Heart Failure Guidelines: Key Recommendations at a Glance

Key recommendations

• Classify heart failure by left ventricular ejection fraction: reduced (40% or less), mildly reduced (41–49%) and preserved (50% or more).
• In heart failure with reduced ejection fraction, four drug classes form the foundation of therapy: an ACE inhibitor or ARNI, a beta-blocker, a mineralocorticoid receptor antagonist and an SGLT2 inhibitor.
• Titrate to target or maximally tolerated doses while monitoring kidney function and potassium.
• Use diuretics to relieve congestion, at the lowest dose that keeps the patient euvolaemic.
• Assess eligibility for device therapy (ICD or CRT) once medical therapy has been optimised.

References

1. McDonagh TA, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42:3599–3726.
2. Heidenreich PA, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Circulation. 2022;145:e895–e1032.