and treatments to prevent HF, to the organization of HF care, comorbidity management, as well as practical issues around the timing of referral and follow-up care. Recognition and treatment of advanced HF is another important aspect of this update, including how to select advanced therapies as well as end of life considerations. Finally, we acknowledge the remaining gaps in evidence that need to be filled by future research.

PMID:
29111106
DOI:
10.1016/j.cjca.2017.08.022
[Indexed for MEDLINE]

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