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Ved fremskreden hjertesvikt vil man kunne merke at pusten blir tyngre når man legger seg ned, og den blir lettere i oppreist stilling.
Ved fremskreden hjertesvikt vil man kunne merke at pusten blir tyngre når man legger seg ned, og den blir lettere i oppreist stilling.

Kronisk hjertesvikt

Hjertesvikt betegner en tilstand der hjertets pumpefunksjon er svekket i forhold til normalt nivå. Hjertet klarer ikke å pumpe tilstrekkelig med blod rundt i kroppen.

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Den ligger åpent tilgjengelig på NHI.no sammen annen relevant informasjon

https://nhi.no/sykdommer/hjertekar/ulike-sykdommer/hjertesvikt-kronisk/ 

Hva er hjertesvikt?

Hjertesvikt, årsaker

Hjertesvikt, diagnostikk

Hjertesvikt, behandling

Egenbehandling

Medikamentell behandling

Annen behandling

Hjertesvikt, prognose

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Referanser

Dette dokumentet er basert på det profesjonelle dokumentet Hjertesvikt, kronisk. Referanselisten for dette dokumentet vises nedenfor.

  1. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2021. doi:10.1093/eurheartj/ehab368 DOI 
  2. Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. 9th ed. Boston: Little, Brown, 1994.
  3. Folkehelseinstituttet. Forekomst av hjerte- og karsykdommer i 2020. FHI 2021. www.fhi.no 
  4. Chioncel O, Lainscak M, Seferovic PM, et al. Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2017 Dec;19(12):1574-1585. Epub 2017 Apr 6. PMID: 28386917.
  5. Aarønæs M, Atar D, Bonarjee V, et al. Kronisk hjertesvikt - etiologi og diagnostikk. Tidsskr Nor Lægeforen 2007; 127: 171-3. PubMed 
  6. Rush CJ, Berry C, Oldroyd KG, et al. Prevalence of Coronary Artery Disease and Coronary Microvascular Dysfunction in Patients With Heart Failure With Preserved Ejection Fraction. JAMA Cardiol 2021. pmid:34160566 PubMed 
  7. Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med 2002; 346: 1845-53. PubMed 
  8. Gevaert AB, Kataria R, Zannad F, et al. Heart failure with preserved ejection fraction: recent concepts in diagnosis, mechanisms and management. Heart 2022; 108: 1342-1350. pmid:35022210 PubMed 
  9. Dosh SA. Diagnosis of heart failure in adults. Am Fam Physician 2004; 70: 2145-52. PubMed 
  10. Real J, Cowles E, Wierzbicki AS, et al. Chronic heart failure in adults: summary of updated NICE guidance. BMJ 2018; 362: k3646. PMID: 30249604 PubMed 
  11. Modin D, Jørgensen ME, Gislason G, et al. Influenza Vaccine in Heart Failure: Cumulative Number of Vaccinations, Frequency, Timing, and Survival: A Danish Nationwide Cohort Study. Circulation 2018. pmid:30586760 PubMed 
  12. Folkehelseinstituttet. Pneumokokkvaksine - veileder for helsepersonell. Sist oppdatert 27.09.2022. Siden lest 18.10.2022 www.fhi.no 
  13. Mueller S, Winzer EB, Duvinage A, et al. Effect of High-Intensity Interval Training, Moderate Continuous Training, or Guideline-Based Physical Activity Advice on Peak Oxygen Consumption in Patients With Heart Failure With Preserved Ejection Fraction A Randomized Clinical Trial. JAMA 2021; 325: 542-51. pmid:33560320 PubMed 
  14. Mathani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure. A Systematic review. JAMA 2018. pmid:30398532 PubMed 
  15. Ezekowitz JA, Colin-Ramirez E, Ross H, et al. Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial. Lancet 2022; 399: 1391-1400. pmid:35381194 PubMed 
  16. Mandras SA, Uber PA, Mehra MR. Sexual activity and chronic heart failure. Mayo Clin Proc 2007; 82: 1203-10. PubMed 
  17. Zhao Q, Chen C, Zhang J, et al. Effects of self-management interventions on heart failure: Systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud. 2020 Jun 16;110:103689. PMID: 32679402 PubMed 
  18. Rizos EC, Ntzani EE, Bika E, et al. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease. JAMA 2012; 308: 1024-33. Journal of the American Medical Association 
  19. Mebazaa A, Davison B, Chioncel O, et al. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet 2022. pmid:36356631 PubMed 
  20. Savage HO, Dimarco AD, Li B, et al. Sequencing of medical therapy in heart failure with a reduced ejection fraction. Heart 2022. pmid:36368882 PubMed 
  21. Lalani GG, Birgersdotter-Green U. Cardiac resynchronisation therapy in patients with chronic heart failure. Heart 2015. doi:10.1136/heartjnl-2014-306835 DOI 
  22. Anker SD, Butler J, Filippatos G, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med 2021. pmid:34449189 PubMed 
  23. Vaduganathan M, Docherty KF, Claggett BL, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. Lancet 2022. doi:10.1016/S0140-6736(22)01429-5 DOI 
  24. Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. N Engl J Med 2022. doi:10.1056/NEJMoa2206286 DOI 
  25. Nielsen EE, Feinberg JB, Bu F-L, et al. Beneficial and harmful effects of sacubitril/valsartan in patients with heart failure: a systematic review of randomised clinical trials with meta-analysis and trial sequential analysis. Open Heart 2020; 7: e001294. pmid:33257469 PubMed 
  26. Mc Causland FR, Lefkowitz MP, Claggett B, et al. Angiotensin-Neprilysin Inhibition and Renal Outcomes in Heart Failure With Preserved Ejection Fraction. Circulation. 2020 Sep 29;142(13):1236-1245. PMID: 32845715 PubMed 
  27. Packer M, Butler J, Zannad F, et al. Effect of Empagliflozin on Worsening Heart Failure Events in Patients with Heart Failure and a Preserved Ejection Fraction: The EMPEROR-Preserved Trial. Circulation 2021. pmid:34459213 PubMed 
  28. Butler J, Usman MS, Filippatos G, et al. Safety and Efficacy of Empagliflozin and Diuretic Use in Patients with Heart Failure and Preserved Ejection Fraction A Post Hoc Analysis of the EMPEROR-Preserved Trial. JAMA Cardiol 2023. pmid:37223933 PubMed 
  29. Mc Causland FR, Claggett BL, Vaduganathan M, et al. Dapagliflozin and Kidney Outcomes in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction A Prespecified Analysis of the DELIVER Randomized Clinical Trial. JAMA Cardiol 2022. pmid:36326604 PubMed 
  30. Butler J, Filippatos G, Siddiqi TJ, et al. Empagliflozin, health status, and quality of life in patients with heart failure and preserved ejection fraction: The EMPEROR-Preserved Trial. Circulation 2021. pmid:34779658 PubMed 
  31. Kosiborod MN, Bhatt AS, Claggett BL, et al. Effect of Dapagliflozin on Health Status in Patients With Preserved or Mildly Reduced Ejection Fraction. J Am Coll Cardiol. 2022. PMID: 36526515 PubMed 
  32. Petrie MC, Verma S, Docherty KF, et al. Effect of Dapagliflozin on Worsening Heart Failure and Cardiovascular Death in Patients With Heart Failure With and Without Diabetes. JAMA 2020; 323: 1353-68. pmid:32219386 PubMed 
  33. Writing Committee; Maddox TM, Januzzi JL, Allen LA, et al. 2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2021; 77: 772-810. pmid:33446410 PubMed 
  34. Berg DD, Jhund PS, Docherty KF, et al. Time to Clinical Benefit of Dapagliflozin and Significance of Prior Heart Failure Hospitalization in Patients With Heart Failure With Reduced Ejection Fraction. JAMA Cardiol 2021; 6: 499-507. pmid:33595593 PubMed 
  35. Zou X, Shi Q, Vandvik PO, et al. Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Heart Failure : A Systematic Review and Meta-analysis. Ann Intern Med. 2022. PMID: 35404670 PubMed 
  36. Docherty KF, Jhund PS, Claggett B, et al. Extrapolating Long-term Event-Free and Overall Survival With Dapagliflozin in Patients With Heart Failure and Reduced Ejection Fraction An Exploratory Analysis of a Phase 3 Randomized Clinical Trial. JAMA Cardiol 2021. doi:10.1001/jamacardio.2021.2632 DOI 
  37. Joshi SJ, Singh T, Newby DE, Singh J. Sodium-glucose co-transporter 2 inhibitor therapy: mechanisms of action in heart failure. Heart 2021. pmid:33637556 PubMed 
  38. Biegus J, Voors AA, Collins SP, et al. Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial. Eur Heart J. 2022. PMID: 36254693 PubMed 
  39. Ferreira JP, Zannad F, Butler J, et al. Empagliflozin and serum potassium in heart failure: an analysis from EMPEROR-Pooled. Eur Heart J 2022. pmid:35687107 PubMed 
  40. MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL randomized intervention trial in congestive heart failure. Lancet 1999; 353: 2001-07.
  41. Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014; 370:1383-92. doi: 10.1056/NEJMoa1313731 DOI 
  42. Filippatos G, Anker SD, Agarval R, et al. Finerenone Reduces Risk of Incident Heart Failure in Patients With Chronic Kidney Disease and Type 2 Diabetes: Analyses from the FIGARO-DKD Trial. Circulation 2021. pmid:34775784 PubMed 
  43. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure: Executive Summary. J Card Fail 2022; 28: 810-830. pmid:35378259 PubMed 
  44. Mann DL, Givertz MM, Vader JM, et al. Effect of Treatment With Sacubitril/Valsartan in Patients With Advanced Heart Failure and Reduced Ejection Fraction A Randomized Clinical Trial. JAMA Cardiol 2021. pmid:34730769 PubMed 
  45. McMurray JJV, Jackson AM, Lam CSP, et al. Effects of sacubitril-valsartan, versus valsartan, in women compared to men with heart failure and preserved ejection fraction: Insights from PARAGON-HF. Circulation 2019. PMID: 31736337 PubMed 
  46. Pieske B, Wachter R, Shah SJ, et al. Effect of Sacubitril/Valsartan vs Standard Medical Therapies on Plasma NT-proBNP Concentration and Submaximal Exercise Capacity in Patients With Heart Failure and Preserved Ejection Fraction The PARALLAX Randomized Clinical Trial. JAMA 2020; 326: 1919-29. pmid:34783839 PubMed 
  47. Swedberg K, Komajda M, Böhm M, et al. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 2010; 376: 875-85. PMID: 20801500 PubMed 
  48. Armstrong PW, Pieske B, Anstrom KJ, et. al, VICTORIA Study Group. Vericiguat in patients with heart failure and reduced ejection fraction. N Engl J Med 2020;382:1883–1893. PMID: 32222134 PubMed 
  49. Yancy CW, Jessup M, et al. 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: An update of the 2013 ACCF/AHA guideline for the management of heart failure. Circulation 2016. doi:10.1161/CIR.0000000000000435 DOI 
  50. Liew AY, Eikelboom JW, Connolly SJ, et al. Efficacy and safety of warfarin vs. antiplatelet therapy in patients with systolic heart failure and sinus rhythm: a systematic review and meta-analysis of randomized controlled trials. Int J Stroke. 2014 ;9(2):199-206. doi: 10.1111/ijs.12036 DOI 
  51. Lip GYH, Shantsila E. Anticoagulation versus placebo for heart failure in sinus rhythm. Cochrane Database of Systematic Reviews 2014, Issue 3. Art. No.: CD003336. DOI: 10.1002/14651858.CD003336.pub3. Accessed 13 April 2021 The Cochrane Library 
  52. Wang TJ, Larson MG, Levy D et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation 2003; 107: 2920-5. Circulation 
  53. Marrouche NF, Brachmann J, Andresen D, et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. N Engl J Med 2018; 378: 417-27. pmid:29385358 PubMed 
  54. Ponikowski P, Kirwan B-A, Anker SD, et al on behalf of the AFFIRM-AHF Investigators. Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: A multicentre, double-blind, randomised, controlled trial. Lancet 2020. PMID: 33197395 PubMed 
  55. Kalra PR, Cleland JGF, Petrie MC, et al. Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial. Lancet 2023; 400: 2199-2209. pmid:36347265 PubMed 
  56. McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019. pmid:31535829 PubMed 
  57. Zhou X, Xu W, Xu Y, et al. Iron Supplementation Improves Cardiovascular Outcomes in Patients with Heart Failure. Am J Med. 2019. PMID: 30853478 PubMed 
  58. Teerlink JR, Diaz R, Felker GM, et al. Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure. N Engl J Med. 2020. PMID: 33185990 PubMed 
  59. Lewis GD, Voors AA, Cohen-Salal A, et al. Effect of Omecamtiv Mecarbil on Exercise Capacity in Chronic Heart Failure With Reduced Ejection Fraction The METEORIC-HF Randomized Clinical Trial. JAMA 2022; 328: 259-269. pmid:35852527 PubMed 
  60. Schou M, Gustafsson F, Videbaek L, et al. Extended heart failure clinic follow-up in low-risk patients: a randomized clinical trial (NorthStar). Eur Heart J. 2012 Aug 8. pmid:PMID: 22875412 PubMed 
  61. Brugts JJ, Radhoe SP, Clephas PRD, et al. Remote haemodynamic monitoring of pulmonary artery pressures in patients with chronic heart failure (MONITOR-HF): a randomised clinical trial. Lancet 2023. pmid:37220768 PubMed 
  62. Long L, Mordi IR, Bridges C, et al. Exercise‐based cardiac rehabilitation for adults with heart failure. Cochrane Database of Systematic Reviews 2019, Issue 1. Art. No.: CD003331. DOI: 10.1002/14651858.CD003331.pub5. The Cochrane Library 
  63. Pandey A, Parashar A, Kumbhani DJ, et al. Exercise training in patients with heart failure and preserved ejection fraction: meta-analysis of randomized control trials. Circ Heart Fail. 2015;8(1):33-40. doi: 10.1161/CIRCHEARTFAILURE.114.001615. DOI 
  64. Tsimploulis A, Lam PH, Arundel C, et al. Systolic blood pressure and outcomes in patients with heart failure with preserved ejection fraction. JAMA Cardiol 2018. pmid:29450487 PubMed 
  65. Taylor CJ, Lay-Flurrie SL, Ordóñez-Mena JM, et al. Natriuretic peptide level at heart failure diagnosis and risk of hospitalisation and death in England 2004–2018. Heart 2021. pmid:34183432 PubMed 
  66. Taylor CJ, Ordonez-Mena JM, Roalfe AK, et al. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019 Feb 13;364:l223. PMID: 30760447 PubMed 
  67. Berge K, Brynildsen J, Røysland R, et al. Prognostic value of cardiac biomarkers and National Early Warning Score 2 in acute dyspnoea. Open Heart 2022. pmid:35387863 PubMed 
  68. Takeda A, Martin N, Taylor RS, Taylor SJC. Disease management interventions for heart failure. Cochrane Database of Systematic Reviews 2019, Issue 1. Art. No.: CD002752. DOI: 10.1002/14651858.CD002752.pub4. Accessed 13 April 2021 The Cochrane Library 
  69. De Vecchis R, Esposito C, Di Biase G, et al. B-type natriuretic peptide-guided versus symptom-guided therapy in outpatients with chronic heart failure: a systematic review with meta-analysis. J Cardiovasc Med (Hagerstown). 2014;15(2):122-34. doi: 10.2459/JCM.0b013e328364bde1.
  70. Norsk kvalitetsforbedring av laboratorieundersøkelser (Noklus). Anbefalte analyser ved ulike kliniske problemstillinger. Siden besøkt 21.09.2020. www.noklus.no