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............................................................................................................................................................................. SpO2 Transcutaneous oxygen saturation SR Sinus rhythm STEMI ST-elevation myocardial infarction STICH Surgical Treatment for Ischemic Heart Failure (trial) STICHES Extended follow-up of patients from the STICH trial STS-PROM Society of Thoracic Surgeons Predicted Risk of Mortality SZC Sodium zirconium cyclosilicate T2DM Type 2 diabetes mellitus TAVI Transcatheter aortic valve implantation TFT Thyroid function test t.i.d. Ter in die (three times a day) TKI Tyrosine kinase inhibitor TMEM43 Transmembrane protein 43 TNNT Troponin-T TR Tricuspid regurgitation TRPM4 Transient receptor potential cation channel subfamily M member 4 TSAT Transferrin saturation TSH Thyroid-stimulating hormone TTN Titin TTR Transthyretin UK United Kingdom US United States VAD Ventricular assist device Val-HeFT Valsartan Heart Failure Trial (trial) VEGF Vascular endothelial growth factor VERTIS-CV Cardiovascular Outcomes Following Ertugliflozin Treatment in Type 2 Diabetes Mellitus Participants With Vascular Disease (trial) VEST Vest Prevention of Early Sudden Death Trial (trial) VKA Vitamin K antagonist VO2 Oxygen consumption VPB Ventricular premature beat vs Versus VV interval Interventricular delay interval WARCEF Warfarin and Aspirin in Reduced Cardiac Ejection Fraction (trial) wtTTR-CA Wild-type transthyretin cardiac amyloidosis XL Extended release

1 Preamble

Guidelines summarize and evaluate available evidence with the aim of assisting health professionals in proposing the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision making of health professionals in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. A great number of guidelines have been issued in recent years by the European Society of Cardiology (ESC), as well as by other societies and organizations. Because of their impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines can be found on the ESC website (https://www.escardio.org/ Guidelines). The ESC Guidelines represent the official position of the ESC on a given topic and are regularly updated.

In addition to the publication of Clinical Practice guidelines, the ESC carries out the EURObservational Research Programme of international registries of cardiovascular (CV) diseases and interventions which are essential to assess diagnostic/therapeutic processes, use of resources and adherence to guidelines. These registries aim at providing a better understanding of medical practice in Europe and around the world, based on high-quality data collected during routine clinical practice. Furthermore, the ESC has developed and embedded in this document a set of quality indicators (QIs), which are tools to evaluate the level of implementation of the guidelines and may be used by the ESC, hospitals, healthcare providers and professionals to measure clinical practice as well as used in educational programmes, alongside the key messages from the guidelines, to improve quality of care and clinical outcomes. The Members of this Task Force were selected by the ESC, including representation from its relevant ESC sub-specialty groups, in order to represent professionals involved with the medical care of patients with this pathology. Selected experts in the field undertook a comprehensive review of the published evidence for management of a given condition according to ESC Clinical Practice Guidelines (CPG) Committee policy. A critical evaluation of diagnostic and therapeutic procedures was performed, including assessment of the riskbenefit ratio. The level of evidence and the strength of the recommendation of particular management options were weighed and graded according to predefined scales, as outlined below. The experts of the writing and reviewing panels provided declaration of interest forms for all relationships that might be perceived as real or potential sources of conflicts of interest. Their declarations of interest were reviewed according to the ESC declaration of interest rules and can be found on the ESC website (http://www.escardio.org/ guidelines) and have been compiled in a report and published in a supplementary document simultaneously to the guidelines. This process ensures transparency and prevents potential biases in the development and review processes. Any changes in declarations of interest that arise during the writing period were notified to the ESC and updated. The Task Force received its entire financial support from the ESC without any involvement from the healthcare industry. The ESC CPG supervises and coordinates the preparation of new guidelines. The Committee is also responsible for the endorsement process of these Guidelines. The ESC Guidelines undergo extensive review by the CPG and external experts. After appropriate revisions the guidelines are signed-off by all the experts involved in the Task Force. The finalized document is signed-off by the CPG for publication in the European Heart Journal. The guidelines were developed after careful consideration of the scientific and medical knowledge and the evidence available at the time of their dating. The task of developing ESC Guidelines also includes the creation of educational tools and implementation programmes for the recommendations including condensed pocket guideline versions, summary slides, summary cards for non-specialists and an electronic version for digital Downloaded from academic.oup.com/eurheartj/article/42/36/3599/6358045 by guest on 07 October 2026