Excerpt

This guideline is a partial update of NICE Guideline No 5: Chronic Heart Failure - national clinical guideline for diagnosis and management in primary and secondary care (2003). The aim of the 2003 guideline was to offer best practice advice on the care of adult patients (aged 18 years or older) who have symptoms or a diagnosis of chronic heart failure. It defined the most effective combination of symptoms, signs and investigations required to establish a diagnosis of heart failure, and those which would influence therapy or provide important prognostic information. It also gave guidance on the treatment, monitoring and support of patients with heart failure.

Since 2003, European and North American guidelines, based on new high-quality evidence from randomised controlled trials in diagnosis, treatment and monitoring have been published. A partial update of the existing NICE guideline is necessary to ensure that the recommendations take into account the new evidence available.

Contents

• National Clinical Guideline Centre for Acute and Chronic Conditions
• Acknowledgements
• Invited Experts
• Members of the Guideline Development Group
• Glossary
• 1. Introduction
  • 1.1 Definition of chronic heart failure
  • 1.2 Definition of a specialist
  • 1.3 Clinical context
  • 1.4 Rationale for the update
  • 1.5 Audience
  • 1.6 Principles for guideline development
  • 1.7 Scope of update
  • 1.8 Other relevant NICE guidance
  • 1.9 Guideline limitations
  • 1.10 Plans for guideline revision
  • 1.11 Disclaimer
  • 1.12 Funding
• 2. Methods
  • 2.1 Introduction
  • 2.2 The Developers
  • 2.3 The process of guideline development
• 3. Key priorities and algorithms
  • 3.1 Key priorities for implementation
  • 3.2 Algorithm summarising recommendations for the diagnosis of heart failure
  • 3.3 Algorithm for the treatment of symptomatic heart failure
• 4. Diagnosing heart failure
  • Introduction
  • 4.1 Symptoms, signs and investigation
  • 4.2 Measurement of circulating natriuretic peptide concentration
  • 4.3 Recommendations for diagnosing heart failure
  • 4.4 Diagnostic algorithm
• 5. Treating heart failure
  • Introduction
  • 5.1 Lifestyle
  • 5.2 Pharmacological treatment of heart failure
  • Drugs reviewed in partial update
  • Drugs not within scope of partial update
  • Recommendations
  • 5.3 Invasive procedures
  • Procedures within the scope of the update
  • Procedures outside the scope of the update
  • Recommendations
  • 5.4 Treatment algorithm
• 6. Rehabilitation in chronic heart failure
  • 6.1 Clinical introduction
  • 6.2 Clinical methodological introduction
  • 6.3 Clinical evidence statements
  • 6.4 Health Economic methodological introduction
  • 6.5 Health economic evidence statements
  • 6.6 From evidence to recommendations
  • 6.7 Recommendations for rehabilitation
• 7. Monitoring
  • 7.1 Serial measurement of circulating natriuretic peptide concentration
  • 7.2 Patient self-monitoring and remote monitoring
  • 7.3 Recommendations for monitoring heart failure
• 8. Referral and approach to care
  • 8.1 Introduction
  • 8.2 Recommendations
• 9. Research recommendations
• 10 References
• Appendices
  • Appendix A Scope of Partial Update
  • Appendix B Clinical Questions
  • Appendix C Review Protocols
  • Appendix D Search Strategies
  • Appendix E Clinical Evidence Tables
  • Appendix F Forest Plots
  • Appendix G Health Economics Evidence Tables
  • Appendix H Cost-Effectiveness Analysis
  • Appendix J Practical Notes
  • Appendix K Criterial for Selecting High Priority Research Recommendations
  • Appendix L Declarations of Interest
  • Appendix M 2003 Guideline
  • Appendix N 2003 Deleted Recommendations

Suggested citation:

National Clinical Guideline Centre. (2010) Chronic heart failure: the management of chronic heart failure in adults in primary and secondary care. London: National Clinical Guideline Centre. Available from: http://guidance.nice.org.uk/CG108/Guidance/pdf/English