Interpretation of the Updates in 2018 NICE Guideline for the Diagnosis and Management of Chronic Heart Failure in Adults

doi:10.12114/j.issn.1007-9572.2019.00.065

Abstract

Abstract: Heart failure is the terminal stage of various heart diseases.It is a complex syndrome with different etiologies，pathogenesis and pathological processes.In 2018，the National Institute for Health and Care Excellence （NICE） published its guideline on the diagnosis and management of chronic heart failure in adults，which is a updated edition of the 2010 one.The major updates in the 2018 edition are multidisciplinary cooperation in the management of heart failure，diagnosis and treatment of heart failure，management，monitoring and rehabilitation of heart failure.

Key words: Heart failure, Diagnosis, Therapy, Guidebooks

摘要：

心力衰竭是各种心脏疾病的终末阶段，是一种复杂的综合征，包括不同的病因、机制和病理过程。在2010英国国家卫生与临床优化研究所（NICE）成年人慢性心力衰竭诊断与管理指南的基础上，NICE发布了2018成年人慢性心力衰竭诊断与管理指南。更新的主要内容包括心力衰竭多学科合作、心力衰竭的诊断、治疗以及心力衰竭的管理、监测与康复等。

关键词: 心力衰竭, 诊断, 治疗, 指南

XU Dingli,MA Zhuang. Interpretation of the Updates in 2018 NICE Guideline for the Diagnosis and Management of Chronic Heart Failure in Adults　[J]. Chinese General Practice, 2019, 22(17): 2015-2019. DOI: 10.12114/j.issn.1007-9572.2019.00.065.
许顶立,马壮. 2018英国国家卫生与临床优化研究所成年人慢性心力衰竭诊断与管理指南更新解读[J]. 中国全科医学, 2019, 22(17): 2015-2019. DOI: 10.12114/j.issn.1007-9572.2019.00.065.

References

［1］National Institute for Health and Care Excellence.Chronic heart failure in adults：diagnosis and management［EB/OL］．（2018-09-12）［2018-10-20］．https：//www.nice.org.uk/guidance/ng106.
［2］National Institute for Health and Care Excellence.Chronic heart failure in adults：management［EB/OL］．［2018-10-20］．https：//www.nice.org.uk/guidance/cg108.
［3］RAO A，WALSH J.Impact of specialist care in patients with newly diagnosed heart failure：a randomised controlled study［J］．Int J Cardiol，2007，115（2）：196-202．DOI：10.1016/j.ijcard.2006.03.010.
［4］JAARSMA T，VAN DER WAL M H，LESMAN-LEEGTE I，et al．
Effect of moderate or intensive disease management program on outcome in patients with heart failure：coordinating study evaluating outcomes of advising and counseling in heart failure （COACH）［J］．Arch Intern Med，2008，168（3）：316-324．DOI：10.1001/archinternmed.2007.83.
［5］PETERS-KLIMM F，CAMPBELL S，HERMANN K，et al．Case management for patients with chronic systolic heart failure in primary care：the HICMan exploratory randomised controlled trial［J］．Trials，2010，11：56．DOI：10.1186/1745-6215-11-56.
［6］MARWICK T H.The role of echocardiography in heart failure［J］．J Nucl Med，2015，56（Suppl 4）：31S-38．DOI：10.2967/jnumed.114.150433.
［7］PHILIP CHEN C L，ZHANG C Y.Data-intensive applications，challenges，techniques and technologies：a survey on big data［J］．Information Sciences，2014，275：314-347.
［8］BOOTH R A，HILL S A，DON-WAUCHOPE A，et al．Performance of BNP and NT-proBNP for diagnosis of heart failure in primary care patients：a systematic review［J］．Heart Fail Rev，2014，19（4）：439-451．DOI：10.1007/s10741-014-9445-8.
［9］BALION C，DON-WAUCHOPE A，HILL S，et al．Use of natriuretic peptide measurement in the management of heart failure［M］．Rockville（MD）：Agency for Healthcare Research and Quality（US），2013.
［10］BJURMAN C，JENSEN J，PETZOLD M，et al．Assessment of a multimarker strategy for prediction of mortality in older heart failure patients：a cohort study［J］．BMJ Open，2013，3（3）：e002254．DOI：10.1136/bmjopen-2012-002254.
［11］DHAR S，PRESSMAN G S，SUBRAMANIAN S，et al．Natriuretic peptides and heart failure in the patient with chronic kidney disease：a review of current evidence［J］．Postgrad Med J，2009，85（1004）：299-302．DOI：10.1136/pgmj.2008.073734.
［12］ALCHAGHOURI S.Atrial fibrillation.2：management［J］．Hosp Med，2004，65（9）：546-552.
［13］REILLY C M，HIGGINS M，SMITH A，et al．Isolating the benefits of fluid restriction in patients with heart failure：a pilot study［J］．Eur J Cardiovasc Nurs，2015，14（6）：495-505．DOI：10.1177/1474515114541729.
［14］COLIN-RAMIREZ E，MCALISTER F A，ZHENG Y G，et al．
The long-term effects of dietary sodium restriction on clinical outcomes in patients with heart failure.The SODIUM-HF（Study of Dietary Intervention Under 100 mmol in Heart Failure）：a pilot study［J］．Am Heart J，2015，169（2）：274-281.e1．DOI：10.1016/j.ahj.2014.11.013.
［15］COHN J N，TOGNONI G.A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure［J］．N Engl J Med，2001，345（23）：1667-1675.
［16］MCMURRAY J J，PACKER M，DESAI A S，et al．Angiotensin-neprilysin inhibition versus enalapril in heart failure［J］．N Engl J Med，2014，371（11）：993-1004．DOI：10.1056/NEJMoa1409077.
［17］ZI M，CARMICHAEL N，LYE M.The effect of quinapril on functional status of elderly patients with diastolic heart failure［J］．Cardiovasc Drugs Ther，2003，17（2）：133-139.
［18］CLELAND J G，TENDERA M，ADAMUS J，et al．The perindopril in elderly people with chronic heart failure （PEP-CHF） study［J］．Eur Heart J，2006，27（19）：2338-2345.
［19］GREENE S J，BUTLER J，ALBERT N M，et al．Medical therapy for heart failure with reduced ejection fraction：the CHAMP-HF registry［J］．J Am Coll Cardiol，2018，72（4）：351-366．DOI：10.1016/j.jacc.2018.04.070.
［20］KOTECHA D，FLATHER M D，ALTMAN D G，et al．Heart rate and rhythm and the benefit of beta-blockers in patients with heart failure［J］．J Am Coll Cardiol，2017，69（24）：2885-2896．DOI：10.1016/j.jacc.2017.04.001.
［21］KOTECHA D，HOLMES J，KRUM H，et al．Efficacy of β blockers in patients with heart failure plus atrial fibrillation：an individual-patient data meta-analysis［J］．Lancet，2014，384（9961）：2235-2243．DOI：10.1016/S0140-6736（14）61373-8.
［22］LEWIS E F，KIM H Y，CLAGGETT B，et al．Impact of spironolactone on longitudinal changes in health-related quality of life in the treatment of preserved cardiac function heart failure with an aldosterone antagonist trial［J］．Circ Heart Fail，2016，9（3）：e001937．DOI：10.1161/CIRCHEARTFAILURE.114.001937.
［23］DESAI A S，LEWIS E F，LI R，et al．Rationale and design of the treatment of preserved cardiac function heart failure with an aldosterone antagonist trial：a randomized，controlled study of spironolactone in patients with symptomatic heart failure and preserved ejection fraction［J］．Am Heart J，2011，162（6）：966-972．DOI：10.1016/j.ahj.2011.09.007.
［24］SWEDBERG K，KOMAJDA M，BOHM M，et al．Ivabradine and outcomes in chronic heart failure（SHIFT）：a randomised placebo-controlled study［J］．Lancet，2010，376（9744）：875-885．DOI：10.1016/S0140-6736（10）61198-1.
［25］NICE.Ivabradine for treating chronic heart failure［EB/OL］．（2012-11-28）［2018-10-20］．https：//www.nice.org.uk/guidance/ta267.
［26］BOHM M，ROBERTSON M，FORD I，et al．Influence of cardiovascular and noncardiovascular co-morbidities on outcomes and treatment effect of heart rate reduction with ivabradine in stable heart failure（from the SHIFT trial）［J］．Am J Cardiol，2015，116（12）：1890-1897．DOI：10.1016/j.amjcard.2015.09.029.
［27］NICE.Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction［EB/OL］．（2016-04-27）［2018-10-20］．https：//www.nice.org.uk/guidance/ta388.
［28］FLUUR C，BOLSE K，STROMBERG A，et al．Patients' experiences of the implantable cardioverter defibrillator（ICD）；with a focus on battery replacement and end-of-life issues［J］．Heart Lung，2013，42（3）：202-207．DOI：10.1016/j.hrtlng.2012.11.006.
［29］BRANNSTROM M，FORSSELL A，PETTERSSON B.Physicians' experiences of palliative care for heart failure patients［J］．Eur J Cardiovasc Nurs，2011，10（1）：64-69．DOI：10.1016/j.ejcnurse.2010.04.005.

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