Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. 2 of Contents Overview 5 Who is it for? 5 1.1 Team working in the management of heart failure 6 1.2 Diagnosing heart failure 9 1.3 Giving information to people with heart failure 12 1.4 Treating heart failure with reduced ejection fraction 12 1.5 Treating heart failure with reduced ejection fraction in people with chronic kidney disease . 18 1.6 Managing all types of heart failure 18 1.7 Monitoring treatment for all types of heart failure 21 1.9 Cardiac rehabilitation 23 1.10 Palliative care 24 Terms used in this guideline 24 Putting this guideline into practice 26 Key facts and figures 28 Current practice 28 Recommendations for research 29 1 Diuretic therapy for managing fluid overload in people with advanced heart failure in the community 29 2 Cardiac MRI versus other imaging techniques for diagnosing heart failure 29 3 The impact of atrial fibrillation on the natriuretic peptide threshold for diagnosing heart 4 The impact of advanced kidney disease on the natriuretic peptide threshold for diagnosing heart failure 31 5 Risk tools for predicting non-sudden death in heart failure 31 Finding more information and committee details 32 3 of Update information 33 4 of This guideline replaces CG108. This guideline is the basis of QS167, QS9 and QS181. Overview This guideline covers diagnosing and managing chronic heart failure in people aged 18 and over. It aims to improve diagnosis and treatment to increase the length and quality of life for people with heart failure. NICE has also produced a guideline on acute heart failure. Who is it for? 