title: The 2011 Canadian Cardiovascular Society heart failure management guidelines update: focus on sleep apnea, renal dysfunction, mechanical circulatory support, and palliative care.
abstract: The 2011 Canadian Cardiovascular Society Heart Failure (HF) Guidelines Focused Update reviews the recently published clinical trials that will potentially impact on management. Also reviewed is the less studied but clinically important area of sleep apnea. Finally, patients with advanced HF represent a group of patients who pose major difficulties to clinicians. Advanced HF therefore is examined from the perspectives of HF complicated by renal failure, the role of palliative care, and the role of mechanical circulatory support (MCS). All of these topics are reviewed from a perspective of practical applications. Important new studies have demonstrated in less symptomatic HF patients that cardiac resynchronization therapy will be of benefit. As well, aldosterone receptor antagonists can be used with benefit in less symptomatic HF patients. The important role of palliative care and the need to address end-of-life issues in advanced HF are emphasized. Physicians need to be aware of the possibility of sleep apnea complicating the course of HF and the role of a sleep study for the proper assessment and management of the conditon. Patients with either acute severe or chronic advanced HF with otherwise good life expectancy should be referred to a cardiac centre capable of providing MCS. Furthermore, patients awaiting heart transplantation who deteriorate or are otherwise not likely to survive until a donor organ is found should be referred for MCS.
authors: Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada. robert.mckelvie@phri.ca
authors: Robert S
authors: RS
authors: McKelvie
authors: Gordon W
authors: GW
authors: Moe
authors: Anson
authors: A
authors: Cheung
authors: Jeannine
authors: J
authors: Costigan
authors: Anique
authors: A
authors: Ducharme
authors: Estrellita
authors: E
authors: Estrella-Holder
authors: Justin A
authors: JA
authors: Ezekowitz
authors: John
authors: J
authors: Floras
authors: Nadia
authors: N
authors: Giannetti
authors: Adam
authors: A
authors: Grzeslo
authors: Karen
authors: K
authors: Harkness
authors: George A
authors: GA
authors: Heckman
authors: Jonathan G
authors: JG
authors: Howlett
authors: Simon
authors: S
authors: Kouz
authors: Kori
authors: K
authors: Leblanc
authors: Elizabeth
authors: E
authors: Mann
authors: Eileen
authors: E
authors: O'Meara
authors: Miroslav
authors: M
authors: Rajda
authors: Vivek
authors: V
authors: Rao
authors: Jessica
authors: J
authors: Simon
authors: Elizabeth
authors: E
authors: Swiggum
authors: Shelley
authors: S
authors: Zieroth
authors: J Malcolm O
authors: JM
authors: Arnold
authors: Tom
authors: T
authors: Ashton
authors: Michel
authors: M
authors: D'Astous
authors: Paul
authors: P
authors: Dorian
authors: Haissam
authors: H
authors: Haddad
authors: Debra L
authors: DL
authors: Isaac
authors: Marie-Hélène
authors: MH
authors: Leblanc
authors: Peter
authors: P
authors: Liu
authors: Bruce
authors: B
authors: Sussex
authors: Heather J
authors: HJ
authors: Ross