《2010HFSA心力衰竭治疗指南》内容预览：

   Heart failure (HF) is a syndrome characterized by high mor-tality, frequent hospitalization, poor quality of life, multiplecomorbidities, and a complex therapeutic regimen. Knowl-edge about HF is accumulating so rapidly that individual clini-cians may be unable to readily and adequately synthesize new***rmation into effective principles of care for patients withthis syndrome. Trial data, though valuable, often do not giveadequate direction for individual patient management.Given the complex and changing picture of HF and the ac-cumulation of evidence-based HF therapy, it is not possiblefor the clinician to rely solely on personal experience and ob-servation to guide therapeutic decisions. The situation is ex-acerbated because HF is now a chronic condition in mostpatients, meaning that the outcome of therapeutic decisionsmight not be apparent for several years. The prognosis of in-dividual patients differs considerably, making it difficult togeneralize. Treatments might not dramatically improvesymptoms of the disease process, yet might provide impor-tant reductions or delays in morbid events and deaths. The as-sessment of specific therapeutic outcomes is complicated bythe potential differential impact of various cotherapies.The complexity of HF, its high prevalence in society, andthe availability of many therapeutic options make it an idealcandidate for practice guidelines. Additional assumptionsdriving the development of HF guidelines are presentedin Table 1.1.
  
    The first HF guideline developed by the Heart FailureSociety of America (HFSA) had a narrow scope, concen-trating on the pharmacologic treatment of chronic, symp-tomatic left ventricular dysfunction.

  It did not considersubsets of the clinical syndrome of HF, such as acute de-compensated HF and ‘‘diastolic dysfunction,’’ or issuessuch as prevention. The subsequent comprehensive clinicalpractice guideline published in 2006 addressed a full rangeof topics including prevention, evaluation, disease manage-ment, and pharmacologic and device therapy for patientswith HF.

  The 2010 guideline updates and expands eachof these areas and adds a section on the Genetic Evaluationof Cardiomyopathy published separately in 2009.

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