Comprehensive in‐hospital monitoring in acute heart failure: applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

  • Veli‐Pekka Harjola
    Emergency Medicine University of Helsinki, Department of Emergency Medicine and Services, Helsinki University Hospital Helsinki Finland
  • John Parissis
    Athens University Hospital Attikon Athens Greece
  • Hans‐Peter Brunner‐La Rocca
    Department of Cardiology Maastricht University Medical Center Maastricht The Netherlands
  • Jelena Čelutkienė
    Vilnius University Faculty of Medicine, Institute of Clinical Medicine, Clinic of Cardiac and Vascular Diseases Vilnius Lithuania
  • Ovidiu Chioncel
    University of Medicine Carol Davila/Institute of Emergency for Cardiovascular Disease Bucharest Romania
  • Sean P. Collins
    Department of Emergency Medicine Vanderbilt University Medical Center Nashville TN USA
  • Daniel De Backer
    Department of Intensive Care Medicine, CHIREC Hospitals Université Libre de Bruxelles Brussels Belgium
  • Gerasimos S. Filippatos
    Athens University Hospital Attikon Athens Greece
  • Etienne Gayat
    Département d'Anesthésie‐ Réanimation‐SMUR Hôpitaux Universitaires Saint Louis‐Lariboisière, INSERM‐UMR 942, AP‐, HP, Université Paris Diderot, Paris France
  • Loreena Hill
    Queens University Belfast UK
  • Mitja Lainscak
    Department of Internal Medicine and Department of Research and Education General Hospital Murska Sobota Murska Sobota Slovenia
  • Johan Lassus
    Cardiology, Heart and Lung Center, University of Helsinki Helsinki University Hospital Helsinki Finland
  • Josep Masip
    Consorci Sanitari Integral University of Barcelona Barcelona Spain
  • Alexandre Mebazaa
    U942 INSERM AP‐HP, Paris France
  • Òscar Miró
    Emergency Department, Hospital Clínic University of Barcelona Barcelona Catalonia, Spain
  • Andrea Mortara
    Department of Cardiology Policlinico di Monza Monza Italy
  • Christian Mueller
    Department of Cardiology and Cardiovascular Research Institute Basel (CRIB) University Hospital Basel Basel Switzerland
  • Wilfried Mullens
    Department of Cardiology, Ziekenhuis Oost Limburg, Genk – Biomedical Research Institute, Faculty of Medicine and Life Sciences Hasselt University Diepenbeek Belgium
  • Markku S. Nieminen
    Department of Cardiology University of Helsinki Helsinki Finland
  • Alain Rudiger
    Cardio‐surgical Intensive Care Unit University and University Hospital Zurich Zurich Switzerland
  • Frank Ruschitzka
    University Heart Center University Hospital Zurich Zurich Switzerland
  • Petar M. Seferovic
    Department of Internal Medicine, Belgrade University School of Medicine and Heart Failure Center Belgrade University Medical Center Belgrade Serbia
  • Alessandro Sionis
    Cardiology Department, Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona Barcelona Spain
  • Antoine Vieillard‐Baron
    INSERM U‐1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, 94807 Villejuif, France University Hospital Ambroise Paré AP‐, HP, Boulogne‐Billancourt France
  • Jean Marc Weinstein
    Cardiology Division Soroka University Medical Centre Beer‐Sheva Israel
  • Rudolf A. de Boer
    Department of Cardiology, University Medical Center Groningen University of Groningen Groningen The Netherlands
  • Maria G. Crespo‐Leiro
    Complexo Hospitalario Universitario A Coruña (CHUAC) Instituto de Investigación Biomédica de A Coruña (INIBIC) CIBERCV, UDC, La Coruña Spain
  • Massimo Piepoli
    Heart Failure Unit Cardiology, G. da Saliceto Hospital Piacenza Italy
  • Jillian P. Riley
    Imperial College London UK

Description

<jats:p>This paper provides a practical clinical application of guideline recommendations relating to the inpatient monitoring of patients with acute heart failure, through the evaluation of various clinical, biomarker, imaging, invasive and non‐invasive approaches. Comprehensive inpatient</jats:p><jats:p>monitoring is crucial to the optimal management of acute heart failure patients. The European Society of Cardiology heart failure guidelines provide recommendations for the inpatient monitoring of acute heart failure, but the level of evidence underpinning most recommendations is limited. Many tools are available for the in‐hospital monitoring of patients with acute heart failure, and each plays a role at various points throughout the patient's treatment course, including the emergency department, intensive care or coronary care unit, and the general ward. Clinical judgment is the preeminent factor guiding application of inpatient monitoring tools, as the various techniques have different patient population targets. When applied appropriately, these techniques enable decision making. However, there is limited evidence demonstrating that implementation of these tools improves patient outcome. Research priorities are identified to address these gaps in evidence. Future research initiatives should aim to identify the optimal in‐hospital monitoring strategies that decrease morbidity and prolong survival in patients with acute heart failure.</jats:p>

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