Heart Failure: Difference between revisions

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===Heart catheterization===
===Heart catheterization===
Heart catheterization is not always part of the routine diagnosis and work-up of patients with HF.  It should be considered however to exclude coronary heart disease (Class of recommendation IIa, level of evidence C, see Table 4). Coronary angiography is recommended in patients at high risk of coronary artery disease  (Class of recommendation I, level of evidence C) and in HF patients with significant valvular disease (Class of recommendation IIa, level of evidence C).
Heart catheterization is not always part of the routine diagnosis and work-up of patients with HF.  It should be considered however to exclude coronary heart disease (Class of recommendation IIa, level of evidence C, see [[Heart_Failure_Table_4 Table 4]]). Coronary angiography is recommended in patients at high risk of coronary artery disease  (Class of recommendation I, level of evidence C) and in HF patients with significant valvular disease (Class of recommendation IIa, level of evidence C).


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!colspan="5"|Table 4. Size of treatment effect
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|valign="top"|'''Class I'''
Benefit >>> Risk
|valign="top"|'''Class IIa'''
Benefit >> Risk
Additional studies with focused objectives needed
|valign="top"|'''Class IIb'''
Benefit ≥ Risk
Additional studies with broad objectives needed; additional registry data would be helpful
|valign="top"|'''Class III'''
Benefit ≥ Risk
No additional studies needed
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|Procedure/treatment should be performed/administered
|It is reasonable to perform/administer treatment
|Procedure/treatment may be considered
|Procedure/treatment should not be performed/administered since it is not helpful and may be harmful
|-
|'''Level A'''
Multiple (3-5) population risk strata evaluated
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*Recommendation that procedure or treatment is useful/effective
*Sufficient evidence from multiple randomized trials or non-randomized trials
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*Recommendation in favor of treatment or procedure being useful/effective
*Some conflicting evidence from multiple randomized trials or meta-analyses
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*Recommendation’s usefulness/efficacy less well established
*Greater conflicting evidence from multiple randomized trials or meta-analyses
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*Recommendation that procedure or treatment not useful/effective and may be harmful
*Sufficient evidence from multiple randomized trials or meta-analyses
|-
|'''Level B'''
Limited (2-3) population risk strata evaluated
|
*Recommendation that procedure or treatment is useful/effective
*Limited evidence from single randomized trial or non-randomized studies
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*Recommendation in favor of treatment or procedure being useful/effective
*Some conflicting evidence from single randomized trial or non-randomized studies
|
*Recommendation’s usefulness/efficacy less well established
*Greater conflicting evidence from single randomized trial or non-randomized studies
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*Recommendation that procedure or treatment not useful/effective and may be harmful
*Limited evidence from single randomized trial or non-randomized studies
|-
|'''Level C'''
Very limited (1-2) population risk strata evaluated
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*Recommendation that procedure or treatment is useful/effective
*Only experts opinion, case studies, or standard-of-care
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*Recommendation in favor of treatment or procedure being useful/effective
*Only diverging expert opinion case studies, or standard-of-care
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*Recommendation’s usefulness/efficacy less well established
*Only diverging expert opinion case studies, or standard-of-care
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*Recommendation that procedure or treatment not useful/effective and may be harmful
*Only expert opinion case studies, or standard-of-care
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==Etiology of heart failure==
==Etiology of heart failure==
===Coronary heart disease===  
===Coronary heart disease===