Excerpt

This guideline covers diagnosing and managing chronic heart failure in people aged 18 and over. It aims to improve diagnosis and treatment to increase the length and quality of life for people with heart failure.

Contents

• Guideline committee members
• NGC technical team members
• Co-optees
• Peer reviewers
• Acknowledgements
• 1. Guideline summary
  • 1.1. Full list of recommendations
  • 1.2. Diagnostic algorithm
  • 1.3. Therapeutic algorithm
  • 1.4. Key research recommendations
• 2. Introduction
  • 2.1. Diagnosis and definition of chronic heart failure
  • 2.2. Clinical context
  • 2.3. Definition of a specialist
  • 2.4. Definitions used in the guideline
  • 2.5. Rationale for the update
  • 2.6. Audience
• 3. Development of the guideline
  • 3.1. What is a NICE guideline?
  • 3.2. Remit
  • 3.3. Who developed this guideline?
• 4. Methods
  • 4.1. Developing the review questions and outcomes
  • 4.2. Searching for evidence
  • 4.3. Identifying and analysing evidence of effectiveness
  • 4.4. Identifying and analysing evidence of cost effectiveness
  • 4.5. Developing recommendations
• 5. Diagnosing heart failure
  • 5.1. BNP and NT-proBNP in diagnosing heart failure
  • 5.2. BNP and NT-proBNP in diagnosing heart failure in people with atrial fibrillation
  • 5.3. BNP and NT-proBNP in diagnosing heart failure in people with chronic kidney disease
  • 5.4. Recommendations for diagnosing heart failure
  • 5.5. Cardiac Magnetic Resonance Imaging (cMRI)
• 6. Treating Heart Failure
  • 6.1. Lifestyle
  • 6.2. Pharmacological treatment
  • 6.3. Invasive procedures
• 7. Rehabilitation in chronic heart failure
  • 7.1. Home-based versus centre-based rehabilitation
• 8. Monitoring
  • 8.1. Monitoring using repeated biomarker measurement or imaging for management of chronic heart failure
  • 8.2. Monitoring using repeated biomarker measurement or imaging for management of chronic heart failure in people who also have chronic kidney disease
  • 8.3. Monitoring using repeated biomarker measurement or imaging for management of chronic heart failure in people who also have atrial fibrillation
  • 8.4. Telemonitoring and self-monitoring
  • 8.5. Recommendations for monitoring heart failure
• 9. Referral and approach to care
  • 9.1. Introduction
  • 9.2. Team working in the management of heart failure
  • 9.3. Transition between heart failure care settings
  • 9.4. Information and support needs regarding diagnosis and prognosis
  • 9.5. Recommendations
• 10. Advanced heart failure and palliative care
  • 10.1. Diuretics in advanced heart failure
  • 10.2. Domiciliary oxygen therapy in people with advanced heart failure
  • 10.3. Discussing Implantable Cardioverter Defibrillatior (ICD) deactivation
  • 10.4. Identifying patients with an increased risk of mortality
  • 10.5. Recommendations
• 11. Reference list
• 12. Acronyms and abbreviations
• 13. Glossary
• Appendices
  • Appendix A. Clinical review protocols
  • Appendix B. Health economic review protocol
  • Appendix C. Clinical study selection
  • Appendix D. Health economic study selection
  • Appendix E. Forest plots
  • Appendix F. Clinical evidence tables
  • Appendix G. Health economic evidence tables
  • Appendix H. GRADE tables
  • Appendix I. Excluded clinical studies
  • Appendix J. Excluded health economic studies
  • Appendix K. Unit costs
  • Appendix L. Scope
  • Appendix M. Declarations of interest
  • Appendix N. Literature search strategies
  • Appendix O. Cost-effectiveness analysis: Thresholds model
  • Appendix P. Research recommendations
  • Appendix Q. NICE technical team
  • Appendix R. Previous NICE chronic heart failure guidelines
  • Appendix S. References

Final

Developed by the National Guideline Centre, hosted by the Royal College of Physicians

Disclaimer: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and, where appropriate, their carer or guardian.

Local commissioners and providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn.