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Year : 2003  |  Volume : 49  |  Issue : 1  |  Page : 1-10

Expert opinion on the identification and pharmacological management of worsening heart failure: A consensus statement from India

1 Department of Cardiology, AIIMS, New Delhi, India
2 Department of Cardiology, Hannover Medical School (MHH), Germany
3 Department of Cardiology, Director, Clinical and Preventive Cardiology- Heart Institute, Medanta-The Medicity, Gurugram, India
4 Department of Cardiology, Director Cardiology and Head -Medical Advanced Heart Failure Program at Fortis Escorts Heart Institute, Delhi, India
5 Department of Cardiology, Senior Consultant Cardiologist & Intervention Cardiologist, Indraprastha Apollo Hospital, Sarita Vihar, Gurugram, India
6 Department of Cardiology, Fortis Hospital, Gurugram, India
7 Department of Cardiology, Senior Director & Unit Head, Cardiac Sciences, Cardiology, Cardiac Electrophysiology-Pacemaker, Interventional Cardiology, Max Smart Super Speciality Hospital, Saket, India
8 Department of Cardiothoracic and Vascular Surgery, AIIMS, New Delhi, India
9 Department of Cardiology, Consultant- Interventional Cardiologist, Indraprastha Apollo Hospital Sarita Vihar, New Delhi, India
10 Department of Cardiology and Incharge, Acute Cardiac Care and Heart Failure Clinic, Holy Family Hospital, New Delhi, India
11 Department of Cardiology, Director Cardiology Accord Hospital, Faridabad, India
12 Department of Cardiology, Associate Director-Cardiac Science Max Super Speciality Hospital, Patparganj, (Delhi), India
13 Department of Cardiology, Consultant, Yatharth Super Specialty Hospital, Greater Noida, India
14 Department of Cardiology, Consultant Cardiologist, Max Hospital, Vaishali, Ghaziabad, India
15 Department of Cardiology, Senior Consultant, Cardiology & CTVS, Metro Group of Hospitals, Noida, Uttar Pradesh, India
16 Department of Cardiology, Assistant Professor, Safdarjung Hospital, New Delhi, India
17 Department of Interventional Cardiology, Director -Clinical and Interventional Cardiology, Max Super Speciality Hospital, Vaishali, India
18 Department of Cardiothoracic and Vascular Surgery, Senior Resident, CTVS, AIIMS, New Delhi, India
19 Department of Cardiology, Consultant Cardiologist, Sir Gangaram Hospital, New Delhi, India
20 Department of Cardiology, Professor, GB Pant Hospital, New Delhi, India
21 Department of Cardiology, Senior Consultant Cardiac Sciences, Max Superspeciality Hospital, Shalimaar Bagh Delhi, India
22 Department of Cardiology, Senior Consultant-Cardiology, Fortis Shalimar Bagh, India
23 Department of Cardiology, Consultant Cardiologist and Physician, Gupta Ultrasound and Heart Care Centre, West Delhi, India
24 Department of Cardiology, Director & HOD Cardiology & Heart Failure Programme, Fortis Hospital Shalimar Bagh, India
25 Department of Cardiology, Director & Head, ISIC -Saroj Cardiac Sciences, Vasant Kunj New Delhi, India
26 Department of Interventional Cardiology, Consultant Interventional Cardiologist, Fortis Hospital, Noida, India
27 Department of Internal Medicine, Senior Consultant Internal Medicine, Max Super Speciality Hospital, Patparganj, India
28 Department of Interventional Cardiology, Director of Interventional Cardiology - Mahavir Heart Institute, Surat, India
29 Department of Interventional Cardiology, Senior Interventional Cardiologist & HF Specialist, Kokilaben Dhirubhai Ambani Hospital & Research Centre, Andheri Mumbai, India
30 Department of Advanced Cardiac Sciences & Heart Transplant, Consultant- Advanced Cardiac Sciences & Heart Transplant, Sir H.N. Reliance Foundation Hospital & Research Centre, Mumbai, India
31 Department of Interventional Cardiology, Senior Consultant Interventional Cardiologist & Heart Failure Specialist, Apollo Hospitals, Chennai, India
32 Department of Cardiology, Professor of Cardiology & Senior Interventional Cardiologist, Bombay Hospital/Horizon Hospital, Mumbai, India
33 Department of Interventional Cardiology, Senior Interventional Cardiologist, Dr. V T Shah's Diagnostic Centre & Clinic, Mumbai, India
34 Department of Cardiology, Senior Cardiologist, AMRI Hospital, Kolkata, India
35 Department of Interventional Cardiology, Senior Interventional Cardiologist, Sparsh Hospital, Bangalore, India
36 Department of Interventional Cardiology, Senior Interventional Cardiologist, SS Sparsh Hospital, Bangalore, India
37 Physician & Intensivist, Aarav Clinic, Surat, India
38 Department of Cardiology, Consultant Physician Cardiology, Lilavati Hospital, Mumbai, India
39 Department of Interventional Cardiology, Interventional Cardiologist, Ruby Hospital, Pune, India
40 Department of Interventional Cardiology, Interventional Cardiologist, Cardio Vision, Pune, India
41 Department of Cardiology, Senior Consulting & Cardiac Physician, HCG Hospital, Ahmedabad, India
42 Department of Interventional Cardiology, Interventional Cardiologist, Apollo Hospital, Hyderabad, India
43 Department of Cardiology, Associate Professor, Safdarjung Hospital, New Delhi, India
44 Department of Medicine, CGHS, Safdarjung Hospital, New Delhi, India
45 Department of Cardiothoracic and Vascular Surgery, Director-CTVS, Fortis Escorts, Delhi, India

Correspondence Address:
Sandeep Seth
Department of Cardiology, AIIMS, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpcs.jpcs_32_23

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Worsening heart failure (WHF) is a distinct under-diagnosed and under-treated condition, independent of location of care. Heart failure (HF) progression is punctuated by repeated WHF events, each resulting in reduced cardiac function. One-third of the patients with HF with reduced ejection fraction experience a decompensation event. These decompensation events often result in the emergency department visits and HF hospitalization. Despite its inclusion in recent guidelines, there is no precise definition of WHF or its various forms. It is worth noting that WHF signals a need for treatment optimization as per guideline-directed medical therapy and the addition of novel drugs like a stimulator of soluble guanylate cyclase that benefit this high-risk patient population. This practical document is based on the expert opinion of cardiologists, cardiothoracic surgeons, and physicians that discussed the definition, assessment, pharmacological management, and monitoring of WHF patients in a hospitalized setting. In addition, there is also a need for an expert opinion for the management of WHF in an outpatient setting.


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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow