The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: Focus on Rehabilitation and Exercise and Surgical Coronary Revascularization

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The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: Focus on Rehabilitation and Exercise and Surgical Coronary Revascularization.

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Presentation transcript:

The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: Focus on Rehabilitation and Exercise and Surgical Coronary Revascularization Gordon W. Moe, MD, MSc, FRCPC, Justin A. Ezekowitz, MB, BCh, MSc, FRCPC, Eileen O'Meara, MD, FRCPC, Jonathan G. Howlett, MD, FRCPC, Steve E. Fremes, MD, FRCPC, Abdul Al-Hesayen, MD, FRCPC, George A. Heckman, MD, MSc, FRCPC, Anique Ducharme, MD, FRCPC, Estrellita Estrella-Holder, RN, BN, MScA, CCN(C), Adam Grzeslo, MD, CCFP, FCFP, Karen Harkness, RN, BScN, CCNC, PhD, Serge Lepage, MD, FRCPC, Michael McDonald, MD, FRCPC, Robert S. McKelvie, MD, FRCPC, Anil Nigam, MD, MSc, FRCPC, Miroslaw Rajda, MD, FRCPC, Vivek Rao, MD, PhD, FRCPS, Elizabeth Swiggum, MD, FRCPC, Sean Virani, MD, FRCPC, Vy Van Le, MD, FRCPC, Shelley Zieroth, MD, FRCPC, J. Malcolm O. Arnold, MD, FRCPC, Tom Ashton, MD, FRCPC, Michel D'Astous, MD, FRCPC, Paul Dorian, MD, FRCPC, Nadia Giannetti, MD, FRCPC, Haissam Haddad, MD, FRCPC, Debra L. Isaac, MD, FRCPC, Simon Kouz, MD, FRCPC, FACC, Marie-Hélène Leblanc, MD, FRCPC, Peter Liu, MD, FRCPC, Heather J. Ross, MD, FRCPC, Bruce Sussex, MD, FRCPC, Michel White, MD, FRCPC Canadian Journal of Cardiology Volume 30, Issue 3, Pages 249-263 (March 2014) DOI: 10.1016/j.cjca.2013.10.010 Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 1 Approach to assessment for coronary artery disease in patients with heart failure. All patients with heart failure are expected to undergo noninvasive measurement of systolic function (not included in this algorithm). *Some centres might additionally perform noninvasive imaging, especially when coronary anatomy is not optimal. †If imaging indicates features of high risk, progression to coronary angiography is expected. ‡Noninvasive imaging might be performed in certain centres for risk stratification or diagnosis. PCI, percutaneous coronary intervention. Canadian Journal of Cardiology 2014 30, 249-263DOI: (10.1016/j.cjca.2013.10.010) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 2 Decision regarding coronary revascularization in heart failure. It is recommended that surgical consultation be performed very early in this process. *Coronary anatomy suitable for CABG includes multivessel disease > 70% stenosis, left main stem stenosis > 50%, or diabetes with left anterior descending artery stenosis > 70%. †In selected cases in which there is noninvasive imaging evidence of extensive cardiac ischemia, PCI might be considered. AVR, aortic valve replacement; CABG, coronary artery bypass grafting; IC, intracoronary; LVEF, left ventricular ejection fraction; PCI, percutaneous coronary intervention. Canadian Journal of Cardiology 2014 30, 249-263DOI: (10.1016/j.cjca.2013.10.010) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions