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Guidelines to Practice

Heart failure with reduced ejection fraction: What’s new in the 2022 guideline?

Michelle M. Kittleson, MD, PhD
Cleveland Clinic Journal of Medicine April 2023, 90 (4) 215-220; DOI: https://doi.org/10.3949/ccjm.90a.22101
Michelle M. Kittleson
Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA; Writing Committee Member, 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
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    TABLE 1

    Classifications of heart failure

    Stages

    A At risk of heart failure due to conditions such as hypertension, diabetes, coronary artery disease

    B Pre-heart failure with no symptoms but evidence for structural heart disease including reduced ejection fraction, increased left ventricular wall thickness, valvular disease

    C Symptomatic heart failure with structural heart disease and heart failure symptoms

    D Advanced heart failure with marked symptoms despite attempts at optimization of guideline-directed medical therapy

    New York Heart Association symptom classes

    I No symptoms

    II Symptoms with moderate exertion

    III Symptoms with mild exertion

    IV Symptoms with minimal exertion or at rest

    Ejection fraction categories
    • Reduced: ≤ 40%

    • Mildly reduced: 41%–49%

    • Preserved: ≥ 50%

    • Improved: > 40% after initially being ≤ 40%

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Cleveland Clinic Journal of Medicine: 90 (4)
Cleveland Clinic Journal of Medicine
Vol. 90, Issue 4
1 Apr 2023
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Heart failure with reduced ejection fraction: What’s new in the 2022 guideline?
Michelle M. Kittleson
Cleveland Clinic Journal of Medicine Apr 2023, 90 (4) 215-220; DOI: 10.3949/ccjm.90a.22101

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Heart failure with reduced ejection fraction: What’s new in the 2022 guideline?
Michelle M. Kittleson
Cleveland Clinic Journal of Medicine Apr 2023, 90 (4) 215-220; DOI: 10.3949/ccjm.90a.22101
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    • ABSTRACT
    • WHO WROTE THE GUIDELINE?
    • WHAT ARE THE MAIN RECOMMENDATIONS?
    • WHAT IS DIFFERENT FROM PREVIOUS GUIDELINES?
    • DO OTHER SOCIETIES AGREE OR DISAGREE?
    • HOW WILL THIS CHANGE DAILY PRACTICE?
    • WHEN WOULD THE GUIDELINES NOT APPLY?
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