Publication details

Srovnání amerických a evropských (českých) doporučení pro diagnostiku a léčbu chronického srdečního selhání

Title in English Comparison of American and European (Czech) guidelines for diagnosis and treatment of chronic heart failure
Authors

ŠPINAR Jindřich ŠPINAROVÁ Lenka VÍTOVEC Jiří LUDKA Ondřej

Year of publication 2014
Type Article in Periodical
Magazine / Source Vnitřní lékařství
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords diagnosis; guidelines; heart failure; treatment
Description The new Czech and European recommendations for diagnosis and treatment of heart failure were published in 2012. The American guidelines ACCF/AHA were published in 2013. Main difference between them is presentation of acute and chronic heart failure in the European guidelines while the American and the Czech guidelines include only chronic heart failure. The American recommendations distinguish heart failure with reduced ejection fraction and with remained ejection fraction. In the beginning, the American guidelines introduce A-D classification which doesn't figure in the European neither Czech guidelines. Class A patients are ill with risk factors, but without heart failure. In contrast, class D patients are decompensated with symptoms in the rest. Epidemiologie data shows interesting results with prevalence about 0.2% in 60-69 years old subjects and 80% in subjects older than 85 years. 5 year mortality is 50%. The American guidelines start to treat class A which is in fact prevention and treatment of risk factors. There is mentioned inevitably treatment of hypertension, both systolic and diastolic which decrease risk of heart failure up to 50%. There is almost no difference in pharmacotherapy. Noteworthy, the American guidelines introduce also ACE inhibitors-fosinopril and quinapril, on the other hand beta-blockers don't involve ne¬ivolol. Wide range of diuretics are mentioned, some of them aren't registered in the Czech Republic. European and Czech guidelines involve ivabradin. Neither nesiritid nor levosimendan for inpatients aren't involved. There is briefly mentioned surgery and cardiac mechanical support, moreover there are references for guidelines for heart transplantation.

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