Cardiovascular Journal of Africa

iCARDIO Alliance Global Implementation Guidelines on Heart Failure 2025

Vijay Chopra* (India), Muhammad Shahzeb Khan (USA), Magdy Abdelhamid (Egypt), William T. Abraham (USA), Offer Amir (Israel), Stefan D. Anker (Germany), John J. Atherton (Australia), Fernando Bacal (Brazil), Ralph Stephan von Bardeleben (Germany), Dulce Brito (Portugal), Lucrecia Maria Burgos (Argentina), Javed Butler (USA), Maria Rosa Costanzo (USA), Albertino Damasceno (Mozambique), Justin A. Ezekowitz (Canada), Ishaque Hameed (USA), Sivadasanpillai Harikrishnan (India), Tiny Jaarsma (Sweden), Anuradha Lala (USA), Ileana L. Piña (USA), Clara Saldarriaga (Colombia), David Sim (Singapore), John R. Teerlink (USA), Nqoba Tsabedze (South Africa), Hiroyuki Tsutsui (Japan), Jing Yu (China), Yuhui Zhang (China), Mohammad Zubaid (Kuwait), Nikhil Balankhe (India), Juan Esteban Gomez­Mesa (Colombia), James L. Januzzi (USA), Marvin Konstam (USA), Rhonda Monroe (USA), Elijah Ogola (Kenya), Vinayagam Palaniappan (India), Mark C. Petrie (UK), Fausto J. Pinto (Portugal), Girish C. Rajadhyaksha (India), Amina Rakisheva (Kazakhstan), Carlos E. Ramos (Honduras), Victor Rossel (Chile), Naoki Sato (Japan), P. Christian Schulze (Germany), Andrew Sindone (Australia), Hadi N. Skouri (Lebanon; United Arab Emirates), Harriette G.C. Van Spall (Canada), Aistė Štaraitė (Lithuania), Lynne Warner Stevenson (USA), Kadhim Sulaiman (Oman), Tzung­Dau Wang (Taiwan), Michael Böhm# (Germany), Andrew J.S. Coats# (Australia), Shelley Zieroth*# (Canada)
Abstract
Inconsistencies in healthcare access, varying infrastructure, resource constraints and diverse local practices as well as practical and political issues restrict the global applicability of currently available guidelines. There is a need for universal recommen­dations that address the unique challenges faced by patients and healthcare providers worldwide. Our iCARDIO Alliance Global Implementation Guidelines emphasize the incorporation of novel therapies, while integrating standard of care with the most up-­to-­date evidence to enable clinicians to optimize patient care. This document is about heart failure (HF), including acute and chronic heart failure, heart failure with reduced ejection fraction and heart failure with preserved ejection fraction as well as cardiomyopathies. Context­ specific recommendations tailored to individual patient needs are highlighted providing a thorough evaluation of the risks, benefits, and overall value of each therapy, aiming to establish a standard of care that im­proves patient outcomes and reduces the burden of hospitalization in this susceptible population. These guidelines provide evidence ­based recommendations that represent a group consensus considering the many other published guidelines that have reviewed many of the issues discussed here, but they also make new recommendations where new evidence has recently emerged. Most importantly these guidelines also provide recommendations on a number of issues where resource limitations may put constraints on the care provided to HF patients. Such “economic adjustment” recommendations aim to provide guid­ance for situations when “Resources are somewhat limited” or when “Resources are severely limited”. Hence, this document presents not only a comprehensive but also concise update to HF management guidelines thereby aiming to provide a unified strategy for the pharmacological, non­pharmacological, invasive and interventional management of this significant global health challenge that is applicable to the needs of healthcare around the globe.
Keywords: heart failure; chronic heart failure; acute heart failure; therapy; guidelines; iCARDIO Alliance
Submitted: April 11, 2025; Accepted: April 16, 2025
Cardiovasc J Afr 2024; 36: 35-62
Volume 36, Issue 2
DOI Citation Reference: dx.doi.org/10.4081/cardio.2025.70
Heart Failure Programme and Research, Max Super Specialty Hospital, Press Enclave Road, Mandir Marg, Saket Institutional Area, Saket, New Delhi, 110017
Vijay Chopra, MD
Y3014409 Tache Avenue, Winnipeg, Manitoba, R2H2A6, Canada
Shelley Zieroth, MD

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