40
d
Figure 4. Stages in the Development of HF and Recommended
Therapy by Stage
Adapted from Hunt SA, et al. J Am Coll Cardiol. 2009;53:e1-e90.
THERAPY
Goals
• Heart-healthy lifestyle
• Prevent vascular,
coronary disease
• Prevent LV structural
abnormalities
Drugs
• ACEI or ARB in
appropriate patients
for vascular disease or
diabetes mellitus
• Statins as appropriate
THERAPY
Goals
• Prevent HF symptoms
• Prevent further cardiac
remodeling
Drugs
• ACEI or ARB as
appropriate
• Beta blockers as appropriate
In selected patients
• ICD
• Revascularization or
valvular surgery as
appropriate
STAGE A
At high risk for HF but without
structural heart disease or
symptoms of HF
eg, Patients with:
• Hypertension
• Atherosclerotic disease
• Diabetes mellitus
• Obesity
• Metabolic syndrome
or
Patients:
• Using cardiotoxins
• With family history of
cardiomyopathy
STAGE B
Structural heart disease but
without signs or symptoms
of HF
eg, Patients with:
• Previous MI
• LV remodeling
including LVH
and low EF
• Asymptomatic
valvular disease
Structural
heart disease
Development
of symptoms
of HF
At Risk for Heart Failure
Treatment
