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| [[File:Siren.gif|30px|link= Congestive heart failure resident survival guide]]|| <br> || <br>
| [[Acute decompensated heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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{{Congestive heart failure}}
{{Congestive heart failure}}
{{CMG}}; {{AOEIC}} {{LG}} {{EdzelCo}}


{{CMG}}
==Overview==
Although [[calcium channel blockers]] cause [[vasodilation]] and may reduce [[afterload]] in the setting of [[heart failure]], their overall benefit in [[heart failure]] is minimized by the fact that they have a [[negative inotropic]] effect and by the reflex activation of the [[sympathetic nervous system]].  These agents are therefore not recommended as [[vasodilators]] in [[patients]] with [[systolic dysfunction]], however they may be useful as [[antihypertensive agents]] in [[patients]] with [[diastolic dysfunction]].
 
== 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref> ==
 
===[[Drugs]] of Unproven Value or That May Worsen [[HF]]===
 
===[[Calcium Channel Blockers]]===
 
{|class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
 
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' In [[patients]] with [[HFrEF]], [[dihydropiridine calcium  channel-blocking  drugs]] are not recommended [[treatment]] for [[HF]].<ref name="pmid8813041">{{cite journal| author=Packer M, O'Connor CM, Ghali JK, Pressler ML, Carson PE, Belkin RN | display-authors=etal| title=Effect of amlodipine on morbidity and mortality in severe chronic heart failure. Prospective Randomized Amlodipine Survival Evaluation Study Group. | journal=N Engl J Med | year= 1996 | volume= 335 | issue= 15 | pages= 1107-14 | pmid=8813041 | doi=10.1056/NEJM199610103351504 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8813041  }} </ref><ref name="pmid24621933">{{cite journal| author=Packer M, Carson P, Elkayam U, Konstam MA, Moe G, O'Connor C | display-authors=etal| title=Effect of amlodipine on the survival of patients with severe chronic heart failure due to a nonischemic cardiomyopathy: results of the PRAISE-2 study (prospective randomized amlodipine survival evaluation 2). | journal=JACC Heart Fail | year= 2013 | volume= 1 | issue= 4 | pages= 308-314 | pmid=24621933 | doi=10.1016/j.jchf.2013.04.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24621933  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
 
|}
 
{|class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
 
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''3.''' In [[patients]] with [[HFrEF]], [[non-dihydropiridine calcium channel-blocking drugs]] are not recommended. <ref name="pmid2220572">{{cite journal| author=| title=Effect of verapamil on mortality and major events after acute myocardial infarction (the Danish Verapamil Infarction Trial II--DAVIT II) | journal=Am J Cardiol | year= 1990 | volume= 66 | issue= 10 | pages= 779-85 | pmid=2220572 | doi=10.1016/0002-9149(90)90351-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2220572  }} </ref><ref name="pmid2899840">{{cite journal| author=Multicenter Diltiazem Postinfarction Trial Research Group| title=The effect of diltiazem on mortality and reinfarction after myocardial infarction. | journal=N Engl J Med | year= 1988 | volume= 319 | issue= 7 | pages= 385-92 | pmid=2899840 | doi=10.1056/NEJM198808183190701 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2899840  }} </ref><ref name="pmid1984898">{{cite journal| author=Goldstein RE, Boccuzzi SJ, Cruess D, Nattel S| title=Diltiazem increases late-onset congestive heart failure in postinfarction patients with early reduction in ejection fraction. The Adverse Experience Committee; and the Multicenter Diltiazem Postinfarction Research Group. | journal=Circulation | year= 1991 | volume= 83 | issue= 1 | pages= 52-60 | pmid=1984898 | doi=10.1161/01.cir.83.1.52 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1984898  }} </ref><ref name="pmid8759075">{{cite journal| author=Figulla HR, Gietzen F, Zeymer U, Raiber M, Hegselmann J, Soballa R | display-authors=etal| title=Diltiazem improves cardiac function and exercise capacity in patients with idiopathic dilated cardiomyopathy. Results of the Diltiazem in Dilated Cardiomyopathy Trial. | journal=Circulation | year= 1996 | volume= 94 | issue= 3 | pages= 346-52 | pmid=8759075 | doi=10.1161/01.cir.94.3.346 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8759075  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|}
 
==Vote on and Suggest Revisions to the Current Guidelines==
*[[The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]


==Overview==
==External Links==
* Although calcium channel blockers cause [[vasodilation]] their overall benefit is minimized by the fact that they have a [[negative inotropic]] effect and by the reflex activation of the sympathetic nervous system.
*[https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000001063.full.pdf 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines]<ref name="pmid35363499">{{cite journal |vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW |title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |volume=145 |issue=18 |pages=e895–e1032 |date=May 2022 |pmid=35363499 |doi=10.1161/CIR.0000000000001063 |url=}} </ref>


* These agents are not recommended as vasodilators in patients with congestive heart failure, however they may be useful as antihypertensive agents in patients with [[diastolic dysfunction]].
*[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref>


==Drugs to Avoid in CHF==
*[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>
* [[Dronedarone]] should be avoided in patients who were hospitalized with CHF (this is a boxed warning)
* [[Sotalol]] (has a negative inotropic effect)


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 21:12, 22 June 2022
Resident
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Congestive Heart Failure Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2] Edzel Lorraine Co, DMD, MD[3]

Overview

Although calcium channel blockers cause vasodilation and may reduce afterload in the setting of heart failure, their overall benefit in heart failure is minimized by the fact that they have a negative inotropic effect and by the reflex activation of the sympathetic nervous system. These agents are therefore not recommended as vasodilators in patients with systolic dysfunction, however they may be useful as antihypertensive agents in patients with diastolic dysfunction.

2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [1]

Drugs of Unproven Value or That May Worsen HF

Calcium Channel Blockers

Class III (No Benefit)
"1. In patients with HFrEF, dihydropiridine calcium channel-blocking drugs are not recommended treatment for HF.[2][3] (Level of Evidence: A) "
Class III (Harm)
"3. In patients with HFrEF, non-dihydropiridine calcium channel-blocking drugs are not recommended. [4][5][6][7] (Level of Evidence: A) "

Vote on and Suggest Revisions to the Current Guidelines

External Links

References

  1. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  2. ↑ Packer M, O'Connor CM, Ghali JK, Pressler ML, Carson PE, Belkin RN; et al. (1996). "Effect of amlodipine on morbidity and mortality in severe chronic heart failure. Prospective Randomized Amlodipine Survival Evaluation Study Group". N Engl J Med. 335 (15): 1107–14. doi:10.1056/NEJM199610103351504. PMID 8813041.
  3. ↑ Packer M, Carson P, Elkayam U, Konstam MA, Moe G, O'Connor C; et al. (2013). "Effect of amlodipine on the survival of patients with severe chronic heart failure due to a nonischemic cardiomyopathy: results of the PRAISE-2 study (prospective randomized amlodipine survival evaluation 2)". JACC Heart Fail. 1 (4): 308–314. doi:10.1016/j.jchf.2013.04.004. PMID 24621933.
  4. ↑ "Effect of verapamil on mortality and major events after acute myocardial infarction (the Danish Verapamil Infarction Trial II--DAVIT II)". Am J Cardiol. 66 (10): 779–85. 1990. doi:10.1016/0002-9149(90)90351-z. PMID 2220572.
  5. ↑ Multicenter Diltiazem Postinfarction Trial Research Group (1988). "The effect of diltiazem on mortality and reinfarction after myocardial infarction". N Engl J Med. 319 (7): 385–92. doi:10.1056/NEJM198808183190701. PMID 2899840.
  6. ↑ Goldstein RE, Boccuzzi SJ, Cruess D, Nattel S (1991). "Diltiazem increases late-onset congestive heart failure in postinfarction patients with early reduction in ejection fraction. The Adverse Experience Committee; and the Multicenter Diltiazem Postinfarction Research Group". Circulation. 83 (1): 52–60. doi:10.1161/01.cir.83.1.52. PMID 1984898.
  7. ↑ Figulla HR, Gietzen F, Zeymer U, Raiber M, Hegselmann J, Soballa R; et al. (1996). "Diltiazem improves cardiac function and exercise capacity in patients with idiopathic dilated cardiomyopathy. Results of the Diltiazem in Dilated Cardiomyopathy Trial". Circulation. 94 (3): 346–52. doi:10.1161/01.cir.94.3.346. PMID 8759075.
  8. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (May 2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check |pmid= value (help).
  9. ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202
  10. ↑ Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967

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