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Medical treatment of heart failure: The Canadian Cardiovascular Society's Consensus Conference revisited

  • Congestive Heart Failure
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Summary

The report of the Canadian Cardiovascular Society's Consensus Conference on the diagnosis and management of heart failure was published in 1994. Focusing on the chronic medical treatment of patients with systolic left ventricular dysfunction, we summarize and update the consensus recommendations in the light of the results of several more recent studies. While the positive treatment recommendations are still fully valid or even reinforced by these new data, a somewhat more liberal use of beta-blockers, amiodarone, and newer calcium channel blockers seems justified.

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References

  1. Johnstone, DE, Abdulla, A, Arnold, JM, et al. Diagnosis and management of heart failure. Canadian Cardiovascular Society. Can J Cardiol 1994;10:613–631.

    Google Scholar 

  2. The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA 1988; 259:539–544.

    Google Scholar 

  3. Packer, M, Gheorghiade, M, Young, JB, et al., for the RADIANCE Study. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme inhibitors. N Engl J Med 1993;329:1–7.

    Google Scholar 

  4. Uretsky, BF, Young, JB, Shahidi, FE, Yellen, LG, Harrison, MC, Jolly, MK, on behalf of the PROVED Investigative Group. Randomized study assessing the effect of digoxin withdrawal in patients with mild to moderate chronic congestive heart failure: Results of the PROVED trial. J Am Coll Cardiol 1993;22:955–962.

    Google Scholar 

  5. Guidelines for the evaluation and management of heart failure. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Evaluation and Management of Heart Failure). J Am Coll Cardiol 1995;26:1376–1398.

    Google Scholar 

  6. Feldman, AM, Bristow, MR, Parmley, WW, et al., for the Vesnarinone Study Group. Effects of vesnarinone on morbidity and mortality in patients with heart failure. N Engl J Med 1993;329:149–155.

    Google Scholar 

  7. The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987;316:1429–1435.

    Google Scholar 

  8. Cohn, JN, Johnson, G, Ziesche, S, et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med 1991;325:303–310.

    Google Scholar 

  9. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991;325: 293–302.

    Google Scholar 

  10. The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med 1992;327:685–691.

    Google Scholar 

  11. Pfeffer, MA, Braunwald, E, Moyé, LA, et al., for the SAVE Investigators. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the Survival and Ventricular Enlargement Trial. N Engl J Med 1992;327:668–677.

    Google Scholar 

  12. The AIRE Investigators. Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet 1993;342: 821–828.

    Google Scholar 

  13. Ambrosioni, E, Borghi, C, Magnani, B, for the Survival of Myocardial Infarction Long-term Evaluation (SMILE) Study Investigators. The effect of the angiotensin-converting-enzyme inhibitor zofenopril on mortality and morbidity after anterior myocardial infarction. N Engl J Med 1995;332:80–85.

    Google Scholar 

  14. Køber, L, Torp-Pedersen, C, Carlsen, JE, et al., for the Trandolapril Cardiac Evaluation (TRACE) Study Group. A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1995;333: 1670–1676.

    Google Scholar 

  15. Gruppo Italiano per lo Studio della Sopravvivenza nell'infarto Miocardico. GISSI-3. Effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Lancet 1994;343:1115–1122.

    Google Scholar 

  16. ISIS-4 Collaborative Group. ISIS-4: A randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet 1995;345: 669–685.

    Google Scholar 

  17. Chinese Cardiac Study Collaborative Group. Oral captopril versus placebo among 13,634 patients with suspected acute myocardial infarction: Interim report from the Chinese Cardiac Study (CCS-1). Lancet 1995;345:686–687.

    Google Scholar 

  18. Cohn, JN, Ziesche, SM, Loss, LE, Anderson, GF, and the V-HeFT Study Group. Effect of felodipine on short-term exercise and neurohormone and long-term mortality in heart failure: Results of V-HeFT III (abstr). Circulation 1995;92:I-143.

    Google Scholar 

  19. Packer, M, Rouleau, J, Swedberg, K, Pitt, B, Fisher, L, Klepper, M, and the Profile Investigators and Coordinators. Effect of flosequinan on survival in chronic heart failure: Preliminary results of the PROFILE study (abstr). Circulation 1993;88:I301.

    Google Scholar 

  20. Califf RM, Adams KF, Armstrong PW, et al. Flolan International Randomized Survival Trial (FIRST): Final results (abstr). J Am Coll Cardiol 1996;27:143A.

    Google Scholar 

  21. Moe GW, Rouleau JL, Proulx G, Arnold M, Sestier F, on behalf of the Canadian PROFILE Investigators. Increased mortality with flosequinan in patients with failure is accompanied by increased plasma norepinephrine (abstr). Circulation 1994;90:I380.

    Google Scholar 

  22. Waagstein, F, Bristow, MR, Swedberg, K, et al., for the Metoprolol in Dilated Cardiomyopathy (MDC) Trial Study Group. Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Lancet 1993;342:1441–1446.

    Google Scholar 

  23. CIBIS Investigators and Committees. A randomized trial of beta-blockade in heart failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). Circulation 1994;90:1765–1773.

    Google Scholar 

  24. Packer, M, Bristow, MR, Cohn, JN, et al., for the U.S. Carvedilol Heart Failure Study Group. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996;334:1349–1355.

    Google Scholar 

  25. Doval, HC, Nul, DR, Grancelli, HO, Perrone, SV, Bortman, GR, Curiel, R, for the Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA). Randomised trial of low-dose amiodarone in severe congestive heart failure. Lancet 1994;344:493–498.

    Google Scholar 

  26. Singh, SN, Fletcher, RD, Fisher, SG, et al., for the Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. N Engl J Med 1995;333:77–82.

    Google Scholar 

  27. Waldo AL, Camm AJ, de Ruyter H, et al. Preliminary motality results from the Survival with Oral D-Sotalol (SWORD) Trial (abstr). J Am Coll Cardiol 1995;25:15A.

    Google Scholar 

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Vantrimpont, P., Rouleau, J.L. Medical treatment of heart failure: The Canadian Cardiovascular Society's Consensus Conference revisited. Cardiovasc Drug Ther 10, 711–716 (1997). https://doi.org/10.1007/BF00053028

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  • DOI: https://doi.org/10.1007/BF00053028

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