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Heart Failure: Difference between revisions
→Management of HF patients with preserved LVEF (HFPEF)
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=== Management of HF patients with preserved LVEF (HFPEF) === | === Management of HF patients with preserved LVEF (HFPEF) === | ||
To date, no evidence exists of any treatment reducing morbidity or mortality in this patient group. With the aim to control water and sodium retention and decrease breathlessness and edema, diuretics are prescribed to HFPEF patients. | To date, no evidence exists of any treatment reducing morbidity or mortality in this patient group. With the aim to control water and sodium retention and decrease breathlessness and edema, diuretics are prescribed to HFPEF patients. | ||
{| class="wikitable" border="1" align="left" style="float: center" | |||
|- | |||
| colspan="6" | '''Table 4''' | |||
|- | |||
| colspan="2" | | |||
| colspan="4" align="center" | '''Size of treatment effect''' | |||
|- | |||
| rowspan="6" | '''Estimate of Certainty (precision) of treatment effect | |||
| rowspan="2" valign="top" style="border-bottom: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | | |||
| valign="top" style="border-bottom: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | '''Class I''' | |||
Benefit >>> Risk | |||
| valign="top" style="border-bottom: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | '''Class IIa''' | |||
Benefit >> Risk | |||
Additional studies with focused objectives needed | |||
| valign="top" style="border-bottom: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | '''Class IIb''' | |||
Benefit ≥ Risk''' | |||
Additional studies with broad objectives needed; additional registry data would be helpful | |||
| valign="top" style="border-bottom: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | '''Class III''' | |||
Benefit ≥ Risk | |||
No additional studies needed | |||
|- | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | Procedure/treatment should be performed/administered | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | It is reasonable to perform/administer treatment | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | Procedure/treatment may be considered | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | Procedure/treatment should not be performed/administered since it is not helpful and may be harmful | |||
|- | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | '''Level A''' | |||
Multiple (3-5) population risk strata evaluated | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | - Recommendation that procedure or treatment is useful/effective | |||
- Sufficient evidence from multiple randomized trials or non-randomized trials | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | - Recommendation in favor of treatment or procedure being useful/effective | |||
- Some conflicting evidence from multiple randomized trials or meta-analyses | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | - Recommendation’s usefulness/efficacy less well established | |||
- Greater conflicting evidence from multiple randomized trials or meta-analyses | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | - Recommendation that procedure or treatment not useful/effective and may be harmful | |||
- Sufficient evidence from multiple randomized trials or meta-analyses | |||
|- | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | '''Level B''' | |||
Limited (2-3) population risk strata evaluated | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | - Recommendation that procedure or treatment is useful/effective | |||
- Limited evidence from single randomized trial or non-randomized studies | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | - Recommendation in favor of treatment or procedure being useful/effective | |||
- Some conflicting evidence from single randomized trial or non-randomized studies | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | - Recommendation’s usefulness/efficacy less well established | |||
- Greater conflicting evidence from single randomized trial or non-randomized studies | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0; background-color: #CCCCFF;" | - Recommendation that procedure or treatment not useful/effective and may be harmful | |||
- Limited evidence from single randomized trial or non-randomized studies | |||
|- | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | '''Level C''' | |||
Very limited (1-2) population risk strata evaluated | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | - Recommendation that procedure or treatment is useful/effective | |||
- Only experts opinion, case studies, or standard-of-care | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | - Recommendation in favor of treatment or procedure being useful/effective | |||
- Only diverging expert opinion case studies, or standard-of-care | |||
| valign="top" style="border-bottom: 0; border-top: 0; border-left: 0; border-right: 0;" | - Recommendation’s usefulness/efficacy less well established | |||
- Only diverging expert opinion case studies, or standard-of-care | |||
| valign="top" style="border-top: 0; border-left: 0; border-right: 0;" | - Recommendation that procedure or treatment not useful/effective and may be harmful | |||
- Only expert opinion case studies, or standard-of-care | |||
|} | |||