Conflict of interest: A.A. Voors receives personally or via his institute a reimbursement for board membership in clinical trials of Novartis, Corthera, Torrent, Johnson&Johnson and Servier, and for advice for Abbott, Boehringer-Ingelheim, Merck/MSD, and Sequel-Pharma, receives a research grant from the European Commission (FP7), the Netherlands Heart Foundation and B.R.A.H.M.S. and royalties from Springer. T.B. Twickler receives funding from the Netherlands Organisation for Health Research and Development (ZonMw) and the Netherlands Organisation for Scientific Research (NWO). E.P. Walma received funding from ZonMw. F.H Rutten en A.W. Hoes receive funding from ZonMw, Netherlands Heart Foundation en Agis Health Insurance.
In the multidisciplinary practice guideline ‘Heart failure 2010’, the diagnosis of heart failure relies on a combination of signs and symptoms and on supplementary investigation with natriuretic peptides and echocardiography. Once diagnosed, it is important to detect the potentially treatable cause of the heart failure.
The non-medical treatment consists of lifestyle advice, of which regular body exercise is the most important component. The medical treatment of patients with systolic heart failure consists of a diuretic, ACE inhibitor, and beta-blocker, optionally extended by an aldosterone antagonist, an angiotensin receptor blocker and/or digoxin.
A restricted group of patients may require an internal cardiac defibrillator (ICD) and/or cardiac resynchronisation therapy.
There is limited scientific evidence concerning treatment of patients with diastolic heart failure.
It is important to coordinate the care of the patient with heart failure within a multidisciplinary team to provide optimal treatment and information for the patient.