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European Journal of Heart Failure 2005 7(3):317-321; doi:10.1016/j.ejheart.2005.01.013
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© 2005 European Society of Cardiology

Current guidelines in the management of chronic heart failure: Practical issues in their application to the community population

Ken McDonald*

Heart Failure Unit, St Vincent's University Hospital Elm Park, Dublin 4, Ireland

* Tel.: +353 1 2304629; fax: +353 1 2304639. E-mail address: kenneth.mcdonald@ucd.ie

Key Words: Heart failure • Guidelines • Management

Received May 18, 2004; Revised December 8, 2004; Revised January 13, 2005;
The first 150 words of the full text of this article appear below.


   1. Introduction
 
Over the last several years there have been significant advances in the management of chronic heart failure, encompassing developments in pharmacotherapy and device-based approaches to this problem. Clinical trials have demonstrated continued improvement in prognosis in this patient population as measured by reduced mortality and declining rates of hospitalisation [1–3]. However, the anticipated improvement in outlook has not materialised in the routine community heart failure population, in part reflecting the less than optimal translation of clinical trial results [4]. To help address this problem, International Societies have published guidelines to outline the appropriate application of recent proven therapies [5,6]. Guideline committees assess available data, distil the information and provide consensus statements on how best to apply the knowledge gained from clinical trials and other relevant sources. However, despite the strong scientific basis underlining these guidelines, application of proven and recommended therapy remains a problem. Aside . . . [Full Text of this Article]

1.1. Clinical trial population
1.2. Trial entry criteria
1.3. Layered therapy in heart failure
1.4. Dose-response
1.5. Beyond combination ACEI and BB therapy: what to use?

   2. End-points
 

   3. Cost-effectiveness
 

   4. Summary
 

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