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New recommendations on devices, drugs and diagnosis: esc heartfailure guidelines by ferujkll sdff
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New recommendations on devices, drugs and diagnosis: esc heartfailure guidelines by FERUJKLL SDFF
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Article Posted: 09/07/2013 |
Article Views: 81 |
Articles Written: 2023 - MORE ARTICLES FROM THIS AUTHOR |
Word Count: 475 |
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New recommendations on devices, drugs and diagnosis: esc heartfailure guidelines |
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New recommendations on devices, drugs and diagnosis in heart failure were launched at the Heart Failure Congress 2012, 19-22 May, inBelgrade, Serbia, and published in the European Heart Journal. The ESC Guidelines for the Diagnosis and Treatment of Acute andChronic Heart Failure 2012 were developed by the European Societyof Cardiology (ESC) in collaboration with the Heart FailureAssociation (HFA) of the ESC. The Congress is the HFA's main annualmeeting. An analysis of the most up to date clinical evidence in the fieldof heart failure by the ESC Guidelines task force led to severalmajor updates since the previous ESC Guidelines were published in2008. In devices, left ventricular assist devices (LVADs) were hailed asa step change in the management of heart failure.
LVADs are morereliable and lead to fewer complications than in 2008. Until now,LVADs have been used as a temporary measure in patients awaiting aheart transplant. But Professor John McMurray (Glasgow, UK),chairperson of the ESC Clinical Practice Guidelines Task Force,says: "LVADs will increasingly be used as a treatment in their ownright, not just as a temporary support while awaitingtransplantation." A new indication for cardiac resynchronisation therapy (CRT) inpatients with mild symptoms is given in the guidelines. Moreevidence from new trials and further analysis of existing trialsalso enabled the task force to provide more clarity about theeffects of CRT. It is clear that patients with left bundle branchblock QRS morphology and those who are in sinus rhythm have thegreatest benefit from CRT.
Conversely, those who have a non-leftbundle branch block QRS morphology and patients in atrial fibrillation have less certain benefit. Also in the device arena, new transcatheter valve interventions arediscussed. "These interventions offer the possibility of treatingaortic stenosis in patients who are unsuitable for surgery," saysProfessor McMurray. In pharmacological treatments, two new indications are highlighted.The guidelines stress that when attempting to reduce heart rate, the dose of beta blocker should be maximised before giving additional medications to reduceheart rate.
"Beta blockers are more established, more effective andless expensive, and should be given first," says ProfessorMcMurray. New evidence has extended the indication for mineralocorticoidreceptor antagonists. This means that for many patients, standardtherapy should include three neurohumoral antagonists - anangiotensin converting enzyme inhibitor (or angiotensin receptorblocker), a beta blocker and, if symptoms persist, now amineralocorticoid receptor antagonist as well. In the area of diagnostics, a new biomarker called mid-regionalpro-A-type natriuretic peptide is mentioned for the first time.
Professor McMurray concludes: "These guidelines makerecommendations based upon evidence for established and newdiagnostic tests and therapies for heart failure. If implemented,they offer a real opportunity to improve the outcome of patientswith this condition." Additional References Citations. I am a professional writer from Modems, which contains a great deal of information about grizzly milling machine , welding shielding gas, welcome to visit!
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