2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Abstract

Aim: The “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure” replaces the “2013 ACCF/AHA Guideline for the Management of Heart Failure” and the “2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure.” The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. Methods: A comprehensive literature search was conducted from May 2020 to December 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (PubMed), EMBASE, the Cochrane Collaboration, the Agency for Healthcare Research and Quality, and other relevant databases. Additional relevant clinical trials and research studies, published through September 2021, were also considered. This guideline was harmonized with other American Heart Association/American College of Cardiology guidelines published through December 2021. Structure: Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients’ interests. Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses.

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

“…Authors’ relationships with industry and other entities information is published in Appendix 1 of the full guideline. 5 Reviewers’ relationships with industry and other entities information is published in Appendix 2 of the full guideline. 5…”

Novel biomarkers of inflammation in heart failure with preserved ejection fraction: analysis from a large prospective cohort study

“…The present study assessed ejection fraction based on a cut point of 45% for HFpEF versus HFrEF. The recently released 2022 heart failure guidelines created a new formal category of heart failure, “heart failure with mildly reduced ejection fraction” including ejection fraction percentages from 41 to 49% [ 19 ]. The present study elected not to reclassify as the new classification has not be specifically implemented in randomized controlled trials and reclassifying to a third class of heart failure would have only generated 33 unique incident cases.…”

Serum Levels of Irisin Predict Cumulative Clinical Outcomes in Heart Failure Patients With Type 2 Diabetes Mellitus

“…On the other hand, T2DM is strongly associated with a 2- to 4-fold increased risk of HF ( Park, 2021 ) and that intensive management of CV risk factors and T2DM reduces the risk of subsequent all-cause death, CV events and HF hospitalization ( Upadhya et al, 2021 ; Dziopa et al, 2022 ). Current clinical guidelines for HF generally recommend the use of natriuretic peptides (NPs), including the N-terminal fragment of brain natriuretic pro-peptide ( McDonagh et al, 2021 ; Heidenreich et al, 2022 ), but the predictive discriminatory potency of NPs varies sufficiently in HFrEF and HFpEF ( Arshi et al, 2021 ) as well as in T2DM and obese patients because of high variability of serum levels of NPs ( Pieske et al, 2019 ).…”