What’s new in heart failure guidance – a user’s guide: Introduction

Br J Cardiol 2022;29(suppl 2):S2 Leave a comment
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Heart failure is such a common problem that all healthcare professionals should be familiar with the contemporary management of these patients. When there are delays in making the diagnosis or treatment is not optimised, patients are at risk of premature death, hospitalisation and many suffer impaired quality of life. To improve outcomes for patients with heart failure, it is imperative that the diagnosis is suspected and made as early as possible. Whilst heart failure specialists are integral to the delivery of optimal patient-centred care, every opportunity should be taken to optimise treatment. We can all help make a real difference for patients.

This supplement provides a user’s guide to what’s new in the guidelines for the diagnosis and treatment of heart failure. This primarily relates to recommendations provided in the updated (2021) European Society of Cardiology (ESC) guidelines for the diagnosis and treatment of acute and chronic heart failure.

The articles summarise the contemporary guidance with respect to the diagnosis and investigation of patients presenting with heart failure; drug therapy (including the early implementation of the ‘four pillars’ of drug treatment for heart failure with reduced ejection fraction); and recommendations on lifestyle, rehabilitation, remote monitoring and device use.

The authors commonly refer to the ESC classes of recommendation and level of evidence and this should be considered as one interprets the data and makes clinical decisions. In summary these are:

Classes of recommendation:

  • Class I – is recommended or indicated
  • Class IIa – should be considered
  • Class IIb – may be considered
  • Class III – is not recommended

Levels of evidence:

  • A – data derived from multiple randomised clinical trials or meta-analysis
  • B – data derived from a single randomised clinical trial or large non-randomised studies
  • C – expert consensus of opinion and/or small studies, retrospective studies or registries.

Please also note that these articles are the authors’ personal interpretation of the most recently available evidence and how this affects practice. It should not replace consulting the original sources and guidance.

Paul Kalra
Guest Editor

Articles in this supplement

New developments in the investigations and diagnosis of heart failure
Drug therapy in heart failure – an update from the 2021 ESC heart failure guideline
Guidance on lifestyle, rehabilitation and devices in heart failure patients


Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The editors/authors/contributors and the publishers Medinews (Cardiology) Ltd have taken care to ensure that the information given in this text is accurate and up to date at the time of publication.

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