Gå direkt till huvudinnehållet

Kronisk hjärtsvikt

Senast uppdaterad: Senast reviderad:
Sakkunnig:
Definition: 
Ett komplext kliniskt syndrom med symtom och tecken på att hjärtats minutvolym är för låg i förhållande till kroppens behov. Kan delas in i hjärtsvikt med bevarad ejektionsfraktion (HFpEF), reducerad ejektionsfraktion (HFrEF) och med mellanvärden för ejektionsfraktionen (HFmEF).
Förekomst: 
Prevalensen anges till 1–2 %, det vill säga omkring 100 000–200 000 patienter i Sverige. 
Symtom:
Typiskt är dyspné, ortopné, paroxysmal nattlig dyspné, minskad ansträngningskapacitet, trötthet/fatigue med förlängd tid till återhämtning, bilateralt ankelödem.
Kliniska fynd:
Typiska fynd är halsvenstas, hepatojugulär reflux, tredje hjärtton, lateralt placerad apikal impuls.
Diagnostik: 
En kombination av symtom, tecken, blodprover där BNP/NT-proBNP har särskilt värde samt EKG och ekokardiografi.
Behandling:
Beror på typ av hjärtsvikt. Vid HFrEF/HFmEF är ACE-hämmare, betablockerare, aldosteronantagonister och SGLT-2-hämmare indicerade medan man vid HFpEF mest inriktar sig på grundsjukdomarna. Diuretika kan användas hos alla patienter med tecken på dekompensation. 
  1. Ponikowski P, Voors AA, Anker SD et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal 2016; 37(27): 2129–200. pmid:27206819. PubMed  
  2. Dosh SA. Diagnosis of heart failure in adults. Am Fam Physician 2004; 70: 2145-52. PubMed  
  3. McMurray JJV, Pfeffer MA. Heart failure. Lancet 2005; 365: 1877-89. PubMed  
  4. 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.
  5. Satpathy C, Mishra TK. Diagnosis and management of diastolic dysfunction and heart failure. Am Fam Physician 2006; 73: 841-6. PubMed  
  6. Vasan RS, Levy D. Defining diastolic heart failure: a call for standardized diagnostic criteria. Circulation 2000; 101: 2118-21. PMID: 10790356. PubMed  
  7. Grossman W. Defining diastolic dysfunction. Circulation 2000; 101: 2020-1. PMID: 10790339. PubMed  
  8. Wachter R, Edelmann F. Diagnosis of heart failure with preserved ejection fraction. Heart Fail Clin. 2014 Jul;10(3):399-406. PMID: 24975904. PubMed  
  9. Cowie MR, Mosterd A, Wood DA, et al. The epidemiology of heart failure. Eur Heart J 1997; 18: 208-25. PMID: 9043837. PubMed  
  10. Brouwers FP, de Boer RA, van der Harst P et al. Incidence and epidemiology of new onset heart failure with preserved vs. reduced ejection fraction in a community-based cohort: 11-year follow-up of PREVEND.. Eur Heart J. 2013 ; 34(19): 1424-31. pmid:23470495 PubMed  
  11. Socialstyrelsen (2015). Nationella riktlinjer för hjärtsjukvård. (Hämtad 2016-11-08) www.socialstyrelsen.se  
  12. Sveriges regioner i samverkan. Nationellt system för kunskapsstyrning Hälso- och sjukvård. Personcentrerat och sammanhållet vårdförlopp, Hjärtsvikt – nydebuterad. Godkänd 2021-02-24 (Hämtad 2021-03-16). nationelltklinisktkunskapsstod.se  
  13. Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med 2002; 347: 1397-402. PMID:12409541. PubMed  
  14. Brutsaert DL, Sys SU, Gillebert TC. Diastolic failure: pathophysiology and therapeutic implications. J Am Coll Cardiol 1993; 22: 318-25. PubMed  
  15. Packer M. The neurohormonal hypothesis: a theory to explain the mechanism of disease progression in heart failure. J Am Coll Cardiol 1992; 20: 248-54. PubMed  
  16. Kastberg A, Mattson G, Magnusson P. Högerkammarsvikt – allvarligt tillstånd med ökad mortalitet. Läkartidningen. 2020;117:FXSI. lakartidningen.se  
  17. Swedberg K. Importance of neuroendocrine activation in chronic heart failure. Impact on treatment strategies. Eur J Heart Fail 2000; 2: 229-33. PubMed  
  18. Francis GS, McDonald K, Chu C et al. Pathophysiologic aspects of end-stage heart failure. Am J Cardiol 1995; 75: 11A-6. PMID:7840049 PubMed  
  19. Lloyd-Jones DM, Larson MG, Leip EP et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002;106(24):3068. pmid: 12473553 PubMed  
  20. El Khoudary SR, Aggarwal B, Beckie TM et al.; American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020 Dec 22;142(25):e506-e532. Epub 2020 Nov 30. PMID: 33251828 PubMed  
  21. McMurray JJ, Adamopoulos S, Anker SD et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC.. Eur Heart J. 2013 ; 34(2): 158. pmid:22611136 PubMed  
  22. European Society of Cardiology. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. 2021 (Hämtad 2021-09-14). www.escardio.org  
  23. Filippatos G, Anker SD, Agarwal 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 published online ahead of print, 2021 Nov 13. Circulation. 2021;10. PMID:34775784. PubMed  
  24. Läkemedelsverket. Diagnostik och behandling av kronisk hjärtsvikt – Behandlingsrekommendation. 2006.
  25. Mant J, Doust J, Roalfe A, et al. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care. Health Technol Assess 2009; 13: . [url]http://www.hta.ac.uk/project/1509.asp[/url] PMID: 19586584. PubMed  
  26. Arrol B, Doughty R, Andersen V. Investigation and management of congestive heart failure. Clinical review. BMJ 2010; 341: c3657. PMID: 20630951. PubMed  
  27. Okonko DO, Mandal AK, Missouris CG, et al. Disordered iron homeostasis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival. J Am Coll Cardiol. 2011;58:1241-51. PMID: 21903058. PubMed  
  28. Klip IT, Comin-Colet J, Voors AA, et al. Iron deficiency in chronic heart failure: an international pooled analysis. Am Heart J. 2013;165:575-82.e3. PMID: 23537975. PubMed  
  29. Li P, Luo Y, Chen YM. B-type natriuretic peptide-guided chronic heart failure therapy: a meta-analysis of 11 randomised controlled trials. Heart Lung Circ. 2013 Oct;22(10):852-60. PMID: 23602555. PubMed  
  30. Troughton RW, Frampton CM, Brunner-La Rocca HP, et al. Effect of B-type natriuretic peptide-guided treatment of chronic heart failure on total mortality and hospitalization: an individual patient meta-analysis. Eur Heart J. 2014 Jun 14;35(23):1559-67. doi: 10.1093/eurheartj/ehu090. [url]http://dx.doi.org/10.1093/eurheartj/ehu090[/url] PMID: 24603309. PubMed  
  31. Felker GM, Anstrom KJ, Adams KF, et al. Effect of Natriuretic Peptide–Guided Therapy on Hospitalization or Cardiovascular Mortality in High-Risk Patients With Heart Failure and Reduced Ejection Fraction. A Randomized Clinical Trial. JAMA 2017; 318: 713-20. PMID:28829876. PubMed  
  32. SBU. Optimering av hjärtsviktsbehandling genom upprepade mätningar av natriuretiska peptider. 2019-07-01 (hämtad 2019-07-09). www.sbu.se  
  33. Redfield MM. Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2016 Nov 10;375(19):1868-1877. PMID: 27959663; Alkhawam H, El-Hunjul M, Nguyen J, et al.Natriuretic peptide hormones in congestive heart failure: challenges, clinical interpretation and review of studies. Acta Cardiol. 2016 Aug;71(4):417-24. Pmid:27594357 PubMed  
  34. 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  
  35. Petrie MC, McMurray JJ. It cannot be heart failure because the heart is not enlarged on chest X-ray. Eur J Heart Fail 2003; 5: 117 - 9. PubMed  
  36. Mueller-Lenke N, Rudez J, Staub D et al. Use of chest X-ray in the emergency diagnosis of acute congestive heart failure. Heart 2006; 92: 695 - 6. PubMed  
  37. Shah MR, Hasselblad V, Gheorghiade M et al. Prognostic usefulness of the six-minute walk in patients with advanced congestive heart failure secondary to ischemic or nonischemic cardiomyopathy.. Am J Cardiol 2001; 88(9): 987-93. pmid:11703994 PubMed  
  38. Bellenger NG, Grothues F, Smith GC et al. Quantification of right and left ventricular function by cardiovascular magnetic resonance. Herz 2000; 25: 392-9. PubMed  
  39. Grothues F, Smith GC, Moon JC et al. Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. Am J Cardiol 2002; 90: 29-34. PubMed  
  40. Grothues F, Moon JC, Bellenger NG et al. Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. Am Heart J 2004; 147: 218-23. PubMed  
  41. Chavey WE, Blaum CS, Bleske BE, van Harrison R, Kesterson S, Nicklas JM. Guideline for the management of heart failure caused by systolic dysfunction: Part I. Guideline development, etiology and diagnosis. Am Fam Physician 2001; 64: 769-74. PubMed  
  42. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure published correction appears in Eur Heart J. 2021 Oct 14;:. Eur Heart J. 2021;42(36):3599-3726. PMID:34447992. PubMed  
  43. Zhao Q, Chen C, Zhang J, Ye Y, Fan X. Effects of self-management interventions on heart failure: Systematic review and meta-analysis of randomized controlled trials published online ahead of print, 2020 Jun 16. Int J Nurs Stud. 2020;110:103689. PMID:32679402. PubMed  
  44. 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  
  45. McConaghy JR, Smith SR. Outpatient treatment of systolic heart failure. Am Fam Physician 2004; 70: 2157-64. PubMed  
  46. 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(10333):1391-1400. PMID:35381194. PubMed  
  47. Alehagen U, Johansson P, Bjornstedt M, Rosen A, Dahlstrom U. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: A 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Int J Cardiol. 2012. PMID: 22626835 PubMed  
  48. SA Mortensen, A Kumar, P Dolliner, et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure. Results from the Q-SYMBIO study. Presented at Heart Failure Congress 2013 Final Programme Number 440. (The full title of the Q-SYMBIO study is: “Coenzyme Q10 as adjunctive treatment of chronic heart failure: a randomised double blind multicentre trial with focus on changes in symptoms, biomarker status with BNP and long term outcome”)
  49. Myers J, Brawner CA, Haykowsky MJ, et al. Prognosis: does exercise training reduce adverse events in heart failure? Heart Fail Clin. 2015 Jan;11(1):59-72. PubMed  
  50. Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2014 Dec 12;12:CD011273. doi: 10.1002/14651858.CD011273.pub2. PMID: 25503364. PubMed  
  51. Exercise-based rehabilitation for heart failure (Review). Taylor RS, Sagar VA, Davies EJ, et al. Cochrane Database Syst Rev. 2014 Apr 27;4:CD003331. doi: 10.1002/14651858.CD003331.pub4. PMID: 24771460. PubMed  
  52. Lewinter C, Doherty P, Gale CP, et al. Exercise-based cardiac rehabilitation in patients with heart failure: a meta-analysis of randomised controlled trials between 1999 and 2013. Eur J Prev Cardiol 2015; Dec;22(12): 1504-12. pmid:25398703 PubMed  
  53. 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 Jan;8(1):33-40. doi: 10.1161/CIRCHEARTFAILURE.114.001615. PMID: 25399909. PubMed  
  54. Mandras SA, Uber PA, Mehra MR. Sexual activity and chronic heart failure. Mayo Clin Proc 2007; 82: 1203-10. PubMed  
  55. Rich MW, Beckham V, Wittenberg C et al. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med 1995; 333: 1190-5. PMID: 7565975. PubMed  
  56. Stewart S, Marley JE, Horowitz JD. Effects of a multidisciplinary, home-based intervention on unplanned readmissions and survival among patients with chronic heart failure: a randomised controlled study. Lancet 1999; 354: 1077-83. PubMed  
  57. Cline CMJ, Israelsson BYA, Willenheimer RB et al. Cost effective management programme for heart failure reduces hospitalisation. Heart 1998; 80: 442-6. PubMed  
  58. Blue L, Lang E, McMurray JJV et al. Randomised controlled trial of specialist nurse intervention in heart failure. BMJ 2001; 323: 715-8. PMID: 11576977. PubMed  
  59. Nätverket för Sveriges Läkemedelskommittéer (LOK). Läkemedelsbehandling vid kronisk hjärtsvikt. Publicerat 2022-01-14 (Hämtad 2022-02-07). janusinfo.se  
  60. Brisco MA, Zile MR, Hanberg JS, et al. Relevance of changes in serum creatinine during a heart failure trial of decongestive strategies: insights from the DOSE trial. J Card Fail. 2016;22(10):753-60. PMID:27374839. PubMed  
  61. McColl A, Roderick P, Gabbay J, Smith H, Moore M. Performance indicators for primary care groups: an evidence based approach. BMJ 1998; 317: 1354-60. PMID: 9812935. PubMed  
  62. Eccles M, Freemantle N, Mason J. North of England evidence based development project: guideline for angiotensin converting enzyme inhibitors in primary care management of adults with symptomatic heart failure. BMJ 1998; 316: 1369-75. PMID: 9563995. PubMed  
  63. Garg R, Yusuf S, for the Collaborative Group on ACE Inhibitor Trials. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. JAMA 1995; 273: 1450-6. Journal of the American Medical Association  
  64. Jong P, Demers C, McKelvie RS, et al. Angiotensin receptor blockers in heart failure: meta-analysis of randomized controlled trials. J Am Coll Cardiol 2002; 39: 463-70. PubMed  
  65. Lee VC, Rhew DC, Dylan M, et al. Meta-analysis: angiotensin-receptor blockers in chronic heart failure and high-risk acute myocardial infarction. Ann Intern Med 2004; 141: 693-704. pmid: 15520426. PubMed  
  66. Phillips CO, Kashani A, Ko DK, Francis G, Krumholz HM. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from randomized clinical trials. Arch Intern Med 2007; 167: 1930-6. PubMed  
  67. Läkemedelsverket 2014-04-11: PRAC avråder ifrån att kombinera läkemedel som påverkar reninangiotensinsystemet. www.lakemedelsverket.se  
  68. Pitt B, Poole-Wilson PA, Segal R, et al. Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomized trial-the Losartan Heart Failure Survival Study ELITE II. Lancet 2000; 355: 1582-87. PubMed  
  69. Poole-Wilson PA, Swedberg K, Cleland JGF, et al. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the carvedilol or metoprolol European trial (COMET): a randomized controlled trial. Lancet 2003; 362: 7-13. PubMed  
  70. Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003; 348: 1309-1321. Pmid: 12668699. PubMed  
  71. Zannad F, McMurray JJ, Krum H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med 2011;364:11-21. PMID: 21073363. PubMed  
  72. Anker SD, Butler J, Filippatos G, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction published online ahead of print, 2021 Aug 27. N Engl J Med. 2021;10.1056/NEJMoa2107038. PMID:34449189. PubMed  
  73. 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  
  74. Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity published online ahead of print, 2023 Aug 25. N Engl J Med. 2023;10.1056/NEJMoa2306963. PMID:37622681. PubMed  
  75. McMurray JJV, Solomon SD, Inzuchhi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019. Epub ahead of print. PMID:31535829. PubMed  
  76. 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 published online ahead of print, 2020 Mar 27. JAMA. 2020;323(14):1353‐1368. PMID:32219386. PubMed  
  77. Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. N Engl J Med. 2022;387(12):1089-1098. PMID:36027570.
  78. Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020;383(15):1413-1424. PMID:32865377. PubMed  
  79. Verma S, Dhingra NK, Butler J, et al. Empagliflozin in the treatment of heart failure with reduced ejection fraction in addition to background therapies and therapeutic combinations (EMPEROR-Reduced): a post-hoc analysis of a randomised, double-blind trial. Lancet Diabetes Endocrinol 2022. pmid:34861154 PubMed  
  80. 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  
  81. Bohm M, Borer J, Ford I, Gonzalez-Juanatey JR, Komajda M, Lopez-Sendon J, Reil JC, Swedberg K, Tavazzi L. Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study. Clin Res Cardiol 2013 102:11-22 PMID: 22575988. PubMed  
  82. PRAC rekommenderar åtgärder för att minska risken för hjärtproblem med Procoralan (ivabradin). Läkemedelsverket 2014-11-07. www.lakemedelsverket.se  
  83. Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255–323. PMID:31497854. PubMed  
  84. Mc Causland FR, Lefkowitz MP, Claggett B, et al. Angiotensin-Neprilysin Inhibition and Renal Outcomes in Heart Failure With Preserved Ejection Fraction. Circulation. 2020;142(13):1236-1245. PMID:32845715. PubMed  
  85. Kuno T, Ueyama H, Fujisaki T, Briasouli A, Takagi H, Briasoulis A. Meta-Analysis Evaluating the Effects of Renin-Angiotensin-Aldosterone System Blockade on Outcomes of Heart Failure With Preserved Ejection Fraction. Am J Cardiol. 2020;125(8):1187-1193. PMID:32081366. PubMed  
  86. McMurray JJ, Packer M, Desai AS et al. PARADIGM-HF Investigators and Committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med 2014;371:993–1004. Pmid:25176015. PubMed  
  87. 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  
  88. Entresto (sakubitril/valsartan). Läkemedelsverket (sidan hämtad 2017-08-22). lakemedelsverket.se  
  89. 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.
  90. Hood WB Jr, Dans AL, Guyatt GH, Jaeschke R, McMurray JJ. Digitalis for treatment of congestive heart failure in patients in sinus rhythm (Cochrane Review). In. The Cochrane Library, Issue 3, 2004. Oxford: Update Software. The Cochrane Library  
  91. The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med 1997; 336: 525-33 PMID: 9036306. PubMed  
  92. Wakai A, McCabe A, Kidney R, et al. Nitrates for acute heart failure syndromes. Cochrane Database Syst Rev. 2013 Aug 6;8:CD005151. PMID: 23922186. PubMed  
  93. Mulder BA, Rienstra M, Van Gelder IC, Blaauw Y. Update un management of atrial fibrillation in heart failure: a focus on ablation. Heart 2022; 108: 422-428. pmid:34088767 PubMed  
  94. McDonagh T1, Macdougall IC. Iron therapy for the treatment of iron deficiency in chronic heart failure: intravenous or oral? Eur J Heart Fail. 2015 Mar;17(3):248-62. doi: 10.1002/ejhf.236. PMID: 25639592. PubMed  
  95. Behandling av järnbrist minskar symtom vid kronisk hjärtsvikt. Läkartidningen.se 2015-03-10. www.lakartidningen.se  
  96. Anker SD, Colet JC, Filippatos G, et al. Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med 2009; 361: e-pub. PMID: 19920054. PubMed  
  97. Silverberg DS, Wexler D, Blum M et al. The cardio renal anemia syndrome: correcting anemia in patients with resistant congestive heart failure can improve both cardiac and renal function and reduce hospitalizations. Clin Nephrol 2003; 60: 93-102. PMID:12940539 PubMed  
  98. Wexler D, Silverberg D, Blum M et al. Anaemia as a contributor to morbidity and mortality in congestive heart failure. Nephrol Dial Transplant 2005; 20 (suppl 7): vii11-vii15. PMID: 16024826 PubMed  
  99. 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  
  100. 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  
  101. Mentz RJ, Garg J, Rockhold FW, et al. Ferric Carboxymaltose in Heart Failure with Iron Deficiency. N Engl J Med 2023. PMID:37632463. PubMed  
  102. Bristow MR, Feldman AM, Saxon LA. Heart failure management using implantable devices for ventricular resynchronization: Comparison of Medical Therapy, Pacing, and Defibrillation in Chronic Heart Failure (COMPANION) trial. COMPANION Steering Committee and COMPANION Clinical Investigators. J Card Fail 2000; 6: 276-85. PubMed  
  103. Tang ASL, Wells GA, Talajic M, et al. Cardiac-resynchronization therapy for mild-to moderate heart failure. N Engl J Med 2010;363:2385-95. PMID:21073365. PubMed  
  104. Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 2005; 352: 1539-49. PMID: 15753115. PubMed  
  105. Moss AJ, Hall WJ, Cannom DS, et al. Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med 2009; 361: 1329-38. PMID: 20178156. PubMed  
  106. . State of the art: cardiac transplantation.. . pmid:25258115 PubMed  
  107. Dunkman WB. Thromboembolism and antithrombotic therapy in congestive heart failure. J Cardiovasc Risk 1995; 2: 107-17. PubMed  
  108. Raphael CE, Whinnett ZI, Davies JE, et al. Quantifying the paradoxical effect of higher systolic blood pressure on mortality in chronic heart failure. Heart 2009; 95: 56-62. PubMed  
  109. Jackson CE, Solomon SD, Gerstein HC, et al. Albuminuria in chronic heart failure: prevalence and prognostic importance. Lancet 2009; 374: 543-50. PubMed  
  110. Wu G, Liu J, Wang S, et al. N-terminal pro-brain natriuretic peptide and sudden cardiac death in hypertrophic cardiomyopathy. Heart 2021. pmid:33361398 PubMed  
  111. Jessup M, Brozena S. Heart failure. N Engl J Med 2003; 348: 2007-18. PubMed  
  112. Haldeman GA, Croft JB, Giles WH, Rashidee A. Hospitalization of patients with heart failure: National Hospital Discharge Survey, 1985 to 1995. Am Heart J 1999; 137: 352-60. PubMed  
  113. Schaufelberger M, Swedberg K, Koster M et al. Decreasing one-year mortality and hospitalization rates for heart failure in Sweden; data from the Swedish Hospital Discharge Registry 1988 to 2000. Eur Heart J 2004; 25: 300-7. PMID: 14984918. PubMed  
  114. Senni M, Redfield MM. Heart failure with preserved systolic function. A different natural history? J Am Coll Cardiol 2001; 38: 1277-82. PMID: 11691495 PubMed  
  115. 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  
  • Faris Al-Khalili, med dr och specialist i kardiologi, Hjärt-lung- och allergimottagningen, Sophiahemmets sjukhus