Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology

Metra M. Tomasoni D. Adamo M. Bayes-Genis A. Filippatos G. Abdelhamid M. Adamopoulos S. Anker S.D. Antohi L. Böhm M. Braunschweig F. Gal T.B. Butler J. Cleland J.G.F. Cohen-Solal A. Damman K. Gustafsson F. Hill L. Jankowska E.A. Lainscak M. Lund L.H. McDonagh T. Mebazaa A. Moura B. Mullens W. Piepoli M. Ponikowski P. Rakisheva A. Ristic A. Savarese G. Seferovic P. Sharma R. Tocchetti C.G. Yilmaz M.B. Vitale C. Volterrani M. von Haehling S. Chioncel O. Coats A.J.S. Rosano G.
June 2023 John Wiley and Sons Ltd

European Journal of Heart Failure
2023 #25 Issue 6 776 - 791 pp.

Episodes of worsening symptoms and signs characterize the clinical course of patients with chronic heart failure (HF). These events are associated with poorer quality of life, increased risks of hospitalization and death and are a major burden on healthcare resources. They usually require diuretic therapy, either administered intravenously or by escalation of oral doses or with combinations of different diuretic classes. Additional treatments may also have a major role, including initiation of guideline-recommended medical therapy (GRMT). Hospital admission is often necessary but treatment in the emergency service or in outpatient clinics or by primary care physicians has become increasingly used. Prevention of first and recurring episodes of worsening HF is an essential component of HF treatment and this may be achieved through early and rapid administration of GRMT. The aim of the present clinical consensus statement by the Heart Failure Association of the European Society of Cardiology is to provide an update on the definition, clinical characteristics, management and prevention of worsening HF in clinical practice.

Emergency department visits , Hospitalization , Intensification of oral therapy , Outpatients , Prognosis , Worsening heart failure

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Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, CIBERCV, Universitat Autònoma de Barcelona, Barcelona, Spain
Department of Cardiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Faculty of Medicine, Cairo University, Giza, Egypt
2nd Department of Cardiovascular Medicine, Onassis Cardiac Surgery Center, Athens, Greece
Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK), partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
Emergency Institute for Cardiovascular Diseases Prof. C.C. Iliescu, Bucharest, Romania
University of Medicine Carol Davila, Bucharest, Romania
Saarland University Hospital, Homburg/Saar, Germany
Department of Medicine, Karolinska Institutet, and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Baylor Scott and White Research Institute, Dallas, TX, USA; Department of Medicine, University of Mississippi, Jackson, MS, United States
British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
Inserm 942 MASCOT, Université de Paris, AP-HP, Hopital Lariboisière, Paris, France
University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, Netherlands
Rigshospitalet-Copenhagen University Hospital, Heart Centre, Department of Cardiology, Copenhagen, Denmark
Queens University Belfast, Belfast, United Kingdom
Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia
Department of Cardiovascular Science, Faculty of Life Science and Medicine, Kings College London, London, United Kingdom
Université Paris Cité, Inserm MASCOT, AP-HP Department of Anesthesia and Critical Care, Hôpital Lariboisière, Paris, France
Faculty of Medicine, University of Porto, Porto, Portugal
Cardiology Department, Porto Armed Forces Hospital, Porto, Portugal
Hospital Oost-Limburg, Genk, Belgium
Clinical Cardiology, IRCCS Policlinico San Donato, Milan, Italy
Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
Scientific Research Institute of Cardiology and Internal Medicine, Almaty, Kazakhstan
School of Medicine, University of Belgrade, Belgrade, Serbia
St. Georges Hospitals NHS Trust University of London, London, United Kingdom
Department of Translational Medical Sciences (DISMET), Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy
Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Rome, Italy
Department of Cardiology and Pneumology, University Medical Center Goettingen, Georg-August University, Goettingen, Germany
German Center for Cardiovascular Research (DZHK), partner site Goettingen, Goettingen, Germany
Heart Research Institute, Sydney, Australia

Cardiology
Heart Institute
Department of Cardiology
Faculty of Medicine
2nd Department of Cardiovascular Medicine
Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK)
Emergency Institute for Cardiovascular Diseases Prof. C.C. Iliescu
University of Medicine Carol Davila
Saarland University Hospital
Department of Medicine
Sackler Faculty of Medicine
Baylor Scott and White Research Institute
British Heart Foundation Centre of Research Excellence
Inserm 942 MASCOT
University of Groningen
Rigshospitalet-Copenhagen University Hospital
Queens University Belfast
Institute of Heart Diseases
Faculty of Medicine
Department of Cardiovascular Science
Université Paris Cité
Faculty of Medicine
Cardiology Department
Hospital Oost-Limburg
Clinical Cardiology
Department of Biomedical Sciences for Health
Scientific Research Institute of Cardiology and Internal Medicine
School of Medicine
St. Georges Hospitals NHS Trust University of London
Department of Translational Medical Sciences (DISMET)
Department of Cardiology
Department of Medical Sciences
Department of Cardiology and Pneumology
German Center for Cardiovascular Research (DZHK)
Heart Research Institute

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