Are the ESC and CKS guidelines for diagnostics and treatment of heart failure different?

Summary

In 2012, Czech and European guidelines for the diagnosis and treatment of heart failure were published. The authors of the Czech guidelines compared both documents. The main difference is that the European guidelines include acute heart failure, while our national guidelines include only chronic heart failure. The diffe­rence is already in the definition of heart failure: the European guidelines do not include natriuretic peptides in the diagnostic criteria and in case of controversial diagnosis, treatment response is not an additional criterion. There is also a partial difference in division of signs and symptoms of heart failure in both recommendations. In the diagnosis of heart failure, there are slight differences in the standards for echocardiographic parameters, especially the parameters of diastolic dysfunction. Standards for natriuretic peptides were changed for non-emergency incoming patients for whom the marginal value of NT-proBNP is below 125 pg/ml and 35 pg/ml for BNP. In the treatment of heart failure, there are the same drug groups. In the European guidelines, for ACE inhibitors, ramipril is not included and perindopril has a target dose of twice 5 mg, while in the Czech guidelines, it is once 10 mg. In the Czech guidelines, Losartan has a target dose of 100 mg, while in the European guidelines it is 150 mg once daily. Among diuretics, in European guidelines, there are triamterene and amiloride, which are not included in Czech guidelines.

Keywords:
guidelines – heart failure – differences