Congestive heart failure ACE inhibitors

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Editor(s)-In-Chief: James Chang, M.D., Cardiovascular Division Beth Israel Deaconess Medical Center, Boston MA, Harvard Medical School [1] and C. Michael Gibson, M.S., M.D. [2], Cardiovascular Division Beth Israel Deaconess Medical Center, Boston MA, Harvard Medical School; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [3];Seyedmahdi Pahlavani, M.D. [4] Edzel Lorraine Co, DMD, MD[5]

## Overview

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The Collaborative Group on ACE Inhibitor Trials demonstrated significant reduction in total mortality and hospitalization with the administration of ACEIs that was consistent among wide range of patients.[1]

## ACE Inhibitors

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### Indications for ACE Inhibitors Use

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1\. The left ventricular ejection fraction (LVEF) is ≤ 40%

2\. There is a prior history of myocardial infarction (MI)

### Background

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* ACE-I or ARB therapy is recommended for ANY patient with reduced left ventricular ejection fraction (≤ 40%) regardless of the etiology of left ventricular systolic dysfunction (ischemic or nonischemic) or presence/absence of symptoms. Patients with or without heart failure (in other words, even those with asymptomatic left ventricular systolic dysfunction) are included in this recommendation.
* In addition, ACE-I or ARB therapy is indicated for patients with history of myocardial infarction whether or not left ventricular systolic dysfunction or heart failure is present.
* ACE-I or ARB therapy is also recommended for patients who are at high risk for the development of heart failure due to the presence of coronary, cerebrovascular, or peripheral vascular disease.
* Treatment should not be deferred in patients with few or no symptoms because of the significant mortality benefit derived from ACEI therapy.

### Dosing

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* ACE-I or ARB therapy should be initiated at low dosage such as 12.5 mg tid of captopril, 2.5 mg bid of enalapril[2][3], or 2.5 mg daily lisinopril.
* Every 4 to 6 weeks the dose is gradually uptitrated, as tolerated, toward target dosages of 20-40 mg daily for lisinopril, 10-20 mg twice daily for enalapril maleate, and 50-100 mg three times a day for captopril, or to the maximum tolerated dosage.
* ACE inhibitors are rarely adequate for the treatment of congestion without the use of diuretics.

## Complications

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* 5-10 % patients cannot tolerate ACE inhibitors because of cough. Cough can be a sign of elevated left-sided filling pressures or a side effect of ACE inhibitors due to excess bradykinin.
* ARBs are reserved for patients who are intolerant of ACE-Is for reasons (such as persistent cough) OTHER than hyperkalemia, progression of chronic kidney disease/worsening azotemia, or hypotension caused by prior ACE-I therapy. If a patient experiences hyperkalemia, worsening azotemia, or hypotension as a result of ACE-I therapy, the same is likely to result from ARB therapy. In the CHARM study candesartan reduced both hospitalization and mortality.[4][5]
* Renal artery stenosis should be considered if there's a decline in renal function with the initiation of ACE inhibitors.

## 2022 AHA/ ACC/ HFSA Heart Failure Guideline/ 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America ((DO NOT EDIT) [6][7][8]

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#### Renin-Angiotensin System Inhibition With ACEi or ARB or ARNi

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Class I

"1. In patients with HFrEF and NYHA class II to III symptoms, the use of ARNi is recommended to reduce morbidity and mortality. [9][10][11][12][13](Level of Evidence: A) "
"2. In patients with previous or current symptoms of chronic HFrEF, the use of ACEi is beneficial to reduce morbidity and mortality when the use of ARNi is not feasible.[3][2][14][15][16][17][1][18] (Level of Evidence: A) "
"3. In patients with previous or current symptoms of chronic HFrEF who are intolerant to ACEi because of cough or angioedema and when the use of ARNi is not feasible, the use of ARB is recommended to reduce morbidity and mortality. [19][20][21][22][23] (Level of Evidence: A) "
"5. In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEi or ARB, replacement by an ARNi is recommended to further reduce morbidity and mortality. [9][10][11][12][13](Level of Evidence: B-R) "
Class Value Statement: High Value

"4. In patients with previous or current symptoms of chronic HFrEF, in whom ARNi is not feasible, treatment with an ACEi or ARB provides high economic value. [24][25][26][27][28][29][30](Level of Evidence: A) "
"6. In patients with chronic symptomatic HFrEF, treatment with an ARNi instead of an ACEi provides high economic value. [31][32][33][34] (Level of Evidence: A) "
Class III (Harm)

"7. ARNi should not be administered concomitantly with ACEi or within 36 hours of the last dose of an ACEi. [35][36] (Level of Evidence: B-R) "
"8. ARNi should not be administered to patients with any history of angioedema.[37][38][39][40] (Level of Evidence: C-LD) "
"9. ACEi should not be administered to patients with any history of angioedema. [41][42][43][44] (Level of Evidence: C-LD) "

## Vote on and Suggest Revisions to the Current Guidelines

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* The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines

## External Links

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* 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[45]

* The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult [46]

* 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation [8]

## References

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1. ↑ 1.0 1.1 Garg R, Yusuf S (1995). "Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials". JAMA : the Journal of the American Medical Association. 273 (18): 1450–6. PMID 7654275. Unknown parameter `|month=` ignored (help); `|access-date=` requires `|url=` (help)
2. ↑ 2.0 2.1 "Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators". The New England Journal of Medicine. 325 (5): 293–302. 1991. doi:10.1056/NEJM199108013250501. PMID 2057034. Retrieved 2012-04-03. Unknown parameter `|month=` ignored (help)
3. ↑ 3.0 3.1 "Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). The CONSENSUS Trial Study Group". The New England Journal of Medicine. 316 (23): 1429–35. 1987. doi:10.1056/NEJM198706043162301. PMID 2883575. Retrieved 2012-04-03. Unknown parameter `|month=` ignored (help)
4. ↑ Pfeffer MA, Swedberg K, Granger CB, Held P, McMurray JJ, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Pocock S (2003). "Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme". Lancet. 362 (9386): 759–66. PMID 13678868. Retrieved 2012-04-03. Unknown parameter `|month=` ignored (help)CS1 maint: Multiple names: authors list (link)
5. ↑ Young JB, Dunlap ME, Pfeffer MA, Probstfield JL, Cohen-Solal A, Dietz R, Granger CB, Hradec J, Kuch J, McKelvie RS, McMurray JJ, Michelson EL, Olofsson B, Ostergren J, Held P, Solomon SD, Yusuf S, Swedberg K (2004). "Mortality and morbidity reduction with Candesartan in patients with chronic heart failure and left ventricular systolic dysfunction: results of the CHARM low-left ventricular ejection fraction trials". Circulation. 110 (17): 2618–26. doi:10.1161/01.CIR.0000146819.43235.A9. PMID 15492298. Retrieved 2012-04-03. Unknown parameter `|month=` ignored (help)CS1 maint: Multiple names: authors list (link)
6. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
7. ↑ Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
8. ↑ 8.0 8.1 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016.DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967
9. ↑ 9.0 9.1 McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR; et al. (2014). "Angiotensin-neprilysin inhibition versus enalapril in heart failure". N Engl J Med. 371 (11): 993–1004. doi:10.1056/NEJMoa1409077. PMID 25176015.CS1 maint: Multiple names: authors list (link)  Review in: Evid Based Med. 2015 Apr;20(2):61 Review in: Ann Intern Med. 2015 Feb 17;162(4):JC2
10. ↑ 10.0 10.1 Wachter R, Senni M, Belohlavek J, Straburzynska-Migaj E, Witte KK, Kobalava Z; et al. (2019). "Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study". Eur J Heart Fail. 21 (8): 998–1007. doi:10.1002/ejhf.1498. PMID 31134724.CS1 maint: Multiple names: authors list (link)
11. ↑ 11.0 11.1 Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K; et al. (2019). "Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure". N Engl J Med. 380 (6): 539–548. doi:10.1056/NEJMoa1812851. PMID 30415601.CS1 maint: Multiple names: authors list (link)
12. ↑ 12.0 12.1 Desai AS, Solomon SD, Shah AM, Claggett BL, Fang JC, Izzo J; et al. (2019). "Effect of Sacubitril-Valsartan vs Enalapril on Aortic Stiffness in Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial". JAMA. 322 (11): 1077–1084. doi:10.1001/jama.2019.12843. PMC 6749534 Check `|pmc=` value (help). PMID 31475296.CS1 maint: Multiple names: authors list (link)
13. ↑ 13.0 13.1 Wang Y, Zhou R, Lu C, Chen Q, Xu T, Li D (2019). "Effects of the Angiotensin-Receptor Neprilysin Inhibitor on Cardiac Reverse Remodeling: Meta-Analysis". J Am Heart Assoc. 8 (13): e012272. doi:10.1161/JAHA.119.012272. PMC 6662364 Check `|pmc=` value (help). PMID 31240976.CS1 maint: Multiple names: authors list (link)
14. ↑ Packer M, Poole-Wilson PA, Armstrong PW, Cleland JG, Horowitz JD, Massie BM; et al. (1999). "Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group". Circulation. 100 (23): 2312–8. doi:10.1161/01.cir.100.23.2312. PMID 10587334.CS1 maint: Multiple names: authors list (link)
15. ↑ Pfeffer MA, Braunwald E, Moyé LA, Basta L, Brown EJ, Cuddy TE; et al. (1992). "Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators". N Engl J Med. 327 (10): 669–77. doi:10.1056/NEJM199209033271001. PMID 1386652.CS1 maint: Multiple names: authors list (link)
16. ↑ "Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators". Lancet. 342 (8875): 821–8. 1993. PMID 8104270.
17. ↑ Køber L, Torp-Pedersen C, Carlsen JE, Bagger H, Eliasen P, Lyngborg K; et al. (1995). "A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group". N Engl J Med. 333 (25): 1670–6. doi:10.1056/NEJM199512213332503. PMID 7477219.CS1 maint: Multiple names: authors list (link)
18. ↑ Woodard-Grice AV, Lucisano AC, Byrd JB, Stone ER, Simmons WH, Brown NJ (2010). "Sex-dependent and race-dependent association of XPNPEP2 C-2399A polymorphism with angiotensin-converting enzyme inhibitor-associated angioedema". Pharmacogenet Genomics. 20 (9): 532–6. doi:10.1097/FPC.0b013e32833d3acb. PMC 2945219. PMID 20625347.CS1 maint: Multiple names: authors list (link)
19. ↑ Cohn JN, Tognoni G, Valsartan Heart Failure Trial Investigators (2001). "A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure". N Engl J Med. 345 (23): 1667–75. doi:10.1056/NEJMoa010713. PMID 11759645.CS1 maint: Multiple names: authors list (link)
20. ↑ Pfeffer MA, McMurray JJ, Velazquez EJ, Rouleau JL, Køber L, Maggioni AP; et al. (2003). "Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both". N Engl J Med. 349 (20): 1893–906. doi:10.1056/NEJMoa032292. PMID 14610160.CS1 maint: Multiple names: authors list (link)  Review in: ACP J Club. 2004 Jul-Aug;141(1):3
21. ↑ Konstam MA, Neaton JD, Dickstein K, Drexler H, Komajda M, Martinez FA; et al. (2009). "Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure (HEAAL study): a randomised, double-blind trial". Lancet. 374 (9704): 1840–8. doi:10.1016/S0140-6736(09)61913-9. PMID 19922995.CS1 maint: Multiple names: authors list (link)  Review in: Evid Based Med. 2010 Apr;15(2):51-2
22. ↑ Dominiak M (2008). "[Commentary to the article: ONTARGET Investigators, Yusuf S, Teo KK, Pogue J et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 2008; 358: 1547-59]". Kardiol Pol. 66 (6): 705–6, discussion 707. PMID 18700309.
23. ↑ Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (TRANSCEND) Investigators. Yusuf S, Teo K, Anderson C, Pogue J, Dyal L; et al. (2008). "Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial". Lancet. 372 (9644): 1174–83. doi:10.1016/S0140-6736(08)61242-8. PMID 18757085.CS1 maint: Multiple names: authors list (link)  Review in: Ann Intern Med. 2009 Feb 17;150(4):JC2-6
24. ↑ Banka G, Heidenreich PA, Fonarow GC (2013). "Incremental cost-effectiveness of guideline-directed medical therapies for heart failure". J Am Coll Cardiol. 61 (13): 1440–6. doi:10.1016/j.jacc.2012.12.022. PMID 23433562.CS1 maint: Multiple names: authors list (link)
25. ↑ Dasbach EJ, Rich MW, Segal R, Gerth WC, Carides GW, Cook JR; et al. (1999). "The cost-effectiveness of losartan versus captopril in patients with symptomatic heart failure". Cardiology. 91 (3): 189–94. doi:10.1159/000006908. PMID 10516413.CS1 maint: Multiple names: authors list (link)
26. ↑ Glick H, Cook J, Kinosian B, Pitt B, Bourassa MG, Pouleur H; et al. (1995). "Costs and effects of enalapril therapy in patients with symptomatic heart failure: an economic analysis of the Studies of Left Ventricular Dysfunction (SOLVD) Treatment Trial". J Card Fail. 1 (5): 371–80. doi:10.1016/s1071-9164(05)80006-5. PMID 12836712.CS1 maint: Multiple names: authors list (link)
27. ↑ Paul SD, Kuntz KM, Eagle KA, Weinstein MC (1994). "Costs and effectiveness of angiotensin converting enzyme inhibition in patients with congestive heart failure". Arch Intern Med. 154 (10): 1143–9. PMID 8185426.CS1 maint: Multiple names: authors list (link)
28. ↑ Reed SD, Friedman JY, Velazquez EJ, Gnanasakthy A, Califf RM, Schulman KA (2004). "Multinational economic evaluation of valsartan in patients with chronic heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT)". Am Heart J. 148 (1): 122–8. doi:10.1016/j.ahj.2003.12.040. PMID 15215801.CS1 maint: Multiple names: authors list (link)
29. ↑ Shekelle P, Morton S, Atkinson S, Suttorp M, Tu W, Heidenreich P; et al. (2003). "Pharmacologic management of heart failure and left ventricular systolic dysfunction: effect in female, black, and diabetic patients, and cost-effectiveness". Evid Rep Technol Assess (Summ) (82): 1–6. PMC 4781559. PMID 14571595.CS1 maint: Multiple names: authors list (link)
30. ↑ Tsevat J, Duke D, Goldman L, Pfeffer MA, Lamas GA, Soukup JR; et al. (1995). "Cost-effectiveness of captopril therapy after myocardial infarction". J Am Coll Cardiol. 26 (4): 914–9. doi:10.1016/0735-1097(95)00284-1. PMID 7560617.CS1 maint: Multiple names: authors list (link)
31. ↑ Gaziano TA, Fonarow GC, Claggett B, Chan WW, Deschaseaux-Voinet C, Turner SJ; et al. (2016). "Cost-effectiveness Analysis of Sacubitril/Valsartan vs Enalapril in Patients With Heart Failure and Reduced Ejection Fraction". JAMA Cardiol. 1 (6): 666–72. doi:10.1001/jamacardio.2016.1747. PMID 27438344.CS1 maint: Multiple names: authors list (link)
32. ↑ Gaziano TA, Fonarow GC, Velazquez EJ, Morrow DA, Braunwald E, Solomon SD (2020). "Cost-effectiveness of Sacubitril-Valsartan in Hospitalized Patients Who Have Heart Failure With Reduced Ejection Fraction". JAMA Cardiol. 5 (11): 1236–1244. doi:10.1001/jamacardio.2020.2822. PMC 7675099 Check `|pmc=` value (help). PMID 32785628 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
33. ↑ King JB, Shah RU, Bress AP, Nelson RE, Bellows BK (2016). "Cost-Effectiveness of Sacubitril-Valsartan Combination Therapy Compared With Enalapril for the Treatment of Heart Failure With Reduced Ejection Fraction". JACC Heart Fail. 4 (5): 392–402. doi:10.1016/j.jchf.2016.02.007. PMID 27039128.CS1 maint: Multiple names: authors list (link)
34. ↑ Sandhu AT, Ollendorf DA, Chapman RH, Pearson SD, Heidenreich PA (2016). "Cost-Effectiveness of Sacubitril-Valsartan in Patients With Heart Failure With Reduced Ejection Fraction". Ann Intern Med. 165 (10): 681–689. doi:10.7326/M16-0057. PMID 27571284.CS1 maint: Multiple names: authors list (link)
35. ↑ Packer M, Califf RM, Konstam MA, Krum H, McMurray JJ, Rouleau JL; et al. (2002). "Comparison of omapatrilat and enalapril in patients with chronic heart failure: the Omapatrilat Versus Enalapril Randomized Trial of Utility in Reducing Events (OVERTURE)". Circulation. 106 (8): 920–6. doi:10.1161/01.cir.0000029801.86489.50. PMID 12186794.CS1 maint: Multiple names: authors list (link)
36. ↑ Kostis JB, Packer M, Black HR, Schmieder R, Henry D, Levy E (2004). "Omapatrilat and enalapril in patients with hypertension: the Omapatrilat Cardiovascular Treatment vs. Enalapril (OCTAVE) trial". Am J Hypertens. 17 (2): 103–11. doi:10.1016/j.amjhyper.2003.09.014. PMID 14751650.CS1 maint: Multiple names: authors list (link)
37. ↑ Vardeny O, Miller R, Solomon SD (2014). "Combined neprilysin and renin-angiotensin system inhibition for the treatment of heart failure". JACC Heart Fail. 2 (6): 663–70. doi:10.1016/j.jchf.2014.09.001. PMID 25306450.CS1 maint: Multiple names: authors list (link)
38. ↑ Messerli FH, Nussberger J (2000). "Vasopeptidase inhibition and angio-oedema". Lancet. 356 (9230): 608–9. doi:10.1016/S0140-6736(00)02596-4. PMID 10968427.
39. ↑ Braunwald E (2015). "The path to an angiotensin receptor antagonist-neprilysin inhibitor in the treatment of heart failure". J Am Coll Cardiol. 65 (10): 1029–41. doi:10.1016/j.jacc.2015.01.033. PMID 25766951.
40. ↑ Ruilope LM, Dukat A, Böhm M, Lacourcière Y, Gong J, Lefkowitz MP (2010). "Blood-pressure reduction with LCZ696, a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin: a randomised, double-blind, placebo-controlled, active comparator study". Lancet. 375 (9722): 1255–66. doi:10.1016/S0140-6736(09)61966-8. PMID 20236700.CS1 maint: Multiple names: authors list (link)
41. ↑ Byrd JB, Adam A, Brown NJ (2006). "Angiotensin-converting enzyme inhibitor-associated angioedema". Immunol Allergy Clin North Am. 26 (4): 725–37. doi:10.1016/j.iac.2006.08.001. PMID 17085287.CS1 maint: Multiple names: authors list (link)
42. ↑ Toh S, Reichman ME, Houstoun M, Ross Southworth M, Ding X, Hernandez AF; et al. (2012). "Comparative risk for angioedema associated with the use of drugs that target the renin-angiotensin-aldosterone system". Arch Intern Med. 172 (20): 1582–9. doi:10.1001/2013.jamainternmed.34. PMID 23147456.CS1 maint: Multiple names: authors list (link)  Review in: Evid Based Med. 2013 Dec;18(6):e52
43. ↑ Makani H, Messerli FH, Romero J, Wever-Pinzon O, Korniyenko A, Berrios RS; et al. (2012). "Meta-analysis of randomized trials of angioedema as an adverse event of renin-angiotensin system inhibitors". Am J Cardiol. 110 (3): 383–91. doi:10.1016/j.amjcard.2012.03.034. PMID 22521308.CS1 maint: Multiple names: authors list (link)
44. ↑ Rasmussen ER, Pottegård A, Bygum A, von Buchwald C, Homøe P, Hallas J (2019). "Angiotensin II receptor blockers are safe in patients with prior angioedema related to angiotensin-converting enzyme inhibitors - a nationwide registry-based cohort study". J Intern Med. 285 (5): 553–561. doi:10.1111/joim.12867. PMID 30618189.CS1 maint: Multiple names: authors list (link)
45. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (May 2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check `|pmid=` value (help).
46. ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202

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