In April of this year, American heart Association released their updated, 2022 Heart Failure (HF) management guidelines. There are many significant changes included and I will highly recommend that you review the attached 2022 AHA – ACC – HFSA Guidelines for Heart Failure.
Though, there are many major updates, I will highlight just a few:
- See the updated stages of HF in the image below.
- There are 4 categories of HF:
- HF with reduced ejection fraction i.e., less than 40% (HFpEF)
- HF with mildly-reduced EF i.e., between 41-49% (HFrEF)
- HF with preserved EF i.e., >40% (HFpEF), and
- HF with improved EF i.e., back to >40% (HFimpEF)
- Besides diuretics for symptoms management, there are 4 key classes of medications that should be used for most of the HF categories including:
- Angiotensin receptor-neprilysin inhibitors (ARNIs) e.g., Entresto (Sacubitril)
- If ARNIs cant be used then prefer ACE Inhibitors over Angiotensin Receptor Blockers
- Sodium-glucose cotransporter 2 (SGLT2) Inhibitors e.g., dapagliflozin (Farxiga), empagliflozin (Jardiance) etc.
- Mineralocorticoid antagonists e.g., spironolactone, eplerenone etc.
- Beta-blockers only for HFrEF e.g., carvedilol, bisoprolol and long-acting metoprolol
- For patients with advanced chronic HF, care should be managed by an interprofessional HF team that includes a high focus on palliation.
Again, these are just few high points, but there is much more important info in the attached report with slides.
More information is available at:
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure – Professional Heart Daily | American Heart Association