p.94 抽出テキスト

Diltiazem or verapamil are not recommended in patients with HFrEF, as they increase the risk of HF worsening and HF hospitalization. III C Recommendations for treatment of patients with HF and aortic stenosis Aortic valve intervention, TAVI or SAVR, is recommended in patients with HF and severe high-gradient aortic stenosis to reduce mortality and improve symptoms. I B It is recommended that the choice between TAVI and SAVR be made by the Heart Team, according to individual patient preference and features including age, surgical risk, clinical, anatomical and procedural aspects, weighing the risks and benefits of each approach. I C Recommendations for treatment of patients with HF and diabetes SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, sotagliflozin) are recommended in patients with T2DM at risk of CV events to reduce hospitalizations for HF, major CV events, end-stage renal dysfunction, and CV death. I A SGLT2 inhibitors (dapagliflozin, empagliflozin, and sotagliflozin) are recommended in patients with T2DM and HFrEF to reduce hospitalizations for HF and CV death. I A Thiazolidinediones (glitazones) are not recommended in patients with HF, as they increase the risk of HF worsening and HF hospitalization. III A The DPP-4 inhibitor saxagliptin is not recommended in patients with HF. III B Recommendations for treatment of patients with HF and iron deficiency It is recommended that all patients with HF be periodically screened for anaemia and iron deficiency with a full blood count, serum ferritin concentration, and TSAT. I C Treatment of anaemia in HF with erythropoietin-stimulating agents is not recommended in the absence of other indications for this therapy. III B Recommendation for treatment of patients with HF and sleep apnoea Adaptive servo-ventilation is not recommended in patients with HFrEF and a predominant CSA because of an increased allcause and CV mortality. III A Recommendation for treatment of patients with HF and arthritis NSAIDs or COX-2 inhibitors are not recommended in patients with HF, as they increase the risk of HF worsening and HF hospitalization. III B Recommendation for treatment of patients with HF and cancer It is recommended that cancer patients at increased risk for cardiotoxicity, defined by a history or risk factors of CV disease, previous cardiotoxicity or exposure to cardiotoxic agents, undergo CV evaluation before scheduled anticancer therapy, preferably by a cardiologist with experience/interest in Cardio-Oncology. I C Recommendations for treatment of patients with HF and amyloidosis Tafamidis is recommended in patients with genetic testing proven hTTR-CA and NYHA class I or II symptoms to reduce symptoms, CV hospitalization and mortality. I B Tafamidis is recommended in patients with wtTTR-CA and NYHA class I or II symptoms to reduce symptoms, CV hospitalization and mortality. I B

ACE-I = angiotensin-converting enzyme inhibitor; AF = atrial fibrillation; AHF = acute heart failure; ARB = angiotensin-receptor blocker; ARNI = angiotensin receptor-neprilysin inhibitor; AV = atrio-ventricular; BNP = B-type natriuretic peptide; CHA2DS2-VASc = congestive heart failure or left ventricular dysfunction, Hypertension, Age >_75 (doubled), Diabetes, Stroke (doubled)-Vascular disease, Age 6574, Sex category (female) (score); CMP = cardiomyopathy; CMR = cardiac magnetic resonance; CRT = cardiac resynchronization therapy; CSA = central sleep apnoea; CV = cardiovascular; DOAC = direct-acting oral anticoagulant; DPP-4 = dipeptidyl peptidase-4; ECG = electrocardiogram; ECV = electrical cardioversion; HbA1c = glycated haemoglobin; HF = heart failure; HFmrEF = heart failure with mildly reduced ejection fraction; HFpEF = heart failure with preserved ejection fraction; HFrEF = heart failure with reduced ejection fraction; hTTR = hereditary transthyretin; IABP = intra-aortic balloon pump; ICD = implantable cardioverter-defibrillator; LBBB = left bundle branch block; LMWH = low-molecular-weight heparin; LV = left ventricular/ventricle; LVEF = left ventricular ejection fraction; MCS = mechanical circulatory support; MI = myocardial infarction; MRA = mineralocorticoid receptor antagonist; NSAID = non-steroidal anti-inflammatory drug; NT-proBNP = N-terminal pro-Btype natriuretic peptide; NYHA = New York Heart Association; OMT = optimal medical therapy; PaO2 = partial pressure of oxygen; QOL = quality of life; QRS = Q, R, and S waves (on an ECG); RV = right ventricular; SAVR = surgical aortic valve replacement; SGLT2 = sodium-glucose co-transporter 2; SpO2 = transcutaneous oxygen saturation; SR = sinus rhythm; T2DM = type 2 diabetes mellitus; TAVI = transcatheter aortic valve implantation; TSAT = transferrin saturation; VAD = ventricular assist device; VKA = vitamin K antagonist; wtTTR-CA = wild-type transthyretin cardiac amyloidosis. aClass of recommendation. bLevel of evidence. cReferences are listed in section 4.2 for this item. dIn those who are able to adhere to the exercise programme. ESC 2021 Downloaded from academic.oup.com/eurheartj/article/42/36/3599/6358045 by guest on 07 October 2026