2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults

Long‐term Outcome of Irish Wolfhound Dogs with Preclinical Cardiomyopathy, Atrial Fibrillation, or Both Treated with Pimobendan, Benazepril Hydrochloride, or Methyldigoxin Monotherapy

“…Indeed, outpatient management guidelines for heart failure patients emphasize a systematic approach, incorporate heart failure performance measures, and stress evidence‐based treatment which includes angiotensin‐converting enzyme inhibitors and digitalis glycosides 9, 10, 11. Clinical trial data are limited in dogs, and the majority of studies have focused on treatment to manage chronic myxomatous valvular disease (MMVD).…”

Dilated Cardiomyopathy

“…10,11 Accordingly, the importance of considering familial disease in DCM has been emphasized in recent consensus statements. 12,13 The study of affected kindreds has revealed familial DCM to be mostly inherited in an autosomal dominant fashion with characteristic age-dependent penetrance and variable clinical expression (Figure 1). Autosomal recessive, X-linked and mitochondrial forms have been described in a limited number of cases, often with associated skeletal myopathy.…”

“…12 Observational studies have found that competitive athletes have an increased rate of adverse events in LMNA associated DCM. 37 Accordingly, it would be reasonable to advise against sustained endurance training in affected patients, even with minimal disease manifestations.…”

“…As described in consensus guidelines, these medications should be titrated to the dose used in clinical trials unless limited by side effect. 12 Patients with DCM were included in the pivotal trials which established the survival benefit associated with ACEi, ARB and BB use in a broad spectrum of patients with DCM; from severe 54,55 to moderate 56,57 heart failure to asymptomatic LV systolic dysfunction. 58,59 The benefit conferred by aldosterone antagonists in patients with mild 60 and severe heart failure 61 was similar in patients with both non-ischemic and ischemic cardiomyopathy.…”

Screening patients for primary prophylaxis implantable cardioverter defibrillators: Insights into current practices

“…Not all patients would benefit from this approach (eg, patients with recent heart failure diagnosis). The current standard of care for patients presenting with heart failure includes 2D echocardiography with Doppler during initial evaluation of ventricular function, LV size, wall thickness and valve function (23). However, for stable heart failure patients in whom the only question is, 'does my patient qualify for a prophylactic ICD?…”