; ; ; † § ** ; ; † † * ; ; † † ; ; ¶ † ; * † * ; . 2013;128:e240–e327. † ; DOI: 10.1161/CIR.0b013e31829e8776 †‡ Circulation * †† * ; Tamara Horwich, MD, FACC Tamara ; ‖ ; Barbara Riegel, DNSc, RN, FAHA ; Barbara Riegel, ; Patrick E. McBride, MD, MPH, FACC ; Patrick † ; Wayne C. Levy, MD, FACC C. Levy, Wayne ; # † † ; Emily J. Tsai, MD, FACC ; Emily J. ; Biykem Bozkurt, MD, PhD, FACC, FAHA Bozkurt, MD, PhD, FACC, ; Biykem ; Gregg C. Fonarow, MD, FACC, FAHA MD, FACC, C. Fonarow, ; Gregg † † † * * * e240 ; Lynne W. Stevenson, MD, FACC Stevenson, W. ; Lynne ; Judith E. Mitchell, MD, FACC, FAHA ; Judith E. Mitchell, MD, FACC, † † ; Maryl R. Johnson, MD, FACC, FAHA ; Maryl R. Johnson, MD, FACC, * † * ; Donald E. Casey, Jr, MD, MPH, MBA, FACP, FAHA FACP, MD, MPH, MBA, Jr, ; Donald E. Casey, † * WRITING COMMITTEE MEMBERS Bruce L. Wilkoff, MD, FACC, FHRS MD, FACC, Wilkoff, Bruce L. Journal of the American College of Cardiology. American College of the Journal Management of Heart Failure Clyde W. Yancy, MD, MSc, FACC, FAHA, Chair FAHA, MD, MSc, FACC, Yancy, W. Clyde ACCF/AHA Practice Guideline ACCF/AHA International Society for Heart and Lung Transplantation International Society for Heart and Lung 2013 ACCF/AHA Guideline for the Guideline for ACCF/AHA 2013 W.H. Wilson Tang, MD, FACC Tang, Wilson W.H. Flora Sam, MD, FACC, FAHA Flora Sam, MD, FACC, Heart Association Task Force on Practice Guidelines Force Task Association Heart Edward K. Kasper, MD, FACC, FAHA MD, FACC, K. Kasper, Edward James L. Januzzi, MD, FACC John J.V. McMurray, MD, FACC McMurray, John J.V. Stephen A. Geraci, MD, FACC, FAHA, FCCP FAHA, A. Geraci, MD, FACC, Stephen . 2013;128:e240-e327.) is available at http://circ.ahajournals.org is available Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation Association of Cardiovascular American by the Endorsed Pamela N. Peterson, MD, MSPH, FACC, FAHA N. Peterson, MD, MSPH, FACC, Pamela Mark H. Drazner, MD, MSc, FACC, FAHA MD, MSc, FACC, Mark H. Drazner, Javed Butler, MBBS, FACC, FAHA MBBS, FACC, Butler, Javed Mariell Jessup, MD, FACC, FAHA, Vice Chair Vice FAHA, Mariell Jessup, MD, FACC, Frederick A. Masoudi, MD, MSPH, FACC, FAHA A. Masoudi, MD, MSPH, FACC, Frederick Heart Rhythm Society representative. Heart Rhythm member during this writing effort. Force Task Former American Academy of Family Physicians representative. Physicians Academy of Family American A Report of the American College of Cardiology Foundation/American American College of Cardiology Foundation/American A Report of the ACCF/AHA representative. ACCF/AHA on Practice Guidelines liaison. Force Task ACCF/AHA American College of Physicians representative. of Physicians American College on Performance Measures liaison. Force Task ACCF/AHA International Society for Heart and Lung Transplantation representative. Transplantation International Society for Heart and Lung Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other from voting Writing committee members are required to recuse themselves Circulation American College of Chest Physicians representative. of Chest Physicians American College ( Association, Inc. American Heart and the of Cardiology Foundation American College © 2013 by the Circulation * † ‡ § ‖ ¶ # ** †† ‡‡ Association Science American Heart and the Trustees Board of of Cardiology Foundation American College by the approved This document was with this article at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIR.0b013e31829e8776/-/DC1. The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/ is available Table Relationships The online-only Comprehensive Drazner MH, Jr, DE Casey Jessup M, Bozkurt B, Butler J, CW, Yancy Association requests that this document be cited as follows: American Heart The This article has been copublished in the American Heart and the of Cardiology (www.cardiosource.org) American College sites of the Web Wide World on the This document is available Copies: AHA statements and guidelines For more on AHA Office of Science Operations. AHA Scientific Statements is conducted by the of Expert peer review express of this document are not permitted without the Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution Developed in Collaboration With the American College of Chest Physicians, Heart Rhythm Society and American College the With in Collaboration Developed entities may apply; see Appendix 1 for recusal information. entities may apply; see Advisory and Coordinating Committee in May 2013. CIR.0b013e31829e8776/-/DC2. Mitchell JE, Peterson McBride PE, McMurray JJV, WC, Masoudi FA, Januzzi JL, Johnson MR, Kasper EK, Levy T, GC, Geraci SA, Horwich Fonarow a report of the guideline for the management of heart failure: ACCF/AHA BL. 2013 Wilkoff Tsai EJ, WHW, Tang LW, Stevenson B, Sam F, PN, Riegel on Practice Guidelines. Force Task Association Heart of Cardiology Foundation/American American College link Topic” by selecting either the “By at http://my.americanheart.org/statements of the document is available A copy Association (my.americanheart.org). purchase additional reprints, call 843-216-2533 or e-mail [email protected]. To or the “By Publication Date” link. link. and select the “Policies and Development” visit http://my.americanheart.org/statements development, Association. Instructions for obtaining permission are located at http://www.heart.org/HEARTORG/General/Copyright- American Heart permission of the appears on the right side of the page. Permissions Request Form” A link to the “Copyright Permission-Guidelines_UCM_300404_Article.jsp. Downloaded from http://circ.ahajournals.org/ by guest on May 14, 2017 Yancy et al 2013 ACCF/AHA Heart Failure Guideline e241 ACCF/AHA TASK FORCE MEMBERS Jeffrey L. Anderson, MD, FACC, FAHA, Chair; Alice K. Jacobs, MD, FACC, FAHA, Immediate Past Chair‡‡; Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect; Nancy M. Albert, PhD, CCNS, CCRN, FAHA; Biykem Bozkurt, MD, PhD, FACC, FAHA; Ralph G. Brindis, MD, MPH, MACC; Mark A. Creager, MD, FACC, FAHA‡‡; Lesley H. Curtis, PhD; David DeMets, PhD; Robert A. Guyton, MD, FACC; Judith S. Hochman, MD, FACC, FAHA; Richard J. Kovacs, MD, FACC, FAHA; Frederick G. Kushner, MD, FACC, FAHA‡‡; E. Magnus Ohman, MD, FACC; Susan J. Pressler, PhD, RN, FAAN, FAHA; Frank W. Sellke, MD, FACC, FAHA; Win-Kuang Shen, MD, FACC, FAHA; William G. Stevenson, MD, FACC, FAHA‡‡; Clyde W. Yancy, MD, MSc, FACC, FAHA‡‡ Table of Contents 5.5. Tachycardia-Induced Cardiomyopathy ........e251 5.6. Myocarditis and Cardiomyopathies Due to Downloaded from Preamble .....................................e242 Inflammation ............................e251 1. Introduction .................................e245 5.6.1. Myocarditis ........................e251 1.1. Methodology and Evidence Review . e245 5.6.2. Acquired Immunodeficiency Syndrome ..e252 1.2. Organization of the Writing Committee ........e245 5.6.3. Chagas Disease .....................e252 1.3. Document Review and Approval..............e245 5.7. Inflammation-Induced Cardiomyopathy: Noninfectious Causes .....................e252 http://circ.ahajournals.org/ 1.4. Scope of This Guideline With Reference to Other Relevant Guidelines or Statements .......e245 5.7.1. Hypersensitivity Myocarditis ..........e252 2. Definition of HF..............................e246 5.7.2. Rheumatological/Connective Tissue 2.1. HF With Reduced EF (HFrEF) ...............e247 Disorders..........................e252 2.2. HF With Preserved EF (HFpEF) ..............e247 5.8. Peripartum Cardiomyopathy................e252 3. HF Classifications ............................e247 5.9. Cardiomyopathy Caused By Iron Overload . e252 4. Epidemiology................................e248 5.10. Amyloidosis.............................e252 4.1. Mortality ................................e248 5.11. Cardiac Sarcoidosis.......................e253 by guest on May 14, 2017 4.2. Hospitalizations...........................e248 5.12. Stress (Takotsubo) Cardiomyopathy ..........e253 4.3. Asymptomatic LV Dysfunction...............e248 6. Initial and Serial Evaluation of the HF Patient ......e253 4.4. Health-Related Quality of Life and 6.1. Clinical Evaluation .......................e253 Functional Status..........................e249 6.1.1. History and Physical Examination: 4.5. Economic Burden of HF ....................e249 Recommendations...................e253 4.6. Important Risk Factors for HF (Hypertension, 6.1.2. Risk Scoring: Recommendation ........e253 Diabetes Mellitus, Metabolic Syndrome, and 6.2. Diagnostic Tests: Recommendations . .e253 Atherosclerotic Disease) ....................e249 6.3. Biomarkers: Recommendations . .e255 5. Cardiac Structural Abnormalities and Other 6.3.1. Natriuretic Peptides: BNP or NT-proBNP . e256 Causes of HF ................................e249 6.3.2. Biomarkers of Myocardial Injury: 5.1. Dilated Cardiomyopathies...................e249 Cardiac Troponin T or I ..............e256 5.1.1. Definition and Classification of Dilated 6.3.3. Other Emerging Biomarkers...........e256 Cardiomyopathies....................e249 6.4. Nonin vasive Cardiac Imaging: 5.1.2. Epidemiology and Natural History Recommendations........................e256 of DCM............................e250 6.5. Invasive Evaluation: Recommendations .......e258 5.2. Familial Cardiomyopathies ..................e250 6.5.1. Right-Heart Catheterization ...........e259