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What is What are the take away of document 2022 AHA/ACC/HFSA Guideline forthe Management of Heart Failure ? and explain in detail?
1. Guideline-directed medical therapy (GDMT) for heartfailure (HF) with reduced ejection fraction (HFrEF)now includes 4 medication classes thatinclude sodium-glucose cotransporter-2 inhibitors(SGLT2i).2. SGLT2i have a Class of Recommendation 2a in HF withmildly reduced ejection fraction (HFmrEF). Weakerrecommendations (Class of Recommendation 2b)are made for ARNi, ACEi, ARB, MRA, and beta blockersin this population.3. New recommendations for HFpEF are made forSGLT2i (Class of Recommendation 2a), MRAs (Class ofRecommendation 2b), and ARNi (Class of Recommendation 2b). Several prior recommendations havebeen renewed including treatment of hypertension(Class of Recommendation 1), treatment of atrialfibrillation (Class of Recommendation 2a), use of ARBs(Class of Recommendation 2b), and avoidance ofroutine use of nitrates or phosphodiesterase-5 inhibitors (Class of Recommendation 3: No Benefit).4. Improved LVEF is used to refer to those patients withprevious HFrEF who now have an LVEF >40%. Thesepatients should continue their HFrEF treatment.5. Value statements were created for select recommendations where high-quality, cost-effectiveness studiesof the intervention have been published.6. Amyloid heart disease has new recommendationsfor treatment including screening for serum andurine monoclonal light chains, bone scintigraphy,genetic sequencing, tetramer stabilizer therapy, andanticoagulation.7. Evidence supporting increased filling pressures isimportant for the diagnosis of HF if the LVEF is >40%.Evidence for increased filling pressures can be obtained from noninvasive (e.g., natriuretic peptide,diastolic function on imaging) or invasive testing(e.g., hemodynamic measurement).8. Patients with advanced HF who wish to prolong survival should be referred to a team specializing in HF. AHF specialty team reviews HF management, assessessuitability for advanced HF therapies, and uses palliative care including palliative inotropes where consistent with the patients goals of care.9. Primary prevention is important for those at risk forHF (stage A) or pre-HF (stage B). Stages of HF wererevised to emphasize the new terminologies of atrisk for HF for stage A and pre-HF for stage B.10. Recommendations are provided for select patientswith HF and iron deficiency, anemia, hypertension,sleep disorders, type 2 diabetes, atrial fibrillation,coronary artery disease, and malignancy.